The Psychological Burden of Scabies in Rohingya Refugee Camp

Abstract

Introduction: Scabies, a contagious skin disease caused by the mite Sarcoptes scabiei, is a pressing public health issue, particularly in overcrowded and unsanitary environments like the Rohingya refugee camps in Cox’s Bazar, Bangladesh. The dense living conditions, limited access to clean water, and inadequate healthcare infrastructure foster the rapid transmission of scabies, resulting in severe itching, rashes, and secondary infections. Beyond its physical symptoms, scabies imposes significant psychological burdens, including anxiety, depression, sleep disturbances, social stigma, and isolation. These challenges are further intensified by the trauma of displacement, loss, and uncertainty faced by the Rohingya community. Despite its prevalence, the psychological dimensions of scabies remain underexplored. This study addresses this gap by employing a mixed-methods approach to quantify the prevalence of anxiety, depression, and sleep disturbances among individuals with scabies and to understand their lived experiences and coping strategies. The findings aim to highlight the necessity for integrated healthcare strategies that combine dermatological treatment with mental health support, aligning with WHO’s call for comprehensive care models in resource-constrained, high risk settings.

Method: Interview and questionnaires are used to collect structured data from a large sample using pre-designed, standardized questions. This ensures consistency and reliability of responses across participants. These tools are particularly effective for gathering data on attitudes, behaviors, and experiences, enabling numerical analysis to identify patterns, trends, or relationships. Examples include collecting demographic details, assessing the frequency of symptoms, or evaluating mental health indicators.

Results: The study population had a mean age of 21.8 years, ranging from 5 to 70 years, with 54.8% females and 45.3% males, and an average household size of 8.31 members. Psychological impacts were severe, with 87.8% experiencing anxiety (mean score: 1.12, SD: 0.328), 91% suffering from depression (mean score: 1.09, SD: 0.287), and 53.3% frequently feeling hopeless (mean score: 1.53, SD: 0.500). Embarrassment was reported by 33.3% (mean score: 4.00, SD: 0.818), while all participants reported stress (mean level: 7.96/10, SD: 1.44) and restricted psychological well-being due to physical health. Daily activities were disrupted for 94%, with no access to mental health support and 73.4% experiencing moderate-to-severe social isolation. Sleep disturbances were universal, with all 400 participants (100%) reporting impaired sleep quality: 37% had poor sleep, 29.3% very poor, and 33.8% extremely poor. Adolescents, particularly females aged 10–18, faced the greatest burden, experiencing heightened stigma, isolation, and mental health challenges, further exacerbating the profound impact of scabies on overall quality of life.

Conclusion: Scabies imposes a significant psychological, social, and functional burden, disproportionately affecting females and younger individuals. Among the Rohingya refugee population, the condition exacerbates anxiety, depression, sleep disturbances, and stigma, particularly for adolescent females. These findings highlight the urgent need for holistic interventions that address both physical symptoms and mental health, including stigma reduction and targeted support for vulnerable groups. The study advocates for integrated healthcare approaches in refugee settings, prioritizing mental health services alongside physical treatment to improve overall well being.

Keywords: Scabies; Communicable Diseases; Poor Sanitation; Infectious Diseases; Psychological Burden

Citation

Islam N, Islam S. The Psychological Burden of Scabies in Rohingya Refugee Camp. WebLog J Public Health Epidemiol. wjphe.2025.j0901. https://doi.org/10.5281/zenodo.17373628