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In recent years, the increase of head louse infestation in Iran (7.4%) and especially in West-Azerbaijan Province (248%) has raised the hypothesis of insecticide resistance development. There are different mechanisms of resistance to various groups of insecticides, and knockdown resistance (kdr) is a prominent mechanism of resistance to pyrethroids, an insecticide group which is used conventionally for pediculosis control. For detection of kdr-type well-known amino acid substitutions (M815I-T917I-L920F) and additional sodium channel mutations potentially associated with kdr resistance in head and body lice, louse populations were collected from West-Azerbaijan and Zanjan Provinces of Iran. Six novel mutations were found to be located in the IIS1-2 extracellular loop (H813P) and IIS5 (I927F, L928A, R929V, L930M, and L932M) of the α-subunit. Genotyping results showed that all specimens (100%) have at least one of these or the well-known mutations. Therefore, the presence of kdr-related and novel mutations in the sodium channel is likely to be the reason for the frequent use of pyrethroid insecticides due to treatment failure against lice. Further studies are now required to evaluate the prevalence of the kdr-like mutant allele for monitoring of insecticide resistance and the management of head and body lice in other provinces of the country.

Background Head lice infestation is a serious health issue among adolescents in Iran. The primary purpose of the study was to determine the association of head lice infestation with cognitive-behavioral factors in female adolescents. Methods The study was cross-sectional, took place between September and October of 2017 in Sarab, East Azerbaijan province, Iran. Using a multi-stage sampling to recruit the study's 226 female adolescents, five of the Sarab's 13 schools were selected through simple random sampling. In the second step, the students were randomly selected using the systematic random sampling method. A survey questionnaire was used to collect the data. Findings The prevalence rate of head lice was calculated 20.4%, and the subjects with head lice infestation had lower levels of severity, benefits, self-efficacy, and preventive behaviors. Those without head lice infestation reported adhering to preventive behaviors. The perceived severity and self-efficacy were the statistically significant predictors of head lice infestation and use of preventive behaviors. Conclusion Public health authorities, with feedback from the community, must design and implement prevention programs, focusing on mothers and their school-aged children, school principals, and managers of public places as potential change agents. In addition to, perceived severity and self-efficacy should be considered as the key categories when developing these prevention programs., Social sciences; Health sciences; Head lice; Health Belief Model (HBM); Adolescents.

Background Head lice infestation (Pediculosis) is one of the most important health challenges particularly in primary school-aged children. It is often present among 6–11-year-old students in various tropical and temperate regions of the world. The aim of this study was to examine epidemiologic indices and comparative analysis of two pyrethroid-based and one non-chemical pediculicide products on head lice treatment of primary school girls in a rural setting of Fars province, south Iran, as part of a randomized controlled assessor blind trial. Methods Before treatment, infested students were screened using plastic detection combs to find live head lice. Three independent parallel groups, each with about 25 participants (#77) were eventually twice with a week apart treated with either 1% permethrin, 0.2% parasidose (d-phenothrin) or 4% dimeticone lotion preparations. In each case, a questionnaire form was completed on epidemiologic factors. Data were registered after a fortnight from primary scalp treatment and re-inspection on days 2, 6, 9 and 14. Data analyses were performed using Chi-square test with a P-value Results From 3728 inspected students, 87 (2.33%) girls were infested with head lice, Pediculus humanus capitis De Geer, 1778. Ten students dropped out pertaining to exclusion criteria. No significant correlation was found between head lice infestation level and hair length, hair style, itching, nationality, age, settlement site and baths; but there was a significant relationship between age and hair style (P = 0.027). The efficacy values on each of the above re-inspection days from each of the three treatments were 81, 74, 70 and 63% for permethrin; 83, 92, 100 and 100% for dimeticone; and 96, 88, 96 and 92% for d-phenothrin; respectively. A quartile difference in efficacy of permethrin relative to dimeticone on day 14 represented the scale of head lice resistance to permethrin treatment. There were significant statistical differences in case re-inspection days 9 (P = 0.008) and 14 (P = 0.003) post treatment. Only two dropout cases, one non-compliant and the other lost before the second-week treatment, from permethrin trial were observed following two applications a week apart. Conclusions Dimeticone lotion had the fullest efficacy (100%) among all treatments. This high cure rate was attributed to the low level of infestation and the extent of patients’ involvement. Parasidose swiftly ameliorated the infested cases by the second day since initial treatment. Female third grade students were the most infested cohort. Trial registration Current Controlled Trials- IRCT2016041627408N1, Dated: 21-08-2017.

Background and Aim: Pediculus humanus capitis has been prevalent throughout the world, especially in developing countries among elementary students and societies with a weak socio-economic status. This study aimed to forecast head lice (Pediculidae: P. capitis) infestation incidence hotspots based on spatial correlation analysis in Ardabil Province, Northwest Iran. Materials and Methods: In this retrospective analytical study, all cases of head lice infestations who were confirmed by Centers for Disease Control office have been studied from 2016 to 2018. Head lice infestation incidence hotspots in the province should be detected based on general G statistics in ArcMap GIS10.4.1. Furthermore, MaxEnt.3.3.3 model was used for modeling the high-risk areas. Results: The prevalence rate of pediculosis was 14.90/100,000 populations. The general G statistics revealed that the head lice infestation in this study area has a high cluster pattern. The analysis showed that the Parsabad and Germi counties were identified as a head lice infestation incidence hotspots. Statistical and spatial analyses of head lice infestation incidence showed a significant positive correlation with head lice infestation incidence hotspots and the altitudes (15-500 m), annual temperature range (14-16.5°C), and slope and average diurnal temperature (12-18°C). Conclusion: The results of this study showed that the most ecologically suitable areas of head lice occurrence were identified in two hotspots (Parsabad and Germi) in the Northern areas of Ardabil Province (Parsabad and Germi counties); in the borderline of Iran and the Republic of Azerbaijan.

