absorption of permethrin. Communities Scabies is endemic in many developing countries, where it tends to be particularly problematic in rural and remote areas. In such settings, community-wide control strategies are required to reduce the rate of disease, as treatment of only individuals is ineffective due to the high rate of reinfection. Large-scale mass drug administration strategies may be required where coordinated interventions aim to treat whole communities in one concerted effort. Although such strategies have shown to be able to reduce the burden of scabies in these kinds of communities, debate remains about the best strategy to adopt, including the choice of drug. The resources required to implement such large-scale interventions in a cost-effective and sustainable way are significant. Furthermore, since endemic scabies is largely restricted to poor and remote areas, it is a public health issue that has not attracted much attention from policy makers and international donors. Epidemiology Scabies is one of the three most common skin disorders in children, along with tinea and pyoderma. As of 2010, it affects about 100 million people (1.5% of the population) and its frequency is not related to gender. The mites are distributed around the world and equally infect all ages, races, and socioeconomic classes in different climates. Scabies is more often seen in crowded areas with unhygienic living conditions. Globally as of 2009, an estimated 300 million cases of scabies occur each year, although various parties claim the figure is either over- or underestimated. About 1–10% of the global population is estimated to be infected with scabies, but in certain populations, the infection rate may be as high as 50–80%. History Scabies has been observed in humans since ancient times. Archeological evidence from Egypt and the Middle East suggests scabies was present as early as 494 BC. In the fourth century BC, Aristotle reported on "lice" that "escape from little pimples if they are pricked" – a description consistent with scabies. Arab physician Ibn Zuhr is believed to have been the first to provide a clinical description of the scabies mites. Roman encyclopedist and medical writer Aulus Cornelius Celsus (circa 25 BC – 50 AD) is credited with naming the disease "scabies" and describing its characteristic features. The parasitic etiology of scabies was documented by Italian physician Giovanni Cosimo Bonomo (1663–1696) in his 1687 letter, "Observations concerning the fleshworms of the human body". Bonomo's description established scabies as one of