The authors reply: In response to Mahé: the aspect of our results that was unexpected was not the substantial decline in scabies prevalence after mass drug administration, but the further decline (in all three trial groups) between the 3-month and 12-month observation points. To explain this finding, we speculated that the 3-month observation may have been an overestimate of prevalence owing to the persistence of scabetic nodules after successful treatment. We wholeheartedly agree with O’Donnell and colleagues about the importance of improving environmental and living conditions in scabies control, regardless of whether mass drug administration is being considered.