Lice Comb Research Articles

Local Solutions against Head Lice: A Comparative Study in Nepalese Schools

Background: Infestation by the human head louse Pediculus humanus var capitis is one of the most common parasitic conditions among children worldwide. Availabiliy of commercial products against head lice is often limited in low‐ and middle‐income countries. Different versions of homemade anti-lice solutions were assessed and compared. In addition, differences in results between using a metal louse comb and a plastic one were also evaluated. Method: In five schools of the Kathmandu Valley, 1,323 schoolchildren were screened for this study, designed as a comparative satisfaction survey. Theatre was used as a tool encourage an open dialogue on this much-stigmatized topic. Results: Out of 351 children affected by lice, 208 were included in the final analysis. In the group receiving the solution containing 5% of salt, vinegar, and a wetting agent, the proportion getting rid of head lice (parasite elimination-adults and nits) was 71,1% as compared to 56,8% with mustard oil (difference 14.4%, p-value=0,032). Among the two saline solutions tested, the one using 1% vinegar instead of 10% appeared just as effective, at less cost. Locally available plastic louse combs also appeared to be just as effective as the standard metal louse comb in eliminating head lice. Conclusions: This research programme showed that a product made with natural ingredients can satisfactorily combat head lice. At the same time theatre as a tool to neutralize the stigma accompanying head lice infestation may have helped in implementing the anti-lice program.

Head Lice: What You Need to Know

Head Lice: What You Need to Know

Polyplax brachyrrhyncha (Anoplura: Polyplacidae) and Rhipicephalus turanicus (Ixodidae: Rhipicephalinae) in an Ancient Louse Comb

A fine-toothed comb found in the Judean Desert and resembling an ancient louse comb was examined. Based on radiocarbon dating, it ranged between 1660 AD and 1950 AD. From the material accumulated between the teeth, an oribatid mite, a pseudoscorpion, exuviae of beetle larvae, a sucking louse (Polyplax brachyrrhyncha Cummings, 1915), as well as a fully engorged larva and a nymph of the ixodid tick Rhipicephalus turanicus Pomerantzev, 1936 were recorded. Additionally, the comb included numerous hairs of a spiny mouse (Acomys sp.). Although finding mites, beetle larvae, and a pseudoscorpion on a louse comb could be regarded as contamination, the findings of P. brachyrrhyncha, as well as of a larva and nymph of R. turanicus, are noteworthy. We hypothesize that the presence of animal lice and ticks could indicate some sort of pet grooming.

Antarctophthirus microchir infestation in synanthropic South American sea lion (Otaria flavescens) males diagnosed by a novel non-invasive method

Antarctophthirus microchir is a sucking louse species belonging to the family Echinophthiriidae and has been reported to parasitize all species of the subfamily Otariinae, the sea lions. Former studies on this ectoparasite mainly required fixation, immobilization, or death of host species and especially examinations of adult male sea lions are still very rare. Between March and May 2018, adult individuals of a unique “urban” bachelor group of South American sea lions (Otaria flavescens) living directly in the city of Valdivia, Chile, were studied regarding their ectoparasite infestation status. For first time, a non-invasive method in the form of a lice comb screwed on a telescopic rod and grounded with adhesive tape was used for sample taking process. Overall, during combing different stages of A. microchir were detected in 4/5 O. flavescens individuals, especially at the junction between the back and hind flippers. Our findings represent the first report of A. microchir infesting individuals of this synanthropic colony and fulfilling complete life cycle in a sea lion group despite inhabiting freshwater and in absence of females/pups. Our “telescopic lice comb apparatus” offers a new strategy to collect different stages of ectoparasites and a range of epidermal material, such as fur coat hair and superficial skin tissue for a broad spectrum of research fields in wildlife sciences in an unmolested and stress reduced manner.

Prevalence and Determinants Factors that Influence the Behaviour of People with Pediculosis Capitis in Orphanage

Pediculosis capitis infestation is caused by Pediculus humanus capitis louse. The prevalence of the disease is still quite high in Indonesia. This disease can cause a variety of problems, from reduced self-esteem, negative social stigma, lack of quality sleep and learning disorders. The study aimed to determine the prevalence and determinants factors that influence the behavior of people with pediculosis capitis in orphanage Kemuning. The cross-sectional design were sampled whole orphanages in the three subdistrict. The respondents were interviewed and examined with pediculosis using a lice comb and a magnifying glass. Later, parasites were storage into bottles containing 70% alcohol. Results showed the prevalence of pediculosis capitis 62% (36 respondents). The highest category was in the age 11-16 years (50.9%); female (60%) and elementary education (54.5%). Based on the illness practice (100%) of the respondents had a bad illness behavior. There is no relationship of age, gender, education, and perception of illness behavior. Further research should proceed on best practice toward disease.

