[Control of scabies in the district of Ytre Nordhordland. An experiment within community medicine in the 1860's].

19th century Norway may be likened to the developing countries of today. Scabies was very prevalent, and traditional approaches to treatment were in vain. The poor peasant population would not spend money on such. Thomas Collett (1835-98), the local doctor in a rural district of western Norway, initiated a programme for community control of scabies. The local Board of Health agreed to purchase a large amount of sulphur ointment. 1/8 of a barrel of ointment was placed at the disposal of local teachers. The teachers were instructed to initiate treatment of school-children who were found to be infected with scabies. The household to which the child belonged was also to be treated, as well as the other children at the school. Gradually, the prevalence of scabies declined. Self-care increased, and eventually, the peasants ended up making their own sulphur ointment. Experiences and recommendations from developing countries of today agree with the strategy adopted by Collett. Individual medical treatment of cases and their contacts is too costly, and fails to reduce the total prevalence of scabies.