Head-lice infestation, pediculosis capitis, remains a public-health burden in many countries. The widely used first-line pediculicides and alternative treatments are often too costly for use in poor socio-economic settings. Ivermectin has been considered an alternate treatment for field practice. This study was composed of 2 parts, a cross-sectional survey and an intervention study. The main objectives were to determine the prevalence and potential factors associated with head-lice infestation, and to evaluate the effectiveness and safety of oral ivermectin administration. A community-based cross-sectional survey was conducted among 890 villagers in rural areas along Thai-Myanmar border. Females with infestations were eligible for the intervention study, and 181 participated in the intervention study. A post-treatment survey was conducted to assess acceptance of ivermectin as a treatment choice. Data analysis used descriptive statistics and a generalized-estimation-equation model adjusted for cluster effect. The study revealed the prevalence of head-lice infestation was 50% among females and only 3% among males. Age stratification showed a high prevalence among females aged

Background Topical occlusive agents, such as petroleum jelly and silicone oils, kill head lice by coating and blocking its excretory system and are unlikely to induce treatment resistance. Although a popular alternative to neurotoxic pediculicides, their efficacy and safety remain unclear. Methods We searched CENTRAL, MEDLINE, HERDIN (from inception to October 31, 2017), and other relevant sources for randomized controlled trials that compared topical occlusive agents with neurotoxic pediculicides to treat patients with head lice infestation. Using Cochrane collaboration methods, we selected studies, assessed risk of bias, and pooled similar studies. We assessed certainty of evidence using GRADEPro. Results Seventeen trials (N = 2005) testing occlusive agents met inclusion criteria. Risk of bias was moderate across trials, mainly from lack of blinding of participants and personnel. As a class, occlusive agents may be more pediculicidal than neurotoxic agents (final cure rate, RR 1.20, 95% CI 1.02, 1.41; 16 RCTs, N = 1779; I2 = 88%; low certainty of evidence). Post hoc subgroup analysis suggests that this benefit may be limited to synthetic combination occlusive products. Adverse effects, such as skin and eye irritation, are similar between groups (RR 0.65, 95% CI 0.36, 1.17; 15 RCTs, N = 1790; I2 = 28%; low certainty of evidence). Conclusions In treating head louse infestation, evidence suggests occlusive agents may be superior to or equally efficacious as neurotoxic pediculicides. Adverse effects are few and minor. Future trials should use appropriate comparators and consider effects of confounders such as neurotoxin resistance. Additionally, optimal occlusive formulation and dosing regimen need to be determined.

To report the clinical features and outcomes of toxic keratitis after application of powdered custard apple seeds for hair washing for head lice infestation.Retrospective review of all patients with toxic keratitis after application of powdered custard apple seed for head lice infestation during the time period from January 2015 to December 2017. Demographic details, clinical features, and visual outcomes were documented.Thirty-one eyes of 19 patients with toxic keratitis after application of crushed custard apple seeds for head lice infestation were included in the study. Eighteen females and 1 male with a median age of 14 years [interquartile range (IQR) 12-34 years] presented with severe epiphora, congestion, photophobia, and defective vision (median logMar visual acuity 0.4, IQR 0.2-0.8) after application of custard apple seed powder for hair washing. Ten eyes (32.2%) had an epithelial defect (median size 9 mm, IQR 5-12 mm), and 21 (67.7%) eyes had punctate epithelial erosions. All the patients were treated with topical antibiotics, and at 3 days follow-up, all of them had resolution of symptoms and signs with a median logarithm of the minimum angle of resolution (logMAR) visual acuity of 0 (IQR 0-0.2).Health education about the harmful effect of this traditional practice for head lice infestation will prevent further similar events.

Few head lice treatments have demonstrated effectiveness against louse eggs. Abametapir, a metalloproteinase inhibitor, is able to target metalloproteinases critical to egg hatching and louse development. In this double-blind, phase 2 study, 50 subjects aged ≥3 years with active head lice infestation were randomized to receive a single treatment of abametapir lotion, 0.74%, or vehicle (control), applied to scalp and hair for 10 minutes. Ovicidal efficacy was measured by recording the hatch rate of eggs collected from each subject’s hair before and after treatment and incubated for 14 days. With abametapir, 100% of treated eggs remained unhatched compared with 64.0% for vehicle. Accounting for pretreatment hatch rates, the absolute reduction in egg hatching was 92.9% for abametapir versus 42.3% for vehicle ( P < .0001). The most frequently reported adverse event was rash (16%). Abametapir lotion, 0.74%, demonstrated significant ovicidal activity against head lice eggs with a single application.

Despite the common association of human lice with abandoned or neglected people, no procedure to assess pediculosis, aimed to detect signs of neglect, exists. Investigating the two most common forms of head louse infestation, regular and severe, we define lice-markers of neglect and develop a protocol and survey form to record and assess pediculosis. The study of head lice from a deceased victim of neglect helped unravel time-length since death, frequency of exposure to neglect and the cause and circumstances related to the death. Nit-clusters are markers of neglect, indicating length and frequency of neglect episodes. In the case study used here that culminated in the death of the victim, sustained abandonment started circa 2 years before discovery. The lice suggested that death was caused by overconsumption of a powerful calcium channel blocker, an antihypertensive, an excess of which in lice food supply (blood) stops oogenesis. Despite hosting thousands of adult females on the hair, lice reproduction stopped and nits were no longer developed or deposited on the hairs at the root end. This short distance of the shaft with no nits provided a time estimation of overdosing of almost 2 months before death.

Background: Human pediculosis is an important factor in assessing the level of public health and personal hygiene. Objectives: The aim of this study was to determine the prevalence of pediculosis (head lice infestation) and the factors affecting the rate of infestation. Methods: A cross-sectional study design was used to conduct the study among the Kormanj tribes in North Khorasan province, northeastern Iran. The study was conducted between April to June of 2016. A total of 867 subjects were selected randomly and an interviewer questionnaire was used on each subject to sort for information on demographic profile and factors associated with rate of infestation to pediculosis. Results: Data was statistically analyzed using Excel 2015 and SPSS Statistics 24 software; t-test and Chi-square tests were used to check for any statistical significant association between the variables. A total of 28 cases (3.2%) were found to be infected with head lice, 10 cases (35.7%) out of the 3.2% prevalence had a history of infestation with head lice in the past while the remaining 18 cases (64.3%) had no history of lice infestation in the past. Significant statistical association was observed between the sex and history of head lice infestation (P < 0.05). There was no significant difference between lice infestation and the level of education of the subjects, family size, sharing of personal belongings, length of hair, hair posture, showering frequency, the frequency of brushing hair, and permanent scarf coverings at home. Conclusions: The pediculosis is one of the main public health problems in nomadic tribes such as Kormanj tribes in North Khorasan province. It seems that improvement of personal health conditions in females and also appropriate treatment in previous infestations for nomadic tribes could significantly reduce the prevalence of human head lice infestation.

