Modeling the Future Burden: Projections of Scabies Prevalence in Af-ghanistan, Iran, and Pakistan until 2040

Abstract

Background: Scabies, a neglected tropical disease (NTD), imposes a significant global burden, particularly in resource-limited and conflict-affected regions. Detailed, long-term projections are essential for informed public health planning. We aimed to model the future burden of scabies in Afghanistan, Iran, and Pakistan up to the year 2040.

Methods: The sex-disaggregated, age-standardized epidemiological data for scabies incidence, prevalence, and mortality were extracted from the Global Burden of Disease (GBD) Study 2023. Using an illness-death model (IDM) calibrated with this historical data, we projected sex-specific age-standardized prevalence rates (ASPR) for each country through 2040.

Results: In 2023, Pakistan exhibited an ASPR of 1717.83 per 100,000, approximately five times higher than Afghanistan (312.49) and Iran (332.06). Projections to 2040 indicate stagnant trends for Afghanistan (-0.11%) and Iran (-0.67%), whereas Pakistan shows a modest decline of 1.02%. The prevalence was consistently slightly higher among females across all nations, with this disparity persisting in projections.

Conclusion: Our analysis reveals a landscape of profound and persistent disparity, with Pakistan carrying an exceptionally high and slowly declining burden. The stable trends in Afghanistan and Iran suggest a state of epidemiological stagnation rather than effective control. These findings underscore an urgent need for targeted, country-specific public health interventions, including mass drug administration in Pakistan and strengthened surveillance and integrated case management in all three countries, to align with the WHO NTD roadmap goals.