Parental attitudes towards head lice infestation in Greece

Background Pediculosis capitis constitutes a growing problem worldwide and is usually considered as an inconvenience. Parents often handle this infestation on their own initiative. Objective We conducted a survey in order to depict the parental attitudes towards head lice infestation in Greece. Methods Parents of children aged 3–14 years, attending a dermatology outpatient clinic at a children’s hospital, were given a questionnaire regarding head lice. Demographic data, management, and prevention strategies were included in the questionnaire. Results Three‐hundred and seventy‐two complete questionnaires were analyzed (response rate: 89%). Pediculosis capitis was more prevalent in the age groups 3–5 years and 6–8 years. The percentage of parents of infested children who sought advice on treatment from the pharmacist was 73%, and only 15% consulted their doctor. Chemical agents to treat head lice were used by 59% of them, products containing natural oils by 38%, and wet combing in parallel was employed by 79% of them. Preventive measures were employed by 66% of the respondents, and 54% applied botanical and synthetic products commercially available for this purpose. Conclusion There is a trend towards the use of natural oils for either prevention or treatment. More needs to be done to promote public education and rational use of either pediculicides or non‐pharmacological agents for pediculosis capitis infestation.     

Prevalence of head lice infestation and pediculicidal effect of permethrine shampoo in primary school girls in a low-income area in southeast of Iran

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 < 0.05). The effectiveness of 1% permethrin shampoo for head lice treatment was 29.2, 68.9, and 90.3% after the first, second, and third weeks, respectively.

Conclusion

The head lice infestation is a health problem in primary school girls of Bashagard County. Improvement of socioeconomic status and providing appropriate educational programs about head lice risk factors and prevention can be effective for reduction of infestation in this area.

Trial registration

This trial has been registered and approved by Hormozgan University of Medical Sciences ethical committee (Trial No.764). Trial registration date: March 17 2014.

     

The prevalence of skin conditions in Romanian school children

Virtually nothing is known about the prevalence of skin conditions in children in the general population. Although we know something about the relative frequency of skin conditions seen by dermatologists, we do not know how such referrals are influenced by factors such as social class, accessibility to medical services or educational and cultural background. In order to estimate the burden and relative frequency of dermatological disease in children in the community, we measured the point prevalence of skin conditions in 1114 Romanian schoolchildren aged 6-12 years, using the British Association of Dermatologists diagnostic index. The overall point prevalence of children with one or more skin diseases was 22.8%, with no significant differences according to age group or sex, except for pityriasis alba which showed a male predominance (P = 0. 007). The most common diseases were infectious dermatoses such as viral warts and insect bites (6.3%), dermatitis/eczema (5.1%), pityriasis alba (5.1%), keratosis pilaris (4.0%) and urticaria (1. 9%). Together, these five groups accounted for more than 84% of the cases. Of the 1114 children, 213 (19.1%) had only one skin disease and 41 (3.7%) had two skin diseases. While acknowledging the limitations in defining which skin conditions can benefit from medical care, this study suggests that skin disorders are common in Romanian schoolchildren, affecting about one-quarter of 6-12 year olds. Such a point prevalence is likely to be conservative because of the tendency of prevalence estimates to exclude many other dermatoses of short duration. The finding that over 80% of the disorders can be grouped into fewer than six categories is important in informing training programmes and delivery of service for primary health care teams. This study provides a baseline for further studies into the morbidity and use of health care services by children with skin disease in the community.     

The importance of socio-economic status and individual characteristics on the prevalence of head lice in schoolchildren

Pediculosis is a common infestation in schoolchildren but little is known about the factors influencing its prevalence. The aim of this study was to determine the prevalence of head lice in schoolchildren in Ghent and to investigate the independent association between individual characteristics of the child, socio-economic status (SES) of the family and head lice. The prevalence of head lice at baseline and 14 days after treatment advice was determined by the wet combing method in a total of 6,169 schoolchildren age 2.5 to 12 years from Ghent (Belgium). Age, sex, educational level and hair characteristics of the child, SES of the family, and number of children in the family was collected by the school health department. The prevalence of head lice was 8.9%. The only statistically significant factors at the child level are SES, the number of children in the family, hair length and hair colour. Treatment failure was recorded in 41% of the children positive at baseline screening and was significantly related to hair colour and SES. This study demonstrated that the prevalence of head lice is determined by clustering of children rather than by characteristics of the child. The management of head lice should take a community-based approach equally involving families, schools, health care professionals and the government.     

The darker side of head lice infestations

Head lice (Pediculus humanus capitis) infestations are prevalent among young children and generally not considered a health hazard. Although massive chronic head lice infestations have been documented in paleo medical literature, their association with severe iron deficiency anemia has been rarely discussed in modern medicine. A recently published case implicating a head lice infestation as the cause of death of a 12-year-old girl brings this topic to the fore. This contribution discusses the available information concerning the circumstances under which this girl died and the ongoing criminal investigation as a springboard for discussion of how head lice infestations may serve as forensic and legal evidence and as a warning sign of mental illness, abuse, neglect, and rape.     