Objective To survey the prevalence of head lice infestation among primary school students in Chiang Rai Province, Northern Thailand from November 2015 to February 2016 and to investigate factors involving these infestations. Methods A total of 703 students were checked for head lice infestations. The data were analyzed by using descriptive statistics i.e. frequencies, percentages and correlations [odds ratio (OR) and 95% confidence interval (CI)]. Results The overall percentage of head lice infestations was 15.1%. No infestation was found in boy students. The prevalence of head lice infestation was significantly associated with itching on a scalp (OR = 5.206, 95% CI = 3.116–8.696), having dirty fingernails (OR = 2.019, 95% CI = 1.217–3.352), wearing dirty clothes (OR = 4.532, 95% CI = 1.651–12.438), having history of head lice infestations (OR = 3.998, 95% CI = 2.174–7.356) and family member having history of head lice infestations (OR = 1.997, 95% CI = 1.092–3.651). Conclusions Pediculosis capitis is still public health problem in this region. Effective treatment is required to control this infestation in urgent.

Pediculosis in humans and especially in children is a very common dermatological disorder caused by the ectoparasite Pediculus humanus capitis De Geer. We investigated the socioeconomic factors affecting the prevalence of pediculosis in the Greek urban area of Athens during 2004-2006. The target population consisted of children from kindergartens. In total, 434 children from single- or two-parent families were investigated with respect to socioeconomic factors such as education, income and family composition, and the prevalence of pediculosis. The overall pediculosis rate was 5.30%. Head louse infestations were significantly higher in female children and in two-parent families. Lice infestations peaked in low- and medium-income families. Head louse infestation rates were influenced by income, parents' education, and nationality.

Amaç: Baş biti enfestasyonu tüm dünyada bir halk sağlığı ve sosyal problemdir. Tedavisi için insektisit bazlı ve dimetikon bazlı solüsyonlar kullanılmakta ve günümüzde birçok ülkede bulunabilmektedir. Bu çalışmada piyasada bulunan insektisit bazlı baş biti ürünleri ile farklı oranlarda dimetikon içeren fiziksel olarak etkili ürünlerin etkinliklerinin in vitro olarak karşılaştırılması amaçlanmıştır.Yöntemler: Baş biti örnekleri, özel taraklar yardımıyla ilkokul öğrencilerinden toplanmıştır. Ürünler ise piyasada bulunduğu şekli ile satın alınmış ve kullanılmıştır. Örnekler, içinde hafifçe ıslatılmış filter kağıdı bulunan 5 cm petri kaplarına tek tek konulmuş ve 28±2 °C ile %50±20 nem sağlanan ortamda tutulmuşlardır. Standardize edilen protokol bütün ürünler için aynı şekilde uygulanmış ve 24 saat sonra ölüm oranları not edilmiştir. Kontrol testlerinde örneklere herhangi bir şey uygulanmamıştır. Her ürün ve kontroller için 10-20 baş biti örneği kullanılmış ve sonuçlar istatistiksel olarak analiz edilmiştir.Bulgular: Çalışmamız mineral yağ içeren iki ürünün (%5,5 dimetikon ve silikon ile dimetikon (oranı prospektüste verilmemiş) ve siklopentasiloksan) baş bitlerinin öldürülmesinde daha etkili olduğunu göstermiştir.Sonuç: Toksik olmamaları ve herhangi bir direnç gelimesi beklenmediği için dimetikon bazlı ürünler tekrarlanarak kullanılabilir, ancak enfestasyonun halk sağlığı düzeyinde kontrol altına alınabilmesi için fiyat açısından rekabet edebilecek düzeye getirilerek bu ürünlerin kullanımının teşvik edilmesi gereklidir, Objective: Head lice infestation is a public health and social problem for almost all countries worldwide. For its treatment, insecticide and dimeticone-based solutions are currently available in the markets in many countries. We aimed to compare the efficacy of commercially available anti-head lice shampoos containing insecticide and physically effective products with different percentages of dimeticone using an in vitro technique.Methods: Head lice specimens were collected from primary school children using special plastic and metal combs. Anti-head lice products were commercially purchased and used directly. The specimens were placed one by one in 5-cm Petri dishes containing a slightly wet filter paper and were kept in a plastic cage at 28±2°C and 50%±20% relative humidity. A standardized protocol was used for testing all the products, and mortality data were obtained after 24 h. Two control tests were performed with each batch of trials. For each product and control, 10-20 head lice specimens were used, and the results were statistically analyzed.Results: Our study demonstrated that among all the tested products, two products containing mineral oils [5.5% dimeticone & silicone (patented product) and dimeticone (no percentage mentioned in the prospectus) & cyclopentasiloxane] were found to be more effective for killing head lice in vitro.Conclusion: Physically effective products can be repetitively used because they are non-toxic and resistance to them is not expected. To control the infestation at a public level, the use of these products needs to be encouraged with respect to their cost price

Wenn es ein Kind am Kopf juckt, konnten das Lause sein. Meist hat die Ubertragung auf andere Personen dann schon stattgefunden. Eine neue Generation von Lausemitteln bekampft die Ubeltater rein physikalisch, ohne Resistenzgefahr und alle auf einen Schlag.

Head lice are a common problem, particularly in school children aged 4–11. The severity of infestation on an individual child can vary from a few lice (fewer than 10) to over 1000 in severe cases. Head lice infestation is known as pediculosis capitis, and ‘nits’ are the empty egg cases attached to hair from which head lice hatch. This article provides advice for health visitors and parents on preventing and treating head lice.

[Extract] Dear Editor, A previous TMAID publication highlighted the spread of ectoparasites in confined conditions [1], a situation that often also applies to short and long-term travellers, including volunteers. One of the most unpleasant tasks of a volunteer sending organization involves premature re-call. While accidents or illness are not entirely preventable, the re-call of volunteers who suddenly cannot cope being away from family or pets, dislike local food or living arrangements, experience a clash between imagined and actual reality, or believe that the whole plan was a bad idea after all, create not only avoidable costs to and ill will from the agency. Such events damage guest-host relationships at a personal and organizational level, leaving the host community bewildered and disappointed.

