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 <20 years, and among 50% of female school-children. The prevalence was persistent among those with a history of infestation. The major risk factors were residing in a setting with other infected cases, and sharing a hair comb. The study also confirmed that ivermectin was safe and effective for field-based practice. It was considered a preferable treatment option. In conclusion, behavior-change communication should be implemented to reduce the observed high prevalence of head-lice infestation. Ivermectin may be an alternative choice for head-lice treatment, especially in remote areas.
Animals ; Comb and Wattles ; Cross-Sectional Studies ; Female ; Hair ; Humans ; Ivermectin ; Lice Infestations ; Male ; Pediculus ; Prevalence ; Risk Factors ; Rural Health ; Statistics as Topic ; Thailand

The high prevalence of pediculosis capitis, commonly known as head lice (Pediculus humanus capitis) infestation, has led to the preparation of a community-based pediculicidal ointment, which is made of common household items and the extract of Tinospora crispa stem. The present study aimed to evaluate the safety, efficacy, and physicochemical characteristics of the T. crispa pediculicidal ointment. The physicochemical properties of the ointment were characterized, and safety was determined using acute dermal irritation test (OECD 404), while the efficacy was assessed using an in vitro pediculicidal assay. Furthermore, the chemical compounds present in T. crispa were identified using liquid-liquid extraction followed by ultra-performance liquid chromatography quadruple time-of-flight mass spectrometric (UPLC-qTOF/MS) analysis. The community-based ointment formulation was light yellow in color, homogeneous, smooth, with distinct aromatic odor and pH of 6.92±0.09. It has spreadability value of 15.04±0.98 g·cm/sec and has thixotropic behavior. It was also found to be non-irritant, with a primary irritation index value of 0.15. Moreover, it was comparable to the pediculicidal activity of the positive control Kwell®, a commercially available 1% permethrin shampoo (P>0.05), and was significantly different to the activity of the negative control ointment, a mixture of palm oil and candle wax (P<0.05). These findings suggested that the community-based T. crispa pediculicidal ointment is safe and effective, having acceptable physicochemical characteristics. Its activity can be attributed to the presence of compounds moupinamide and physalin I.
Chromatography, Liquid ; Family Characteristics ; Hydrogen-Ion Concentration ; In Vitro Techniques ; Lice Infestations ; Liquid-Liquid Extraction ; Odors ; Pediculus* ; Permethrin ; Prevalence ; Tinospora*

Head lice, Pediculus humanus capitis, infestation is an important public health problem in Egypt. Inadequate application of topical pediculicides and the increasing resistance to the commonly used pediculicides made the urgent need for the development of new agents able to induce irreversible changes in the exposed lice leading to their mortality. The aim of the present work is to evaluate pediculicidal efficacy of some natural products such as olive oil, tea tree oil, lemon juice, and ivermectin separately in comparison with tetramethrin-piperonyl butoxide (licid), as a standard pediculicide commonly used in Egypt. The effects of these products were evaluated by direct observation using dissecting and scanning electron microscopes (SEM). Results showed that after 1 hr exposure time in vitro, absolute (100%) mortalities were recorded after exposure to 1% ivermectin and fresh concentrate lemon juice. The mortalities were decreased to 96.7% after exposure to tea tree oil. Very low percentage of mortality (23.3%) was recorded after 1 hr of exposure to extra virgin olive oil. On the other hand, the reference pediculicide (licid) revealed only mortality rate of 93.3%. On the contrary, no mortalities were recorded in the control group exposed to distilled water. By SEM examination, control lice preserved outer smooth architecture, eyes, antenna, respiratory spiracles, sensory hairs, and legs with hook-like claws. In contrast, dead lice which had been exposed to pediculicidal products showed damage of outer smooth architecture, sensory hairs, respiratory spiracles and/or clinching claws according to pediculicidal products used.
Animals ; Biological Products ; Egypt ; Hair ; Hand ; Hoof and Claw ; In Vitro Techniques ; Ivermectin ; Leg ; Mortality ; Olive Oil ; Pediculus* ; Phthiraptera ; Plant Extracts* ; Plants* ; Public Health ; Tea Tree Oil ; Water

