Abstract
BackgroundHead 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.MethodsBefore 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 < 0.05 being taken as statistically significant.ResultsFrom 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.ConclusionsDimeticone 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 registrationCurrent Controlled Trials- IRCT2016041627408N1, Dated: 21-08-2017.
Highlights
Head lice infestation (Pediculosis) is one of the most important health challenges in primary school-aged children
Application of permethrin and lindane, a non-aromatic neurotoxic organochlorine insecticide, have produced comparable results in an earlier study [3], but permethrin was generally found to be more effective in a systematic review [14], while use of lindane is no longer recommended
From an overall population of 3728 female primary school students screened for head lice infestation at Kavar, Fars province, Iran, 87 (2.33%) girls were infested with live head lice
Summary
Head lice infestation (Pediculosis) is one of the most important health challenges in primary school-aged children It is often present among 6–11-year-old students in various tropical and temperate regions of the world. Pediculosis capitis or infestation with the human head lice, Pediculus humanus capitis De Geer, 1778 (Anoplura: Pediculidae), an obligatory ectoparasitic hematophagous insect on man [1], is still a persistent health menace to many socioeconomic groups worldwide. This disease is not self-healing, almost insidious and irritating [2]. Despite increasing knowledge on head lice control, burden of this infestation in communities has remained unbearable
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