Neglected tropical disease meets neglected community: Street children's susceptibility to scabies in Addis Ababa, Ethiopia

Scabies is a neglected tropical disease (NTD) with high prevalence rate in resource-limited settings. Though street children are susceptible because of lack of sanitation and contact with vectors, few attempts have been made to identify the lived experience of street children with scabies in the global south. This study explored perceived susceptibility to scabies and related lived experiences of street children in Addis Ababa. Using in-depth interviews, we collected qualitative data from selected children of the street to identify their understanding of the causes of scabies, their experiences of managing the condition, and their health-seeking behavior. Informants were recruited to include maximum variation in terms of age, sex, and experience of infestation. The study showed that scabies was common among street children and that the infestation has physical, psychological and social impacts. Study participants believed that scabies had its origin in their living conditions (including poor environmental sanitation and lack of personal hygiene), with lice playing a significant role as vectors of transmission. The informants reported visiting modern healthcare facilities, traditional healers and self-care in response to infestation. By uncovering the embodied experience of a stigmatized skin NTD in a neglected community in the global south, this study contributes to combating neglect and addressing health disparities. Having identified living conditions as the major factor contributing to susceptibility, efforts need to be exerted to change street children's living situations and other structural conditions through reunification with their families or other communities, reintegration and other exit strategies.