{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:54:13Z","timestamp":1782489253105,"version":"3.54.5"},"reference-count":31,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"unspecified","delay-in-days":10,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,4,24]]},"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Scabies is a common skin condition and poses a substantial disease burden in resource-poor tropical settings. The Rohingya refugee camps in Cox\u2019s Bazar, Bangladesh represent one of the world\u2019s largest and most protracted humanitarian crises. Using 3 years of data from 2021 to 2023, this study analysed the seasonality of scabies and examined its association with climatic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a retrospective observational study conducted in the Rohingya refugee camps and adjacent host communities in Ukhiya and Teknaf, Cox\u2019s Bazar. All patients clinically diagnosed with scabies and who received treatment at 35 International Organization for Migration (IOM)-supported health facilities between 1 January 2021 and 31 December 2023 were included. Climate data, including daily mean, minimum and maximum temperature and total and maximum rainfall, were obtained from the Bangladesh Meteorological Department. Seasonal\u2013Trend decomposition using LOESS (locally estimated scatterplot smoothing) (STL) was applied. Associations between climatic variables and the decomposed seasonal component of scabies cases and corresponding attack rate, as well as overall scabies case counts and overall attack rate, were assessed using Pearson\u2019s correlation tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 323\u2009106 new scabies cases were reported from IOM-supported health facilities between January 2021 and December 2023. Children aged under 5 years and 6\u201318 years accounted for the highest proportion of cases (32.08% and 38.95%, respectively). The average monthly number of scabies cases was highest in November (12 625) and lowest in May (5862). Case numbers increased from November to February (high season), with a peak between October and November, and declined between April and June (low season). An inverse relationship was observed between temperature and scabies incidence, with higher case numbers during cooler months and lower numbers during warmer months. Pearson\u2019s correlation analysis demonstrated a strong and significant negative correlation between the seasonal components of both scabies cases and attack rate and temperature variables, including maximum (cases: r=\u22120.492, p=0.002; attack rate: r=\u22120.484, p=0.003), minimum (cases: r=\u22120.506, p=0.002; attack rate: r=\u22120.489, p=0.002) and mean temperature (cases: r=\u22120.525, p=0.001; attack rate: r=\u22120.511, p=0.001). No significant association was observed between the seasonal component of scabies cases or attack rate and humidity or rainfall.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study identified a distinct seasonal pattern of scabies, with higher caseloads and attack rate during late autumn and winter (October to February) and lower caseloads and attack rate during summer months (April to June). Temperature showed a strong negative association with the seasonal component of scabies burden. These findings may inform the timing of public health strategies, including mass drug administration, intensified case management and social and behavioural change communication, in humanitarian settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-117016","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T12:35:46Z","timestamp":1778502946000},"page":"e117016","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Seasonality of scabies and its association with climatic factors in Rohingya refugee camps, Cox\u2019s Bazar: a retrospective observational study, 2021\u20132023"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4862-7745","authenticated-orcid":false,"given":"Charls Erik","family":"Halder","sequence":"first","affiliation":[{"name":"Migration Health Division (MHD), International Organization for Migration, Cox\u2019s Bazar, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9205-7810","authenticated-orcid":false,"given":"Md Abeed","family":"Hasan","sequence":"additional","affiliation":[{"name":"Migration Health Division (MHD), International Organization for Migration, Cox\u2019s Bazar, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James Charles","family":"Okello","sequence":"additional","affiliation":[{"name":"Migration Health Division (MHD), International Organization for Migration, Cox\u2019s Bazar, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Feroz","family":"Khan","sequence":"additional","affiliation":[{"name":"Epidemiology Team, World Health Organization, Cox\u2019s Bazar, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel Roba","family":"Soma","sequence":"additional","affiliation":[{"name":"Migration Health Division (MHD), International Organization for Migration, Cox\u2019s