Can neem oil help eliminate lice? Randomised controlled trial with and without louse combing

Background: Neem oil and wet combing with conditioner are both claimed to facilitate elimination of head louse infestation. The aim of this pilot study was to identify whether a 1% neem oil lotion showed activity itself and/or enhanced the effectiveness of combing in treating infestation. Methods: We treated 47 participants with 1% neem-based lotion on four occasions 3-4 days apart in a randomised, community based trial, analysed by intention to treat. The participants were randomly divided between two groups: One group used a grooming comb (placebo) and the other a head louse detection and removal comb (wet combing with conditioner method) to systematically comb the hair. Cure was defined as no lice on both Day 10 and Day 14. Results: The cure rates of 6/24 (25.0%) for the placebo comb group and 8/23 (34.8%) for the louse comb group were not significantly different. Conclusion: These results indicate that this formulation of neem oil was ineffective in the treatment of head louse infestations, even when accompanied by combing. Both combing methods were also ineffective, despite being implemented throughout by trained professionals.

Management and Treatment of Human Lice.

Of the three lice (head, body, and pubic louse) that infest humans, the body louse is the species involved in epidemics of louse-borne typhus, trench fever, and relapsing fever, but all the three cause pediculosis. Their infestations occur today in many countries despite great efforts to maintain high standards of public health. In this review, literature searches were performed through PubMed, Medline, Google Scholar, and EBSCOhost, with key search words of “Pediculus humanus”, “lice infestation”, “pediculosis”, and “treatment”; and controlled clinical trials were viewed with great interest. Removing lice by hand or with a lice comb, heating infested clothing, and shaving the scalp were some of the oldest methods of controlling human lice. Despite the introduction of other resources including cresol, naphthalene, sulfur, mercury, vinegar, petroleum, and insecticides, the numbers of lice infestation cases and resistance have increased. To date, viable alternative treatments to replace insecticides have been developed experimentally in vitro. Today, the development of new treatment strategies such as symbiotic treatment and synergistic treatment (antibiotics + ivermectin) in vitro has proved effective and is promising. Here, we present an overview on managing and treating human lice and highlight new strategies to more effectively fight pediculosis and prevent resistance.

Head Lice Prevalence and Associated Factors in Two Boarding Schools in Sivas

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. 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. 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 < 0.05). Children who had been infested in the past (27.1%) were more likely to be infested than those who had not been infested previously (7.2%) (p < 0.05). The same was true for children whose family members were previously infested and those who were not (30% and 8.5%, respectively) (p < 0.05). Head lice infestation was highest (20%) in children aged 6-11 and lowest (5.3%) in children aged 13-15 (p < 0.05). The frequency of bathing and washing their hair, sharing combs, beds and towels, the hair color, hair thickness and quantity of dandruff, the number of family members and number of rooms per family member, were not significantly different between infested and non-infested children, A significant difference was found in the infestation of long haired (15.1%) compared with short haired pupils (4.5%) (p < 0.05). Girls were more often infested than boys and children who were previously infested with lice, or came from families where there had been previous infestation, had a greater chance of being re-infested.

