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      Is Hair Lice Still a Public Health Problem?

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          Pediculosis capitis: new insights into epidemiology, diagnosis and treatment.

           H Feldmeier (2012)
          Pediculosis capitis is a ubiquitous parasitic skin disease caused by Pediculus humanus capitis. Head lice are highly specialised parasites which can propagate only on human scalp and hair. Transmission occurs by direct head-to-head contact. Head lice are vectors of important bacterial pathogens. Pediculosis capitis usually occurs in small epidemics in play groups, kindergartens and schools. Population-based studies in European countries show highly diverging prevalences, ranging from 1% to 20%. The diagnosis of head lice infestation is made through the visual inspection of hair and scalp or dry/wet combing. The optimal method for the diagnosis of active head lice infestation is dry/wet combing. Topical application of a pediculicide is the most common treatment. Compounds with a neurotoxic mode of action are widely used but are becoming less effective due to resistant parasite populations. Besides, their use is restricted by safety concerns. Dimeticones, silicone oils with a low surface tension and the propensity to perfectly coat surfaces, have a purely physical mode of action. This group of compounds is highly effective and safe, and there is no risk that head lice become resistant. The control of epidemics requires active contact tracing and synchronised treatment with an effective and safe pediculicide.
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            Pediculosis capitis.

            Pediculosis capitis is a worldwide public health concern. Infestation occurs most commonly in children, with a peak incidence between 5 to 11 years of age. The condition is more common in girls and less common in Black children. Direct head-to-head contact is the most common mode of transmission. Pruritus is the most common symptom of infestation. The gold standard for diagnosing pediculosis capitis is finding a live louse or nymph in the scalp or viable egg in the scalp hair. Pediculicides are the most effective treatment. All household members and close contacts should be examined and treated concurrently if infested. The child should be allowed to return to school or to a child care facility after proper treatment. The child should be discouraged from close, direct head contact with others or from sharing items that have come in contact with the hair.
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              Prevalence of Head Lice Infestation and Its Associated Factors among Primary School Students in Iran: A Systematic Review and Meta-analysis

              Objectives Head lice infestation is one of the most important health problems, generally involving children aged 5–13 years. This study aims to estimate the prevalence of head lice infestation and its associated factors among primary school children using systematic review and meta-analysis methods. Methods Different national and international databases were searched for selecting the relevant studies using appropriate keywords, Medical Subject Heading terms, and references. Relevant studies with acceptable quality for meta-analysis were selected having excluded duplicate and irrelevant articles, quality assessment, and application of inclusion/exclusion criteria. With calculating standard errors according to binomial distribution and also considering the Cochrane's Q test as well as I-squared index for heterogeneity, pediculosis prevalence rate was estimated using Stata SE V.11 software. Results Forty studies met the inclusion criteria of this review and entered into the meta-analysis including 200,306 individuals. Using a random effect model, the prevalence (95% confidence interval) of head lice infestation among primary school children was estimated as 1.6% (1.2–2.05), 8.8% (7.6–9.9), and 7.4% (6.6–8.2) for boys, girls, and all the students, respectively. The infestation rate was found to be associated with low educational level of parents, long hair, family size, mother's job (housewife), father's job (worker/unemployed), using a common comb, lack of bathrooms in the house, and a low frequency of bathing. Conclusion This meta-analysis revealed that the prevalence of head lice infestation among Iranian primary school children is relatively high with more prevalence among girls. We also found that economic, social, cultural, behavioral, and hygienic factors are associated with this infestation.

                Author and article information

                [1. ] Dept. of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
                [2. ] Dept. of Laboratory Sciences, Faculty of Paramedicine, Tabriz University of Medical Sciences, Tabriz, Iran
                [3. ] Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
                [4. ] Faculty of Paramedicine, Tabriz University of Medical Sciences, Tabriz, Iran
                [5. ] Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
                Author notes
                [* ] Corresponding Author: Email: Behroz.mahdavi@
                Iran J Public Health
                Iran. J. Public Health
                Iranian Journal of Public Health
                Tehran University of Medical Sciences
                December 2016
                : 45
                : 12
                : 1671-1672
                5207115 ijph-45-1671
                Copyright© Iranian Public Health Association & Tehran University of Medical Sciences

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

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