Background: There is an increase in the prevalence of head lice among urban communities with high density in recent years. This study was aimed to determine the efficacy of 1% permethrin shampoo and some traditional physical treatment for head lice infestation in Qom Province, central Iran. Methods: This analytical cross-sectional study was carried out on all 11,223 cases in six categories that were referred to Qom health care system from 2016 to March of 2017. The infested people were treated with 1% permethrin shampoo, twice at a 1-week interval and other recommended therapeutic categories, such as the use of physical treatments such as wooden fine-toothed combs impregnated with a mixture of water and white vinegar on infested hair for 30 min and secondly, carrier oils such as olive oil, bitter almond on infested hair over a therapeutic period. After completing the course of treatment, treatment success was checked by questionnaires. Results: A total of 11,223 cases with head lice infestation were confirmed and were enrolled for study. Out of six categories, three therapeutic categories were utilized as follows: (a) 1% permethrin shampoo and the use of physical treatments; (b) 1% permethrin shampoo and the use of carrier oils; (c) the above-mentioned therapeutic categories combined had high treatment success. It was estimated to be 82.00%, 87.31%, and 94.33%, respectively. Conclusions: According to the findings, in addition to the application of 1% permethrin shampoo, the use of physical treatments and carrier oils such as olive oil, bitter almond can increase the treatment success of head lice infestation.

PURPOSE Head lice (pediculosis capitis) affects approximately 6-12 million children in the United States each year, with resistance to currently available head lice treatments increasing. The majority of these treatments require two applications, applied 7-10 days apart. Abametapir lotion 0.74% is a new single-application product for the treatment of head lice infestation. A Phase 2b study conducted in children aged ≥2 years demonstrated that a single application of abametapir lotion (0.74% w/w) resulted in 86% of subjects being lice-free at 14 days post-treatment [1]. These …

Background A neem-based conditioner lotion (ONC) used against head lice was previously tested clinically and shown to be relatively ineffective. To improve the activity against lice and their eggs, it was reformulated into a silicone vehicle (NNC) as part of a project to improve pediculicidal medical devices. An ultrasound nit comb was also developed to be used in conjunction with the neem lotion to remove louse eggs from the hair. Methods A single-centre, parallel group, randomised, controlled, open-label community-based clinical study was set up to test the NNC lotion in comparison with a marketed product based on isopropyl myristate and cyclomethicone (IPM/C) with two treatments 7 days apart. In parallel, the lubrication effects of the NNC and ONC lotions were compared in use with the ultrasound comb. Results For 134 randomised participants (50 NNC, 53 IPM/C, 17 NNC plus comb, and 14 ONC plus comb), the cure rate was 72.0% for NNC and 69.8% for IPM/C (OR 1.112, 95% CI, 0.47 to 2.61). Additional combing gave 82.4% cure using NNC and 28.6% using ONC (OR 11.67; 95% CI 2.13 to 64.04). No difference in efficacy of nit removal was detected although combing with conditioner was physically easier. Conclusions One percent neem oil in silicone (NNC) is as effective to eliminate head lice as other silicone products. Nit combing is easier using a conditioner lubricant to facilitate sliding of the eggshells along hairs. Trial registration Current Controlled Trials Registry ISRCTN77673809

Cancellation of surgery has significant adverse impact on patients, health care providers, and their associated facilities. Although head lice infestation has not been shown to be associated with adverse surgical outcomes, it often prompts case cancellation by surgical and anesthesia personnel. The purpose of our study was to evaluate the extent and impact of surgery cancellations due to head lice infestation. In our study, a total of 9 patients were cancelled over a 3-year period. Although there is no direct evidence to show that head lice infestation poses a risk to surgical outcomes, the possibility of underlying secondary bacterial infection at the skin excoriation site is often the concern in these patients. This study offers the first investigation into the impact of head lice infections on operating room cancellations, which may prove to be a potential source of intervention to prevent cancellations.

Background. Health providers need to know which measures to take and children to prioritize in order to decrease costs associated with head lice infestations. Objective. Our aim was to determine the most important predictors for head lice and identify the major drivers of an infestation outbreak in a low-prevalence area. Methods. The study was based on three datasets of head lice prevalence (retrospective, point prevalence and prospective approach) from primary school children (ages 6–12) at 12 schools in Oslo, Norway. The tested predictors were siblings with lice, individual and household characteristics as well as class and school affiliation. Self-reported monthly incidences (prospective approach) of head lice were used to evaluate infestation dynamics. Results. Infested siblings strongly increased the odds of head lice infestation of school children (odds ratio 36, 26 and 7 in the three datasets) whereas having short hair halved the odds. Household characteristics were of minor importance, and class affiliation proved more important than school affiliation. Having head lice in one school term increased the odds of an infestation in the next, but this effect diminished over time. About 97% of all self-reported infestations were noted in two consecutive months or less. Conclusions. With the exception of hair length, we have found that individual and household characteristics are of minor importance to predict head lice infestations in a low-prevalence country and that unnoticed transmissions in school classes and families are likely to be the major driver upon outbreaks.

The therapy of pediculosis remains a common problem in pediatric clinical practice. As resistance to commonly used chemical pediculicides, such as permethrin, is constantly increasing, there is a need for the development of new compounds that are effective in causing mortality in adult lice and their eggs. Natural products have been used in traditional medicine for thousands of years and recently have been of increasing interest, since the costs are usually lower and they are considered less toxic by the public. Here we present a review on plant compounds used for the treatment of head lice. An overview is given on published evidence on the use of natural product pediculicides and ovicides in clinical trials and in vitro studies. We conclude that several plant products offer promise for new compounds to treat head lice infestation. However, the number of clinical studies is very limited, and there is an urgent need to increase research assessing the effectiveness and safety of promising compounds. Over the counter natural products should be supported by in vitro data and by adequately designed comparative trials that evaluate cure rates and safety.

This study aimed to examine scientific articles performed in Turkey on the prevalence and management of PK (diagnosis, contagion, prevention, treatment) from a critical perspective. The population of the systematic review consisted of total 63 published and unpublished theses or dissertations and peer-reviewed articles published in Turkish or English in national or foreign scientific journals from studies performed in Turkey between 1982 and 2012 years. It reached 578,938 people in 63 studies. Seventy-eight percent of the studies were related to the prevalence of PK and/or associated factors. The number of the studies was limited regarding diagnosis, prevention, contagion, treatment compliance, difficulties and causes of failure. Of the studies, 90.5% had been performed in public schools, almost exclusively elementary schools. The prevalence of PK was 0.3-34.1%, 0-35.4%, and it was 0.3-34.1% in elementary school children. It increased with years of education. It was double that of the boys in the girls (p

An endeavour to delineate the salient details of the treatment of head lice infestation has been made in the present article. Treatment modalities including over the counter permethrin and pyrethrin, and prescription medicines, including malathion, lindane, benzyl alcohol, spinosad are discussed. Salient features of alternative medicine and physical treatment modalities are outlined. The problem of resistance to treatment has also been taken cognizance of.

