Integrated scabies surveillance during a lymphatic filariasis mass drug administration campaign in Futuna in 2025 — The Association Specialists
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Integrated scabies surveillance during a lymphatic filariasis mass drug administration campaign in Futuna in 2025 (24118)

Clément Couteaux 1 , Laure Masson 1 , Manuel Munoz 1 , Andrew Steer 2 , Yves-Marie Ducrot 3 , Yael Levy 4 , Emerenzia Maituku 1 , Sesilia Logote 1 , Heimoana Takasi 1 , Lucia Romani 5 , Antoine Bertolotti 6
  1. Agence de santé, Mata Utu, WALLIS AND FUTUNA, Wallis and Futuna
  2. Murdoch Children’s Research Institute, Melbourne, Australia
  3. Ouest Réunion Hospital, Saint Paul, Réunion, France
  4. Pediatric and Congenital Cardiac Intensive Care Unit, University Hospital of Réunion, Saint Denis, Réunion, France
  5. UNSW Sydney, Kirby Institute, Sydney, NSW, Australia
  6. Department of Infectious Diseases and Dermatology, University Hospital of Réunion, Saint Pierre, Réunion, France

Introduction
Scabies is a neglected tropical disease highly endemic in many Pacific Island settings. It is strongly associated with bacterial skin infections and acute rheumatic fever risk. Despite this burden, epidemiological data remain limited in several French Pacific territories. We aimed to estimate the prevalence of scabies and associated skin infections in Futuna, a remote Pacific island, through an integrated public health approach embedded within a lymphatic filariasis mass drug administration (MDA) campaign conducted in 2025.

Methods
A cross-sectional community-based survey was conducted in Futuna during a triple-drug lymphatic filariasis MDA campaign in March 2025. Participants aged >2 years were clinically assessed by trained nurses and physicians using simplified International Alliance for the Control of Scabies (IACS) criteria. Data on demographics, pruritus, scabies severity, and skin infections were collected. Mixed-effects logistic regression was used to assess the association between scabies and skin infections. Spatial heterogeneity was explored using Moran’s I and SaTScan cluster analyses.

Results
Among 1,699 participants (57% of the eligible population), scabies prevalence was 9.1% (95%CI: 7.8–10.6), while severe scabies accounted for 1.1% of cases. Secondary bacterial skin infections were observed in 32.3% of scabies cases. Individuals with scabies had markedly increased odds of skin infection (aOR = 27.9; 95%CI: 15.9–49.1). Nearly one quarter (22.7%) of scabies cases reported no pruritus. Major geographical disparities were observed, with prevalence ranging from 1.2% to 30.9% across villages. Spatial analyses identified a significant high-risk cluster in southwestern Futuna (RR = 3.0; p = 0.001).

Conclusion
Scabies represents a major public health concern in Futuna, with prevalence close to WHO thresholds for ivermectin-based MDA campaigns and substantial spatial heterogeneity. This study demonstrates the feasibility and added value of integrating neglected tropical disease surveillance into operational public health campaigns in resource-limited Pacific Island settings.