Bazar, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julekha Tabassum","family":"Poly","sequence":"additional","affiliation":[{"name":"Migration Health Division (MHD), International Organization for Migration, Cox\u2019s Bazar, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamim","family":"Tassdik","sequence":"additional","affiliation":[{"name":"Migration Health Division (MHD), International Organization for Migration, Cox\u2019s Bazar, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md Sobuz","family":"Hosen","sequence":"additional","affiliation":[{"name":"Migration Health Division (MHD), International Organization for Migration, Cox\u2019s Bazar, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U Maung","family":"Prue","sequence":"additional","affiliation":[{"name":"Migration Health Division (MHD), International Organization for Migration, Cox\u2019s Bazar, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul","family":"Hannan","sequence":"additional","affiliation":[{"name":"Meterology, Bangladesh Meteorological Department, Cox\u2019s Bazar, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"key":"2026062608321926000_16.5.e117016.1","unstructured":"Scabies . 2025. 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MASSIVE scabies outbreak in rohingya refugee camps, cox\u2019S bazar: epidemiology and impact of a mass drug administration (mda) campaign \u2013 a retrospective study. Epidemiology [Preprint] 2025. doi:10.64898\/2025.12.05.25341689","DOI":"10.64898\/2025.12.05.25341689"},{"key":"2026062608321926000_16.5.e117016.18","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1500987"},{"key":"2026062608321926000_16.5.e117016.19","doi-asserted-by":"crossref","DOI":"10.1051\/parasite\/2016065","article-title":"The effects of climate factors on scabies. A 14-year population-based study in Taiwan","volume":"23","author":"Liu","year":"2016","journal-title":"Parasite"},{"key":"2026062608321926000_16.5.e117016.20","doi-asserted-by":"publisher","DOI":"10.3347\/KJP.2019.57.4.399"},{"key":"2026062608321926000_16.5.e117016.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2008.11.005"},{"key":"2026062608321926000_16.5.e117016.22","doi-asserted-by":"crossref","first-page":"374","DOI":"10.26444\/aaem\/109319","article-title":"Epidemiology of scabies in relation to socio-economic and selected climatic factors in north-east Poland","volume":"27","author":"Korycinska","year":"2020","journal-title":"Ann Agric Environ Med"},{"key":"2026062608321926000_16.5.e117016.23","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0005772","article-title":"Economic impact of a large-scale scabies upsurge on healthcare facilities in Rohingya refugee camps: a retrospective costing study","volume":"6","author":"Halder","year":"2026","journal-title":"PLOS Glob Public Health"},{"key":"2026062608321926000_16.5.e117016.24","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268899002277"},{"key":"2026062608321926000_16.5.e117016.25","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1046\/j.1365-2133.2003.05329.x","article-title":"Seasonality trends of scabies in a young adult population: a 20-year follow-up","volume":"149","author":"Mimouni","year":"2003","journal-title":"Br J Dermatol"},{"key":"2026062608321926000_16.5.e117016.26","doi-asserted-by":"publisher","DOI":"10.1186\/s13071-017-2234-1"},{"key":"2026062608321926000_16.5.e117016.27","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2023-075103","article-title":"Scabies outbreak management in refugee\/migrant camps in Europe 2014-2017: a retrospective qualitative interview study of healthcare staff experiences and perspectives","volume":"13","author":"Richardson","year":"2023","journal-title":"BMJ Open"},{"key":"2026062608321926000_16.5.e117016.28","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0003981","article-title":"High caseload of Scabies amongst Rohingya refugees in Cox\u2019s Bazar, Bangladesh: a retrospective analysis of the epidemiological and clinical characteristics of cases, July 2022 to November 2023","volume":"5","author":"Alhaffar","year":"2022","journal-title":"PLOS Glob Public Health"},{"key":"2026062608321926000_16.5.e117016.29","doi-asserted-by":"crossref","first-page":"100220","DOI":"10.1016\/j.jmh.2024.100220","article-title":"Prevalence of scabies and its associated environmental risk factors among the Forcibly Displaced Myanmar Nationals living in the Cox\u2019s Bazar district of Bangladesh","volume":"9","author":"Rahman","year":"2024","journal-title":"J Migr Health"},{"key":"2026062608321926000_16.5.e117016.30","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.2166\/wh.2023.045","article-title":"Water, sanitation and hygiene challenges of forcibly displaced Myanmar nationals in Rohingya camps in Bangladesh","volume":"21","author":"Shapna","year":"2023","journal-title":"J Water Health"},{"key":"2026062608321926000_16.5.e117016.31","unstructured":"Halder CE , Hasan MA , Okello JC , et al . Rise of hepatitis-a in Rohingya refugee camps. 2025. 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