Objective To help health authorities in adopting the ways to control pollution in the Kashan city and improve public health. Methods In descriptive epidemiologic research, 2 151 students were examined in 23 male and female schools. Their hair was examined for head louse infestation. Demographic data and related information were obtained by interview and observation. The data were recorded in the standard questionnaire and analyzed by SPSS statistical software by using Chi -square and fisher's exact tests. Results The prevalence of head louse infestation in students was 0.70%. This survey showed that 0.75% and 0.60% of the students in female and male schools were infected to head louse respectively. Statistical tests showed significant relation between pediculosis and, father's and mother's job, father's and mother's education, previous history of infection, itchy scalp and school health teachers ( P Conclusions The study indicated that the prevalence of pediculosis wasn't a major concern and health priority in Kashan's schools (2013). However, it was suggested that individual hygiene should be considered as a priority in the city to prevent the increase of infestation incidence, and also measures should be taken to increase the level of knowledge of individuals within the city.

Resumen Introducción. La pediculosis capitis es un problema recurrente que afecta anualmente de 6 a 12 millones de niños; no existen datos epidemiológicos en el estado de Nuevo León, y en México son escasos, por lo cual se necesitan estudios fundamentados para diseñar estrategias de control basadas en los factores que predisponen a la infestación por piojos. Objetivo. Determinar la prevalencia de Pediculus capitis en niños de educación primaria para detectar factores de riesgo y conocer las características individuales y las condiciones socioeconómicas asociadas estadísticamente con la infestación. Materiales y métodos. Se incluyeron 840 escolares de seis municipios, previa firma del consentimiento informado por parte de los padres y de los niños. Los ectoparásitos se recolectaron en cada niño infestado utilizando un peine fino. Los participantes contestaron una encuesta que incluía variables individuales y socioeconómicas, como la edad, el sexo, el grado escolar, las características del cabello, el hacinamiento y la pediculosis en hermanos, entre otras. Resultados. La prevalencia de pediculosis capitis en los niños fue de 28 % (235/840), con una mayor prevalencia en las niñas (33,7 %; 140/417); los niños del quinto grado (10 a 11 años) fueron los más afectados (6,2 %; 52/840). El sexo femenino, el cabello largo y el nivel escolar de los padres se asociaron significativamente con la pediculosis capitis. Conclusiones. Los resultados demostraron que la prevalencia de pediculosis capitis en Nuevo León es una de las más altas de México y que es un problema real de salud pública,por lo cual es importante establecer programas de prevención en la escuela y en el hogar para disminuirla o controlarla con la ayuda de las autoridades de salud pública. Abstract Introduction: Pediculosis capitis is a recurring problem affecting 6 to 12 millions of children annually; there are no epidemiological data on this subject in the state of Nuevo León, and there are few in México. Therefore, new contributions are needed to design control strategies based on factors that may predispose to head lice infestation. Objective: To determine the prevalence of Pediculus capitis in primary school children and to evaluate risk factors and individual or socioeconomic characteristics statistically associated with infestation. Materials and methods: We included 840 schoolchildren from six municipalities after parents and children signed an informed consent. Ectoparasites were collected from infested children using a fine-toothed comb. Participants were interviewed using a questionnaire on individual and socioeconomic variables including age, gender, education, hair characteristics, overcrowding, and siblings with pediculosis, among others. Results: The overall prevalence of head lice in schoolchildren was 28% (235/840), the highest prevalence was among girls (33.7%, 140/417), and children from the fifth grade (10-11 years old) were the most affected (6.2%; 52/840). Female gender, long hair and the father's education level were significantly associated with P. capitis. Conclusion: Our results showed that the P. capitis prevalence in Nuevo León is one of the highest in Mexico, that it constitutes a real public health problem,and that there is need to establish prevention programsat home and school to decrease or to controlP. capitis with the support of public health authorities.

Background Head lice infestation is a common public health problem that is most prevalent in primary school children throughout the world, especially in developing countries including different parts of Iran. This study aimed to determine the prevalence and risk factors associated with head lice infestation and pediculicidal effect of 1% permethrin shampoo in primary schools girls of Bashagard County, one of the low socioeconomic areas in southeast of Iran. Methods In this interventional study six villages with similar demographical situations were selected and randomly assigned into intervention and control areas. In each area 150 girl students aged 7–12 years were selected randomly and screened for head lice infestation by visual scalp examination. In intervention area, treatment efficacy of 1% permethrin shampoo was evaluated via re-examination for infestation after one, two, and three weeks. Pre-tested structured questionnaire was used to collect data on socio-demographic and associated factors of head lice infestation. Results The prevalence of head lice infestation was 67.3%. There was significant association between head lice infestation and school grade, family size, parents’ literacy, bathing facilities, frequency of hair washing, and use of shared articles (p

The present clinical trial was conducted to obtain additional data for the safety and efficacy of a head lice shampoo that is free of silicone compared with an anti-head lice product containing dimethicone. Both products act by a physical mode of action. This randomized, investigator-blinded, controlled clinical study was conducted between July and November 2016 in households of two villages (Abou Rawash and Shandalat) in Egypt. Children older than 2 years with an active head lice infestation were treated with either a shampoo-based head lice treatment containing neem extract (Licener®) or dimethicone (Jacutin® Pedicul Fluid) on day 1 and additionally on day 9. Assessment for living lice by combing was conducted before and 1–2 h after treatment and on days 5 and 13. The main objective was to demonstrate a cure rate of the test product of at least 85% after a single application (day 5 and 9). Secondary objectives were to scrutinize patient safety and satisfaction as well as cure rates on day 13 after two treatments and the evaluation of ovicidal and licicidal efficacies of the products. Sixty-one children in the test-group (Licener®) and 58 children in the reference group (Jacutin® Pedicul Fluid) were included in this study. The test product and the reference product were very well tolerated. Both products exceeded the objective of cure rates of over 85% after single treatment (test group 60/60 = 100%; 95% CI = 94.04–100.00%; reference group 54/57 = 94.74%; 95% CI = 85.38–98.90%; p = 0.112; CI by Clopper-Pearson) and after two treatments (test group 58/58 = 100%; 95% CI = 93.84–100.00%; reference group 52/54 = 96.30%; 95% CI = 87.25–99.55%; p = 0.230) with higher cure rates and non-inferiority for the test product. The combined success rate shows significant superiority of the test product against the reference product (test group 58/58 = 100%; 95% CI = 93.84–100.00%; reference group 49/54 = 90.7%; 95% CI = 79.70–96.92%; p = 0.024). The test product showed higher ovicidal efficacy than the reference product. Thus, the present study demonstrates that a single treatment with a head lice product like Licener® can be sufficient to eliminate a head lice infestation.