Fomite transmission in head lice

Control of various infestations requires an accurate understanding of transmission. After thousands of years of lice infestation, scientific documentation of indirect contact transmission has been substantiated. Lice can be transferred in the egg, instar, and adult stages. Lice have now been shown in the laboratory to be readily dislodged by air movements such as blow-drying one's hair, combing, and toweling. Moreover, passive transfer to adjoining fabric is also frequently observed. Louse transmission by fomites occurs more frequently than has been commonly believed. Close proximity suffices to increase the likeliness of a new infestation. Thus louse control measures should take account of fomite transmission and include screening of all individuals within an infested person's immediate circle of contact, laundering of everything within the infested individuals' bed or quarantining of such material for 10 days, thorough vacuuming of floors, carpets, upholstery, with a standard vacuum cleaner.     

Head lice infestation in schoolchildren and related factors in Mafraq governorate, Jordan

Background Little is known about the effect of socioeconomic status on the infestation by head lice in schoolchildren in Jordan. Materials and methods A cross‐sectional school‐based study was conducted from December 2009 to February 2010. A list of all primary schools in Mafraq governorate was obtained (394 primary schools). Eight primary schools were randomly selected (four male schools and four female schools). Data were collected by five well‐trained nurses. Hair was examined for head lice as well as for eggs/nits. Analysis of data was conducted by using SPSS software version 16. The chi‐square test was used to assess statistical significance of subgroup differences in the prevalence of infestation, and multivariate logistic regression was used to control for potential confounding. Results Out of 1550 primary schoolchildren screened, 412 (26.6%) were infected with lice, 163 (19.6%) boys and 249 (34.7%) girls. The results showed significant variations in head lice infestation by factors such as gender, age, and socioeconomic variables (family income, father’s education, mother’s education, number of rooms, number of siblings younger than 15 years, frequency of hair washing per week, and bathing per week). There was no significant variation in lice infestation with parents’ occupation (P > 0.05). Conclusions Socioeconomic status is a major factor influencing the occurrence of pediculosis capitis among schoolchildren in both sexes. Improving standards of living and personal hygiene might significantly reduce pediculosis capitis in schoolchildren in Jordan.     

Getting ahead of head lice

Dermatologists are the nominal experts in the management of head lice in Australia, yet many dermatologists infrequently treat patients with this condition. Most people are managed in the community by school nurses, local council health officers, pharmacists, paediatricians or general practitioners. Only a small number will present to the dermatologist and commonly these patients will have tried a variety of treatments and failed to respond. Resistance is reported to all of the currently available insecticide treatments and this makes management of this common community-acquired infestation more involved.     

The prevalence of pediculosis capitis in schoolchildren in Mersin,Turkey

BACKGROUND: Pediculosis capitis is an endemic parasitosis affecting many countries of the world. The aim of this study was to investigate the incidence of head lice infestation in Mersin, Turkey. METHODS: A total of 5318 elementary schoolchildren, aged 8-16 years, were examined for the presence of Pediculus capitis. If any evidence of head lice was detected, such as live or dead eggs, or nits, the child was considered to be infected. The following details were recorded for each child: age, sex, family size, monthly income, number of siblings, parents' education, presence or absence of social security of the family, pet (cat or dog) ownership, and frequency of hair washing (per week). The chi-squared test and logistic regression analysis were performed to analyze the results. RESULTS: Pediculosis capitis was detected in 360 (6.8%) children. The prevalence of infestation was significantly higher in girls (13.3%) than in boys (1.1%) (chi2 = 313.2, d.f. = 1, P = 0.000). Children aged 8-9 years exhibited a significantly lower prevalence rate than those aged 10-11 years and those aged 12 years and above. The following variables were found to be statistically significantly related to pediculosis capitis: sex, age, father's education level, and pet ownership (cat or dog). CONCLUSIONS: Our results show that the prevalence of pediculosis capitis is not very high in Mersin, Turkey, and is observed in all schools regardless of the socio-economic and personal hygiene status of the children.     

Traffic-related air pollution, climate, and prevalence of eczema in Taiwanese school children

The prevalence of childhood eczema is increasing in many countries. Epidemiological studies, however, say little of its association to outdoor air pollution and climate factors. We conducted a nationwide survey of middle-school students in Taiwan from 1995 to 1996. The 12-month prevalence of eczema was compared with air monitoring station data of temperature, relative humidity, and criteria air pollutants. A total of 317,926 children attended schools located within 2 km of 55 stations. Prevalence rates of recurrent eczema were 2.4 and 2.3% in boys and girls, respectively, with prevalence rates of flexural eczema 1.7% in both sexes. After adjustment for possible confounders, flexural eczema was found to be associated with traffic-related air pollutants, including nitrogen oxides and carbon monoxide. Recurrent eczema was associated with traffic-related air pollution only in girls. There were no associations for the highest monthly means of temperature, whereas the annual means and the lowest monthly means of temperature were negatively related to flexural eczema, but only in girls. The lowest monthly mean relative humidity was positively related to eczema. The results suggest that air pollution and climatic factors, which showed stronger associations in girls than boys, may affect the prevalence of childhood eczema.     

Assessment of the safety and efficacy of three concentrations of topical ivermectin lotion as a treatment for head lice infestation

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‐minute application of product on day 1. Evaluations were completed at two and six hours 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 six hours 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.