{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T18:12:08Z","timestamp":1791223928314,"version":"4.1.0"},"reference-count":91,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2021,10,6]],"date-time":"2021-10-06T00:00:00Z","timestamp":1633478400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"norwegian programme for capacity development in higher education and research for development\/ south ethiopia network of universities in public health","award":["ETH-13\/0025"],"award-info":[{"award-number":["ETH-13\/0025"]}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Skin problems cause significant sickness in communities with poor living conditions, but they have received less attention in national or global health studies because of their low mortality rates. In many developing regions, the prevalence of parasitic skin diseases among schoolchildren is not reported. Previous studies thus have attempted to identify risk factors for these conditions using the frequentist approach. This study aimed to assess the occurrence and risk factors of skin infections among rural schoolchildren in southern Ethiopia by combining a frequentist and a Bayesian approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methodology\/Principal findings<\/jats:title>\n                    <jats:p>Using three-stage random sampling, we assessed 864 schoolchildren aged 7\u201314 years from the Wonago district in southern Ethiopia. We detected potential risk factors for scabies, tungiasis, and tinea infections and recorded their hygienic practices and socio-demographic information. The frequentist model revealed a clustering effect of 8.8% at the classroom level and an insignificant effect at the school level. The Bayesian model revealed a clustering effect of 16% at the classroom level and 5.3% at the school level. Almost three-fourths of the sample had at least one type of skin problem, and boys were at higher overall risk than girls (adjusted odds ratio [aOR] 1.55 [95% Bayesian credible interval [BCI] 1.01, 2.28). Risk factors included unclean fingernails (aOR 1.85 [95% BCI 1.08, 2.97]); not washing the body (aOR 1.90 [95% BCI 1.21, 2.85]) and hair (aOR 3.07 [95% BCI 1.98, 4.57]) with soap every week; sharing a bed (aOR 1.97 [95% BCI 1.27, 2.89]), clothes (aOR 5.65 [95% BCI 3.31, 9.21]), or combs (aOR 3.65 [95% BCI 2.28, 5.53]); and living in a poor household (aOR 1.76 [95% BCI 1.03, 2.83]). Washing legs and feet with soap daily was identified as a protective factor for each of the three skin diseases (aOR 0.23 [95% BCI 0.15, 0.33]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusions\/Significance<\/jats:title>\n                    <jats:p>We observed high variation in skin problems at the classroom level, indicating the presence of shared risk factors in these locations. The findings suggest the need to improve children\u2019s personal hygiene via health education by schoolteachers and health workers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0009816","type":"journal-article","created":{"date-parts":[[2021,10,6]],"date-time":"2021-10-06T14:49:36Z","timestamp":1633531776000},"page":"e0009816","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":28,"title":["Risk factors for scabies, tungiasis, and tinea infections among schoolchildren in southern Ethiopia: A cross-sectional Bayesian multilevel model"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9116-274X","authenticated-orcid":true,"given":"Hiwot Hailu","family":"Amare","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernt","family":"Lindtjorn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,10,6]]},"reference":[{"issue":"5","key":"pntd.0009816.ref001","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1001\/jamadermatol.2016.5538","article-title":"Global skin disease morbidity and mortality: An update from the global burden of disease study 2013","volume":"153","author":"C Karimkhani","year":"2017","journal-title":"JAMA Dermatol"},{"issue":"10","key":"pntd.0009816.ref002","doi-asserted-by":"crossref","first-page":"3635","DOI":"10.1007\/s00436-013-3551-8","article-title":"Tungiasis: A neglected epidermal parasitic skin disease of marginalized populations-a call for global science and policy","volume":"112","author":"K Karunamoorthi","year":"2013","journal-title":"Parasitol Res"},{"issue":"6","key":"pntd.0009816.ref003","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1038\/jid.2013.446","article-title":"The global burden of skin disease in 2010: An analysis of the prevalence and impact of skin conditions","volume":"134","author":"RJ Hay","year":"2014","journal-title":"J Invest Dermatol"},{"issue":"9524","key":"pntd.0009816.ref004","doi-asserted-by":"crossref","first-page":"1767","DOI":"10.1016\/S0140-6736(06)68772-2","article-title":"Scabies.","volume":"367","author":"J Heukelbach","year":"2006","journal-title":"The Lancet"},{"issue":"5","key":"pntd.0009816.ref005","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1007\/s11908-005-0012-2","article-title":"Ectoparasitic infestations.","volume":"7","author":"J Heukelbach","year":"2005","journal-title":"Curr Infect Dis Rep"},{"issue":"6","key":"pntd.0009816.ref006","doi-asserted-by":"crossref","first-page":"1647","DOI":"10.4269\/ajtmh.17-0242","article-title":"Ignoring the \"Itch\": The global health problem of scabies.","volume":"97","author":"LV Stamm","year":"2017","journal-title":"Am J Trop Med Hyg"},{"issue":"4","key":"pntd.0009816.ref007","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1111\/j.1365-3156.2006.01809.x","article-title":"Clinical features and associated morbidity of scabies in a rural community in Alagoas, Brazil.","volume":"12","author":"A Jackson","year":"2007","journal-title":"Trop Med Int Health"},{"issue":"945","key":"pntd.0009816.ref008","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1136\/pgmj.2003.014563","article-title":"Scabies: More than just an irritation.","volume":"80","author":"JS McCarthy","year":"2004","journal-title":"Postgrad Med J."},{"issue":"7517","key":"pntd.0009816.ref009","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1136\/bmj.331.7517.619","article-title":"Scabies: diagnosis and treatment","volume":"331","author":"G Johnston","year":"2005","journal-title":"BMJ"},{"key":"pntd.0009816.ref010","unstructured":"World Health Organization. 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