Objective: To determine the efficacy of cooking coconut oil and vinegar as compared to 1% Permethrin shampoo in the treatment of Pediculosis humanus capitis in children 3 – 12 years old. Methodology: The study was conducted in Barangay 704, Zone 77 in Malate among children 3 – 12 years old. Two hundred forty-five subjects were screened and the computed sample size was 150. Subjects were randomized to three treatment groups: coconut oil (CO) group; vinegar plus coconut oil (CV) group; and 1% permethrin shampoo (PS) group. Treatments were given on the 1st and 8th day. The final level of infestation was determined on the 14th day. Cure rates, failure rates, and expenses were also determined. Results: Permethrin achieved superiority over plain coconut oil (X2=18.77 p-value = 0.00). There was no sufficient evidence to prove the superiority of permethrin over coconut-vinegar solution (X2=1.04 p-value = 0.30). Twenty-two percent (11) of the participants from the PS group developed itching and irritation. No adverse effect was reported from the CO and CV groups. Permethrin was 14 times and five times more expensive than coconut oil and vinegar plus coconut oil, respectively. Conclusion Permethrin shampoo had a cure rate of 98%. Plain coconut oil and vinegar plus coconut oil had cure rates of 68% and 94%, respectively. Plain coconut oil had the highest failure rate at 36%, vinegar plus coconut oil at 6%, and permethrin shampoo with 2%. Adverse effects were exclusive to the PS group. Plain coconut oil was the most economical but coconut oil with vinegar with its significant cure rate can be an alternative therapy to permethrin shampoo in the treatment of head lice in children.
Pediculus ; Coconut Oil ; Acetic Acid ; Permethrin ; Lice Infestations

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.
Adolescent ; Animals ; Child ; Child, Preschool ; Enterobiasis/*epidemiology/parasitology ; Enterobius/genetics/*isolation & purification/physiology ; Female ; Humans ; Hygiene ; Lice Infestations/*epidemiology/parasitology ; Male ; Orphanages/statistics & numerical data ; Pediculus/genetics/*physiology ; Prevalence ; Republic of Korea/epidemiology

BACKGROUND: Pediculosis continues to be a common yet neglected public health problem especially in children. Trials to test for effectiveness for head lice interventions are heterogeneous, and a recent systematic review recommended  the use of cluster randomization and centralized administration (e.g. school) of permethrin for pediculosis trials.

OBJECTIVE: To compare the effectiveness of a school-based to a home-based intervention using permethrin 1% shampoo in treating pediculosis capitis. 

METHODS: We conducted a pragmatic, cluster-randomized trial at the Makati Elementary School. All Grade Four students  (n = 211), belonging to a total of five class sections, were invited to participate in the study. Students with a known allergic reaction to permethrin 1% shampoo, with open wounds on the scalp, or were absent on Days 1 or 10 of the intervention period were excluded. The five class sections were randomized to receive permethrin 1% shampoo to be applied either in school, or at home. The students were classified as having none, light, medium, or heavy infestation prior to Day 1 and after Day 10 treatment. Prevalence, incidence, and treatment outcomes were measured.

RESULTS: The baseline prevalence of pediculosis capitis was 58.4%. General characteristics of students were similar between groups. No significant clustering in pediculosis classification was observed. The school-based group had the same prevalence in pediculosis at Days 1 and 10, had no incident cases, and were limited to light infestation by Day 10, but had no treatment success outcomes. The home-based group had increased prevalence by Day 10, poor compliance with Day 1 and 10 shampoo,  incident cases, although it registered a higher treatment success rate.

CONCLUSION: Compared to standard home based intervention, a school-based strategy resulted in less incident cases (0% vs. 37%), reduction in pediculosis severity (p = 0.007), and higher compliance (100% vs. 58.3%). Control of pediculosis in this specific community is largely warranted because of its high prevalence rate of 59.7%.

 

Human ; Male ; Female ; Child ; Pediculus ; Lice Infestations ; Permethrin ; Scalp ; Public Health ; Schools ; Treatment Outcome ; Students ; Hypersensitivity