Reindeer Warble Fly–associated Human Myiasis, Scandinavia

Reindeer Warble Fly–associated Human Myiasis, Scandinavia

Efficacy of a grapefruit extract on head lice: a clinical trial

Twenty children aging 2-9 years old--four boys with short hair and 16 girls with long hair--were included in a clinical test on the efficacy of a product against head lice (Pediculus humanus capitis). Their hair were exposed to Licatack, which is a recently developed new anti-louse medicinal product containing extracts of grapefruits besides high quality shampoo components. Prior to this field trial, the product Licatack was tested dermatologically to be skin safe receiving the grade "very good". The children's mothers combed the kids prior to the start of the test in order to confirm that they were all lice-infested. The obtained lice were used for in vitro tests. All children were heavily infested. After combing and preservation of the living lice, the hair was wet with tap water. Then, 50 ml of the Licatack shampoo was placed onto the top of each child's head. Then, the mothers distributed the rather fluid product all over the hair thoroughly from their base at the skin until the free end. During this process, a type of massage, the product became foamy and it was easily recognized where the product covered the hair, thus, avoiding untreated spots. The hair of half of the treated children were washed with tap water after 10 min of exposition; while in the other half of the children, the exposition period was prolonged to 20 min before washing. When combing the kids with a metal louse comb after the washing, the lice were found immobile and they did not recover during the following observation period of 4 h. Only two lice from the group with an exposition time of only 10 min showed some slight leg movements after they had been combed off, but they died within the next 2 h. Thus, this new anti-louse medicinal product has a very quick and efficient activity besides its advantages of being non-inflammable, skin safe, and nice smelling. None of the kids claimed any burning at the skin or other side effects, although the skin showed, prior to treatment, lots of scars due to louse bites. The dead lice always appeared considerably shrunken due to drying. The second treatment after 10 days revealed a few dead larval stages since, apparently, some larvae (apparently treated at an early stage of development when treated) had hatched from the extremely numerous nits in the period between first and second treatment. Experiments with cutoff nits, however, showed that the product also kills larval stages inside nits.

Head Lice Treatments and School Policies in the US in an Era of Emerging Resistance

Head lice are a common infection in school-age children worldwide. Several authorities in the US have recommended different treatments and school policies in order to control this disease. Recent concerns of emerging lice resistance worldwide raise the necessity to reassess the current recommendations. To perform a cost-effectiveness analysis (from the US caregiver perspective) of three head lice treatments commonly used in the US, permethrin 1%, malathion 0.5% and the lice comb, in order to evaluate the cost effectiveness of different treatments in the current era, and to explore the effect of different factors in this analysis. We used a decision-tree model to represent the costs and effectiveness of the different treatment strategies. A patient/caregiver perspective was applied, with a time horizon of 2 weeks. Probabilities of treatment success or failure of the three treatments were based on the literature. Effectiveness was measured as the successful eradication of head lice, and costs - including the costs of the treatment, the physician co-pay and the costs of days out of school - were calculated. One-way and multi-way analyses were performed using decision analysis software (Treeage Pro Healthcare 2008). Combing was dominated by permethrin 1%. The incremental cost-effectiveness ratio of malathion 0.5% versus permethrin 1% was $US161.75 per cure. For caregivers whose willingness to pay is <$US161.75 per cure, permethrin 1% is the most cost-effective option. For those with a willingness to pay of > or =$US161.75 per cure malathion 1% may offer the highest net monetary benefit. Twenty percent of the uncertainty in the model is due to variation in permethrin 1% resistance, and approximately 73% of the total variability of the model is attributed to the number of days the student has to be out of school because of the school's policy. Our study suggests that permethrin 1% was the most cost-effective treatment for those with a willingness to pay of <$US162 per cure. Sensitivity of lice to permethrin and the specific school head lice policy had major effects on the model. Thus, informing communities in a given geographical area about the degree of head lice resistance and sensitivity is necessary in order for the public to make a rational decision regarding treatment. Schools' head lice policies have a major effect on the cost of head lice treatments.

The impact of well-developed preventative strategies on the eradication of head lice

In the 1970s Donaldson applied the principles of infectious disease surveillance to pediculosis capitis infestation with head lice. This provided a lasting insight into an effective strategy for prevention. Research in Teesside, UK, proved that the first step in breaking the chain of transmission is the engagement of parents in an intensive detection/treatment campaign. United action halved the infestation rate, even though failing lindane treatments were in use. Subsequently although effective malathion treatment was introduced, it became clear that the late detection of light cases of head lice still undermines eradication. This paper analyzes the development by the health charity, Community Hygiene Concern, of the Bug Busting programme based on this solid evidence. In the 1990s the charity solved the problem of detecting asymptomatic lice using a specially designed Bug Buster louse comb in wet, conditioned hair. It undertook the popularization of this method and the co-ordination of national detection days (Bug Busting Days) through primary schools. In 2004 this structured approach to prevention was adopted in Chester. It produced a 24% reduction in health authority spending on treatment products in the first year and appreciable savings in professional time. It is concluded that participation in the Bug Busting programme benefits community health providers and schools. Provision of dependable detection combs with the correct instructions to families at risk, empowers them to gain sustainable, cost-effective control of head lice.

