Scabies is endemic in Fiji and is a significant cause of morbidity. Little is known about the sociocultural beliefs and practices that affect the occurrence of
scabies and
impetigo, or community attitudes towards the strategy of
mass drug administration that is emerging as a public health option for
scabies and
impetigo control in Fiji and other countries. Data were collected during semi-structured interviews with 33 community members in four locations in Fiji's Northern Division. Thematic analysis examined participants' lived experiences of
scabies and
impetigo; community knowledge and perceptions about
scabies and
impetigo aetiology and transmission; community-based treatment and prevention measures; and attitudes towards
mass drug administration. Many indigenous Fijian (iTaukei) participants noted extensive and ongoing experience of
scabies and
impetigo among children in their families and communities, but only one participant of Indian descent (Indo-Fijian) identified personal childhood experience of
scabies.
Scabies and
impetigo were perceived as diseases affecting children, impacting on school attendance and families' quality of sleep. Awareness of
scabies and
impetigo was considerable, but there were major misconceptions around disease causation and transmission. Traditional remedies were preferred for
scabies treatment, followed by biomedicines provided by local health centres and hospitals. Treatment of close household contacts was not prioritised. Attitudes towards
mass drug administration to control
scabies were mostly positive, although some concerns were noted about adverse effects and hesitation to participate in the planned
scabies elimination programme. Findings from this first study to document perspectives and experiences related to
scabies and
impetigo and their management in the Asia Pacific region illustrate that a community-centred approach to
scabies and
impetigo is needed for the success of control efforts in Fiji, and most likely in other affected countries. This includes community-based health promotion messaging on the social dynamics of
scabies transmission, and a campaign of education and community engagement prior to
mass drug administration.