BACKGROUND: Resistance to standard permethrin lotion has been reported. There is a continuing search for more natural and safe remedies for head lice infestation among children. Citronella, a natural repellant, has been reported as a pediculocide.
OBJECTIVE:To compare the efficacy of Citronella shampoo versus 5% permethrin lotion in controlling head lice (Pediculosis humanus capitis) among children between 5 years old.
METHODS: A double-blind randomized clinical trial was performed at the community outpatient department of MPI-Medical Center Muntinlupa Foundation, PNR (Phil. National Railway) Site Bgy. Putatan, City of Muntinlupa. Children living in areas endemic for head lice were screened, and if found positive, were randomized equally to daily citronella shampooing (CS) or permethrin lotion (PL). Subjects were manually 2nd, 7th and 14th day of treatment. Chi-square test was used to compare proportions, which considered p-values less than .05 as statistically significant.
RESULTS: Eighty-two children with head lice were included in the final analysis. Children in both groups were comparable in terms of age, sex, family size with head lice, anthropometric measures, frequency of bathing and shampooing and baseline severity of head lice infestation. Citronella shampoo was as effective as the standard 5% permethrin lotion in eradicating head lice in children. The cure rates were comparable for day 2 (CS=65.1% versus PL=72.1%, p=.76), day 7 (CS=65.1% versus PL= 79.1%, p=.30), and day 14 (CS=81.4% versus PL =90.7%, p=33) of treatment. There were no re-infestations and adverse reactions noted for the use of Citronella and the refragrance was more acceptable.
CONCLUSION: Citronella is a effective as Permethrin lotion in the eradication of headlice and Citronella shampooing can be an alternative natural remedy of headlice and Citrone for pediatric head lice.

Human ; Male ; Female ; Adolescent ; Child ; Child Preschool ; Pediculus ; Lice Infestations ; Cymbopogon ; Permethrin ; Outpatients ; Family Characteristics ; Antiparasitic Agents

OBJECTIVETo determine the prevalence of infestation with head lice in primary schoolchildren in the eastern area of Bangkok, Thailand.

METHODSThe present study was to determine the head lice infestation (Pediculosis) levels in primary schoolchildren, during May, 2011 to July, 2011, A total of 3 747 schoolchildren aged 5-12 years old from 12 selected primary school of Ladkrabang district, the eastern area of Bangkok were examined for head lice. Pediculosis was defined as the presence of at least on living adult, nymph and viable egg.

RESULTSThe overall head lice infestation rate was 23.32% and infestation rate was higher in girls (47.12%) than in boys (0%). The infestation rate among schoolchildren varied from 12.62% to 29.76%. The infestation rate among girls varied from 26.07% (12 years old group) to 55.89% (8 years old group).

CONCLUSIONSPediculosis is a common public health problem affecting primary schoolchildren in eastern area of Bangkok and those levels are epidemic importance.

Animals ; Child ; Child, Preschool ; Female ; Humans ; Lice Infestations ; epidemiology ; Male ; Pediculus ; Prevalence ; Scalp Dermatoses ; epidemiology ; Students ; statistics & numerical data ; Thailand ; epidemiology

The aim of this article is to provide guidelines to diagnosis and therapeutics for HLI in Korea. Head lice infestation (HLI) caused by Pediculus humanus capitis is still common in Korean children in spite of an improvement since the 1980s in the country's economic status and the concepts of hygiene. HLI is troublesome and, if not treated, can lead to secondary bacterial infection as a result of scratching of the irritated scalp induced by an inflammatory reaction to injected saliva or anticoagulant. In addition, HLI causes social and psychological problems as well as physical symptoms. Confirmation of the HLI depends on identification of adult lice, nymphs, or viable nits. Nits are more commonly found at the nape of the neck and retroauricular areas. The differential diagnosis includes hair casts, dandruff, and debris by hair spray. Few chemical shampoos such as those containing lindane or pyrethrin are currently available in Korea. Although HLI is an important public health issue in Korea, little information is available on HLI. Medical doctors, school nurses, and teachers should be acquainted with HLI for the successful control of this disease, which is distressing a number of children covertly.
Adult ; Arthropods ; Bacterial Infections ; Child ; Diagnosis, Differential ; Hair ; Humans ; Hygiene ; Korea ; Lindane ; Neck ; Nymph ; Pediculus ; Phthiraptera ; Public Health ; Saliva ; Scalp ; Skin ; Skin Diseases

Head louse infestation (HLI) is one of the most frequently occurring parasitic diseases in children. This study was conducted to investigate the socioeconomic and personal factors influencing HLI in the Republic of Korea. A total of 2,210 questionnaires about various factors related to HLI were obtained from children in 17 primary schools throughout the country. The rate of HLI was significantly lower in children who lived together with mother or in a family where both parents worked. In addition, HLI was lower in children whose fathers or mothers were public officers or teachers. However, HLI was higher in children who had small families and washed their hair less often. Education levels of parents and the number of children in family were not significant. Improvement of socioeconomic factors and personal hygiene will be helpful for reducing HLI.
Animals ; Child ; Educational Status ; Family ; Female ; Humans ; Lice Infestations/*epidemiology/parasitology ; Male ; Pediculus/*physiology ; Questionnaires ; Republic of Korea/epidemiology ; Risk Factors ; Socioeconomic Factors