The louse comb: past and present

Louse combs were used for centuries for the control of louse infestations and became redundant with the introduction of pediculicides. The oldest combs, which are similar to today's louse combs, are known from 1,500 B.C. Royal combs from Pharonic times in Egypt were used for delousing. Most of the combs were two-sided: one side of the comb was used to untangle knots in the hair while the other side with the fine teeth was used to remove lice and eggs. Most combs found in archaeological excavations were made of wood; some were made from bone and ivory. Today, there are a large number of plastic and metal combs on the market, which are used for the detection of head lice but also to control louse infestations and remove the nits from the hair. A battery-operated louse comb was developed to electrocute lice. There is also a battery-operated vibrating comb, which can open the hair knots and expel lice from the hair.

Prevention and treatment of head lice in children.

Head louse infestations (pediculosis) are prevalent worldwide. In developed countries, the infestation rate of 4- to 13-year-old children remains high despite preventive efforts. This is due to the existence of numerous ineffective pediculicides, the incorrect use of the effective agents, toxicological concerns and the development of louse strains resistant to insecticides. One of the most effective tools for the prevention and control of lice is the louse comb, which should be used regularly for the detection of living lice at an early stage of infestation, and as an accessory to any treatment method to remove living and dead lice. The louse comb can also be used systematically for the treatment of infestations, for confirmation that treatment with pediculicides has been successful, and for the removal of nits (dead eggs or egg shells). Most pediculicides are only partially ovicidal. Therefore, 10 days after beginning treatment with any antilouse product, the scalp of the child should be examined. If no living lice are found, the treatment should be discontinued. If living lice are still present, treatment should be continued with a product containing a different active ingredient. Suffocating agents such as olive, soya, sunflower and corn oils, hair gels and mayonnaise are able to kill a significant number of lice only if they are applied in liberal quantities for more than 12 hours. However, they lubricate the hair and therefore may facilitate combing and removing lice and eggs from the scalp. Nits may remain glued on the hair for at least 6 months, even after a successful treatment, and lead to a false positive diagnosis of louse infestation. If nits are seen on the hair, the child should be examined, but treatment should be initiated only if living lice are found. Formulations containing 5% acetic acid or 8% formic acid, as well as acid shampoos (pH 4.5 to 5.5) and conditioners, in combination with a louse comb, can be helpful for removing nits. There is no conclusive evidence that using essential oils to repel lice is effective. Regular examination of the child's head using a louse comb is the best measure to detect re-infestation at an early stage. Educating caregivers, nurses and teachers about louse biology, epidemiology, prevention and control is of paramount importance. The psychological effect of an infestation with lice is significant and often associated with anxiety and fear. The child should not be made to feel responsible for having lice, or be punished or reprimanded.

Control of Human Lice (Anoplura: Pediculidae) Infestations: Past and Present

Removing lice by hand or with a lice comb, and shaving the scalp and body, were some of the oldest methods of controlling human lice. Date flour was used in the 16th century B.C. for this purpose. Later, quicksilver, cresol, naphthalene, sulphur, mercury, and kerosene, alone or in combination with oil and vinegar, also were applied. Today, insecticides used for the treatment of head and body lice include organochlorines (DDT, lindane), organophosphates (malathion), carbamates (carbaryl), pyrethrins (pyrethrum), and pyrethroids (permethrin, phenothrin, and bioallethrin). Despite the introduction of these effective insecticides, the number of cases of lice infestation has increased worldwide since the mid-1960s, reaching hundreds of millions yearly. This is because most of the products in the market are either ineffective formulations, or they have lost their efficacy because of the development of resistant strains of lice. Cross-resistance of lice to different pyrethroids has been reported in Israel and several European countries. Mosaic treatment, rotation of the pediculicides, and combination of 2 insecticides within the same formulation, should be implemented to slow the development of resistance. Future efforts should be directed toward the development of pediculicides based on new chemicals. Biological control of lice in humans may be of scientific interest only. Education of the parents on the biology and control of head lice is important.

Deer Ked Infestation on White-Tailed Deer in East Texas

Deer Ked Infestation on White-Tailed Deer in East Texas