Background: We aimed to determine the prevalence of head lice infestation, effectiveness of over-the-counter treatment options, and the effectiveness and safety of lindane shampoo among female Saudi Arabian secondary school students. Methods: This study was conducted in October-November 2016 in two secondary schools each from the northern and southern parts of Jeddah. Investigators completed a standardized questionnaire. Students’ hair and scalps were examined manually for head lice or scalp lesions. Students with head lice infestation were asked to use 1% lindane shampoo. Results: Of the 337 students examined, 106 (31%) were infested with live lice and eggs; 55% and 45% were from northern and southern schools, respectively (P=0.02). Among students who shared a comb and those who did not, the prevalence rates of head lice were 67% (n=28) and 33% (n=14), respectively. A history of head lice was more prevalent among students with positive head lice test results (49%) than among those with negative results (40%; P

Pediculosis capitis is the most common ectoparasitic disease in children in industrialized countries and extremely common in resource-poor communities of the developing world. The extensive use of pediculicides with a neurotoxic mode of action has led to the development and spread of resistant head lice populations all over the world. This triggered the development of compounds with other modes of action. The current literature on treatment approaches of head lice infestation was searched, and published randomized controlled trials were critically analyzed. The following compounds/family of compounds were identified: spinosad, a novel compound with a new neurotoxic mode of action, isopropyl myristate, 1,2-octanediol, ivermectin, plant-based products, and dimeticones. The efficacy and safety of these compounds are reviewed and recommendations for the treatment of pediculosis capitis in individuals as well as the interruption of ongoing epidemics are provided.

Many medications are available for treatment of pediculosis capitis including ivermectin. Our aim is to compare the efficacy and safety of topical versus oral ivermectin in treatment of pediculosis capitis. Sixty-two patients with proved head lice infestation were included and divided into group I (31 patients; received single topical application of 1% ivermectin) and group II (31 patients; received single dose of oral ivermectin). Treatment was repeated after 1 week for nonresponders. At 1 week after treatment, the eradication rates and improvement of pruritus were significantly higher among patients who received topical than oral ivermectin. When a second treatment, topical or oral, was given to nonresponders, the cure rates of infestation and pruritus was 100% and 97% among patients treated with topical and oral ivermectin, respectively with no significant difference between the two groups. This study suggests that both topical and oral ivermectin demonstrate high efficacy and tolerability in treatment of pediculosis capitis. However, a single treatment with topical ivermectin provides significantly higher cure of infestation and faster relief of pruritus than oral ivermectin. In addition, whether topical or oral ivermectin is used to treat head lice, a second dose is required in some cases to ensure complete eradication.

Head lice infestation (or pediculosis) is an important public health problem in Thailand, especially in children between the ages 5 and 11 years. Head lice resistance is increasing, chemical pediculicides have lost their efficacy, and, therefore, alternative pediculicides such as herbal shampoos have been proposed to treat head lice infestation. Thus, the present study investigated the efficacy of three herbal shampoos based on native plants in Thailand (Acorus calamus Linn., Phyllanthus emblica Linn., and Zanthoxylum limonella Alston) against head lice and compared them with carbaryl shampoo (Hafif shampoo®, 0.6 % w/v carbaryl), malathion shampoo (A-Lice shampoo®, 1.0 % w/v malathion), and commercial shampoos (Babi Mild Natural’ N Mild® and Johnson’s baby shampoo®) in order to assess their in vitro and in vivo efficacy. For in vitro study, doses of 0.12 and 0.25 ml/cm2 of each herbal shampoo were applied to filter paper, then 10 head lice were place on the filter paper. The mortalities of head lice were recorded at 5, 15, 30, and 60 min. The results revealed that all herbal shampoo were more effective on pediculicidal activity than chemical and commercial shampoos with 100 % mortality at 15 min; LT50 values ranged from 0.25 to 1.90 min. Meanwhile, chemical shampoos caused 20–80 % mortality, and LT50 values ranged from 6.50 to 85.43 min. On the other side, commercial shampoos showed 4.0 % mortality. The most effective pediculicide was Z. limonella shampoo, followed by A. calamus shampoo, P. emblica shampoo, carbaryl shampoo, malathion shampoo, and commercial shampoo, respectively. In vivo results showed that all herbal shampoos were also more effective for head lice treatment than chemical and commercial shampoos with 94.67–97.68 % of cure rate after the first treatment; the second treatment, 7 days later, revealed that the cure rate was 100 %. Meanwhile, chemical shampoo showed 71.67–93.0 % of cure rate and, unfortunately, commercial shampoos were nontoxic to head lice and showed 0 % of cure rate after the first and the second treatments. Our data showed that three herbal shampoos of native plants in Thailand in this study are suitable to be used as pediculicides for Thai children since it is safe for children and there is no side-effect after application.

How head lice infestations are managed by households is an important but generally neglected issue in head lice research. In the present study, we investigate actions taken against head lice by Norwegian households in association with socioeconomic status, family background, school-related variables and other key factors. Repeat questionnaires distributed to caretakers of the same elementary school children during a 2-year period enabled us to study both previous head lice management and any changes in this management through time. Households from 12 schools spanning the main socioeconomic variation found in Norway participated in the study. All students with active head lice infestation were treated in the four investigated periods. Most caretakers used a thorough head lice checking technique and informed others of own infestation. Checking frequency was low as most children were inspected less than monthly. The best determinant of increased checking frequency and thoroughness was personal experience with head lice. The increased awareness, however, seemed to be somewhat short-lived, as there was a decrease in checking frequency and thoroughness within 1 year after infestation. Personal experience with head lice also increased general knowledge related to the parasite. Parents born in developing countries checked their children for head lice more frequently, although less thoroughly, informed fewer contacts when infested, used pediculicides preventively more often and knew less about head lice than parents born in developed countries. Households with highly educated mothers had a lower checking frequency, but their knowledge and willingness to inform others was high. Single parents were more concerned about economic costs and kept children home from school longer while infested than other parents. As head lice management varied among socioeconomic groups and with parental background, differentiated advice should be considered in the control of head lice. The biannual focus on head lice during the 2 years of investigation increased checking thoroughness, while checking frequency remained unchanged. Based on the results, we suggest new head lice management guidelines for health authorities.

