Abstract
Head lice (Pediculus humanus capitis) are one of the most common insects causing infestations in humans worldwide, and infestation is associated with adverse socio-economic and public health effects. The development of genetic insensitivity (e.g., target site insensitivity = knockdown resistance or kdr) to topical insecticides has impaired effective treatment. Therefore, this study was undertaken to review and meta-analyze the frequency of pyrethroid resistance in treated head louse populations from the beginning of 2000 to the end of June 2021 worldwide. In order to accomplish this, all English language articles published over this period were extracted and reviewed. Statistical analyses of data were performed using fixed and random effect model tests in meta-analysis, Cochrane, meta-regression and I2 index. A total of 24 articles from an initial sample size of 5033 were accepted into this systematic review. The mean frequency of pyrethroid resistance was estimated to be 76.9%. In collected resistant lice, 64.4% were homozygote and 30.3% were heterozygote resistant. Globally, four countries (Australia, England, Israel, and Turkey) have 100% kdr gene frequencies, likely resulting in the ineffectiveness of pyrethrin- and pyrethroid-based pediculicides. The highest resistance recorded in these studies was against permethrin. This study shows that pyrethroid resistance is found at relatively high frequencies in many countries. As a result, treatment with current insecticides may not be effective and is likely the cause of increased levels of infestations. It is recommended that resistance status be evaluated prior to insecticide treatment, to increase efficacy.
Highlights
Infestations of humans by Pediculus lice (Pediculosis) are increasing both in developed and developing countries alike [6]
This review focused on studies about kdr gene mutations and treatment of head lice that were published in English language journals between the year 2000 and June 2021
The Scopus, Web of Science, PubMed, Cochrane database library and Science Direct databases were searched in medical subject headings (MeSH) and relevant keywords: Resistance, Knockdown Resistance, Insecticide Resistance, Pyrethroid Resistance, Pediculicide Resistance, Genetic Diversity, Molecular Monitoring, Resistance Mutations, Head Lice, Head Louse, Pediculosis, and Treatment
Summary
Infestations of humans by Pediculus lice (Pediculosis) are increasing both in developed and developing countries alike [6]. Head lice usually live on the scalp and body lice are commonly found in the folds of clothing of infested people. The global prevalence rate of head louse infestation is about 19%, as reported in a recent meta-analysis-based systematic review [32]. These data reflect the scope and variability of this problem
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