Of the 1595 students at different elementary grades, 115 female students and 10 male students were found infested with head louse. The relative frequency of head louse infestation was 7.2 and 0.62 for girls and boys, respectively. Accordingly, the highest rate of head louse infestation was in the age group of 7 years and the first grade, while the lowest rate of head louse infestation was observed in the age group of 12 years and the sixth grade. Further study shows that girls are more exposed to head louse infestation than boys. © 2019 Malhotra Publishing House.

Archaic mummies from northern Chile were examined for the presence of Pediculus humanus capitis. The excellent preservation of mummies and louse nits/eggs permitted a study of the degree of head lice infestation. We studied 63 Chinchorro mummies (ca. 5000–3000 years B.P.) from the Arica-Camarones coast. An area of 2 cm × 2 cm on each mummy's head was systematically inspected for louse nits/eggs. Hairs with nits/eggs and lice were collected and analyzed using optic and scanning electronic microscopy. About 79% (50/63) of the mummies resulted positive for pediculosis, with an average of 2.1 nits/eggs/cm2 per positive individual. Microscopic analyses revealed the micromorphology of all developmental stages, including eggs/nits, nymphal instars and adults. Chinchorro people lived in small huts increasing the transmission of ectoparasites. Considering that head lice thrive in crowded conditions, their prevalence could be used as an bioindicator to assess and debate cultural behavior (e.g., degree of crowdedness and sedentism) and to study paleoepidemiology in prehistoric populations.

Background: Infestation with the head louse, Pediculus humanus capitis, is one of the most common parasitic infestations of human worldwide. Traditionally, the main treatment for control of head lice is chemical control that includes wide variety of neurotoxic synthetic insecticides. The main difficulty posed in controlling the head louse infestation is increasing lice resistance to synthetic pediculicidal drugs. Plant-based drugs; especially essential oil components and standardized extracts have been suggested as an alternative source of materials for insect control. Ageratum conyzoides L. (Asteraceae) has been reported to possess antifungal and insecticidal properties. In the present research work, an attempt has been made to evaluate in vitro pediculicidal activity of A. conyzoides. Methods: A filter paper diffusion bioassay was carried out in order to determine the pediculicidal activity of different extracts of A. conyzoides. Results: The study elucidates the active plant part and suitable extract responsible for the therapeutic efficacy of this plant in the management of pediculosis. Conclusion: Findings of the present study indicate the potential of A. conyzoides extract to be included in the formulations as a pediculicidal agent. Keywords: Ageratum,conyzoidesL,Leaves,Bioassay,Eugenol,Pediculosis.

To determine whether pinworm infections and head lice infestations spread among children in orphanages, 117 children from 4 orphanages in Busan-si and Ulsan-si, Korea, were examined for enterobiasis and head lice infestation between January and February 2014. The overall rate of Enterobius vermicularis egg positivity was 0.85%, whereas none of the children had head lice infestations. The rate of pinworm infection was much lower among the orphanage children compared to the rates observed in previous studies among kindergarten and primary school students. Moreover, the risk factors for enterobiasis were less frequent among these subjects than previously reported. The personal hygiene and health of the orphanage children were supervised by a regular, employed nurse through a health education program. In conclusion, pinworm infection was efficiently controlled among the children in orphanages, and this might be related to good personal hygiene practices in Korea.

Amaç: Bu çalışmada ilköğretim çağındaki çocuklarda baş biti görülmesini etkileyen faktörlerin belirlenmesi amaçlanmıştır. Yöntemler: Bu amaçla yatılı ilköğretim bölge okullarında (Merkez YİBO ve Pamukpınar YİBO) öğrenim gören, yaşları 6-15 arasında değişen 249’u kız ve 93’ü erkek olmak üzere toplam 342 çocuk baş biti açısından değerlendirilmiştir. 23 sorulu bir anket çocuklara dağıtılmıştır. Bulgular: Öğrencilerin 35’inde (%10.2) bit infestasyonu tespit edilmiştir. Kız öğrenciler arasında (%13.7) baş biti görülme oranının erkeklere (%1.1) göre daha fazla olduğu ve aradaki farkın istatistiksel olarak anlamlı olduğu saptanmıştır (p, Objective: The aim of the study was to determine the prevalence of head louse infestations and the factors affecting the rate of infestation in primary school children in Sivas. Methods: A total of 342 children (249 girls and 93 boys) were examined with a louse comb for the presence of head lice. A questionnaire with 23 questions was distributed among the pupils and their parents. Results: The overall infestation rate for head lice was 10.2% (n=35). The infestation rate was higher in girls (13.7%) than in boys (1.1%) (p

Objective: The aim of this study was to investigate the prevalence and risk factors of pediculosis capitis in schoolchildren living in rural and urban areas in Kayseri, a city located in central Anatolia in Turkey. Methods: This cross-sectional school-based study was performed in 24 randomly selected public schools. A total of 8,122 schoolchildren aged 5-16 years, from kindergarten to eighth grade, were examined for the presence of pediculosis capitis. A child was defined as being infested by the presence of live or dead lice or eggs/nits. The results were analyzed using the chi-squared test and logistic regression analysis. Results: The overall prevalence of head lice infestation was 13.1%. Pediculosis was more frequent in girls (25.2%) than in boys (0.86%) (p

The prevalence of head lice (Pediculus humanus capitis) infestation was studied among the children (1 to 7 years) in the area of Mirpur Bihari Camp, Mirpur-11, Dhaka. A total of 300 children was examined from February 2011 to January 2012 and 59.67% prevalence of head lice infestation was observed. The prevalence of pediculosis was significantly higher (p

Head lice infestation, a worldwide head infestation caused Pediculus humanus capitis De Geer, is an important public health problem in Thailand. Several chemical pediculicides have lost in efficacy due to increasing resistance of lice against insecticide. Therefore, non-toxic alternative products, such as natural products from plants, e.g. plant extract pediculicides, are needed for head lice control. The aims of this study were to evaluate the potential of pediculicidal activity of herbal shampoo base on three species of Thai local plants (Accacia concinna (Willd.) DC, Averrhoa bilimbi Linn. and Tamarindus indica Linn.) against head lice and to compare them with carbaryl shampoo (Hafif shampoo®; 0.6 % w/v carbaryl) and non-treatment control in order to assess their in vitro. Doses of 0.12 and 0.25 ml/cm2 of each herbal shampoo were applied to filter paper, and ten head lice were place on the filter paper. The mortalities of head lice on the filter paper were recorded at 1, 5, 10, 30 and 60 min by sterio-microscope. All herbal shampoos at 0.25 ml/cm2 were more effective pediculicide than carbaryl shampoo with 100 % mortality at 5 min. The median lethal time (LT50) of all herbal shampoos at 0.25 ml/cm2 showed no significant differences over at 0.12 ml/cm2 (P < 0.01). The most effective pediculicide was T. indica extract shampoo, followed by Av. bilimbi extract shampoo and Ac. concinna extract shampoo, with LT50 values

Background Ivermectin is a broad-spectrum parasiticide in widespread systemic use, including as an off-label treatment for head lice infestation. The potential of the topical use of ivermectin as a treatment for head lice infestation was suggested by an in vitro report of a novel lotion formulation. Objectives This study investigated the relative effectiveness of three ivermectin lotion concentrations (0.15, 0.25 and 0.5%) compared with vehicle placebo in eliminating head lice infestation. Methods In this randomized, blinded study, 78 head lice-infested subjects, aged 2‐62 years, received a single, 10-min application of product on day 1. Evaluations were completed at 2 and 6 h post-application, and on days 2, 8 (±1) and 15 (+2). Safety was assessed according to the evaluations of trained observers and adverse event (AE) reports. Efficacy was assessed according to scalp and hair examinations. Results Compared with placebo, all ivermectin concentrations resulted in the statistically significant (P £ 0.003) eradication of head lice through to day 15, with the highest level of eradication (73.7%) in subjects who received the 0.5% concentration. The severity of pruritus decreased from baseline in all treatment groups, including the placebo group, from 6 h post-treatment to day 15, with the greatest reduction in the 0.5% concentration group. No ocular irritation was observed. All three ivermectin treatment strengths and vehicle were well tolerated. Conclusions A single application of a 0.5% concentration of this ivermectin lotion formulation shows promise as a safe and effective treatment for head lice infestation and the associated signs of pruritus.

Background The increase in resistance of head lice to neurotoxic pediculicides and public concern over their safety has led to an increase in alternative treatments, many of which are poorly researched or even untested. Methods A multicentre, randomised, assessor-blind, parallel-group trial (Trial 1) was conducted to compare the safety and efficacy of a head lice treatment containing Australian eucalyptus oil and Leptospermum petersonii (EO/LP solution; applied thrice with 7-day intervals between applications) with a neurotoxic treatment containing pyrethrins and piperonyl butoxide (P/PB mousse; applied twice with a 7-day interval) in children. A single-blind, open trial (Trial 2) was conducted to assess the efficacy of EO/LP solution following a single application. In addition, skin irritancy and sensitisation tests using EO/LP solution were performed in adults and children. In vitro tests were performed to further assess the ovicidal and pediculicidal efficacy of EO/LP solution. Results EO/LP solution was found to be more than twice as effective in curing head lice infestation as P/PB mousse in per-protocol participants (Trial 1; 83% vs 36%, P

Background: Head louse infestation caused by Pediculus capitis is a health issue that frequently affects school aged children. This infestation has harmful social and mental effects and is related to the populations with low social-hygiene status. Objectives: The current study aimed to evaluate the prevalence of head lice and determine its related factors. Materials and Methods: The children were selected by stratified systematic cluster random sampling of primary schools in 2008 - 2009 in Khorramshahr, Iran. A total of 750 pupils were screened from ten primary schools from the first to fifth grades. Students were examined for live lice or nits by experienced educators. The data were compared by Chi-square analysis. Also, P value less than 0.05 was considered significant. Results: According to the obtained results, Pediculosis spp. prevalence was 2% among male and female students of Khorramshahr primary schools; it was 2.6% in females and 1.5% in males. There was a significant relationship between using common tools and equipment (comb, towel, hat, headscarf and bed). There was a significant relationship between bathing and infestation. There was no statistically significant difference between infestation and mothers’ education and occupation. But, the difference between fathers’ education and occupation and pupils’ infestation rate was significant. Conclusions: The overall infestation rate in the present study is probably one of the lowest infestation rates in Iran and in the region. It appears necessary to examine pupils by trained persons for early detection of infestation.

International audience; Reports of treatment failure and the emergence of resistance to topical head lice treatments have become increasingly common, driving the need for continued development of new therapeutic options for pediculosis. Ivermectin has been proposed as a potential alternative for the treatment of pediculosis but has not been sufficiently evaluated. In this study, the effectiveness of oral ivermectin versus shampoo in the treatment of pediculosis in Senegal was compared. The study was conducted in two neighbouring villages of Sine-Saloum, Senegal: Dielmo (ivermectin trial group; 201 female participants) and Ndiop (shampoo trial group; 239 female participants). In the ivermectin group, patients received two doses of oral ivermectin (400 mu g/kg body weight; Mectizan (R)) 7 days apart. In contrast, the shampoo group received a shampoo treatment based on D-phenothrin (0.23%; Hegor (R)). At the beginning of the study, 70 (34.8%) of 201 participants in the ivermectin group were infested by head lice versus 145 (60.7%) of 239 participants in the shampoo group. At Day 15 post-treatment, the efficacy of the treatment against head lice reached 41/53 (77.4%) in the ivermectin group (53 patients were tested in this group) versus 42/130 (32.3%) in the shampoo group (130 patients were tested in this group) (P < 10(-7)). However, 4 (7.5%) of the 53 females in the ivermectin group exhibited probable ivermectin treatment failure, suggesting the emergence of ivermectin-resistant lice. This study demonstrates that oral ivermectin is highly effective for the treatment of pediculosis compared with shampoo, but also suggests that ivermectin resistance may emerge during treatment. (C) 2016 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.