Evaluation of a Potential Association between Head Lice (Pediculus capitis) Infestation and Anemia among Female Primary School Students in Holy Makkah, Saudi Arabia

Aims: This study aimed to determine if there was an association between head lice infestation and anemia among female primary schools students. Study Design: Case-control study. Place and Duration of Study: Holy Makkah, Saudi Arabia between August 2020 and November 2020. Methodology: We conducted a case-control study by comparing hemoglobin levels among study subjects with and without head lice infestation. Female students at 6 randomly selected primary schools were examined for the presence of head lice. Hemoglobin levels were obtained from each study subject; both those with and without head lice. Selected characteristics of study subjects were recorded and examined to determine associations between those factors and anemia. Results: A total of 82 subjects were included in the study; 44 subjects with head lice. The average (± standard deviation) age of subjects was 11 (± 2) (range: 6-11) years. We found a significant (p<0.028) association between the presence of head lice and hemoglobin level, the OR= 2.036 at 95% confidence interval 0.23 to 18.009. The mean of hemoglobin in subjects with lice was 13(±2) while the level in subjects without lice was 14.8(±2). Other factors significantly associated with the level of hemoglobin were being aged 10-11 years (p<0.05) and having a non-working mother (p<0.05). Conclusion: In our study we found a significant association between head lice and level of hemoglobin among study subjects. Further studies are needed to determine the reason of this association in order to determine the appropriate management and prevention of this problem.

Children’s Perception Scale of Head Lice Infestation (CPS-HLI): Design and Psychometrics

Background: Pediculosis is a common ectoparasitic infestation that involves especially the skin of children worldwide. Studying the children’s perception of the disease’s risk factors, the effectiveness of personal preventive measures, and its implications for their health could be a major leap forward in health promotion activities. Objectives: This study aimed to develop and evaluate the psychometric properties of the Children’s Perception Scale of Head Lice Infestation (CPS-HLI) and its initial feasibility assessment for use on Iranian and possibly other elementary school children. Methods: The scale’s items were retained based on an extensive literature search and classified into the underlying constructs of the Extended Health Belief Model (EHBM). An expert panel endorsed the qualitative content and face validity of the preliminary draft, and 47 items remained for quantitative validity testing on a sample of 362 elementary school students in the city of Paveh, West of Iran. Explanatory and confirmatory factor analyses (EFA and CFA) were employed to test the content and structural validity of the constructed instrument. Cronbach's alpha and intra-class correlation coefficients were calculated to assess the internal consistency and reliability of the scale. Results: The values of Lawshe's content validity index (0.90) and content validity ratio (0.77), the subscales’ Cronbach's alpha (0.59), and intra-class correlation (0.72) coefficients confirmed plausible internal consistency of the scale. The values of root mean square error of approximation (RMSEA) (< 0.08 with χ2 < 0.05), Tucker-Lewis Index (TLI), and Comparative Fit Index (CFI) > 0.9 approved the applied statistical model’s goodness of fit. The ranges of Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy for the underlying subscales (0.49 - 0.74) and the statistically significant result of Bartlett’s test of sphericity (P < 0.001) confirmed the patterned relationship among the constructed scale’s items. The principal component analysis that was performed using STATA favored the 11-factor solution. Conclusions: The study findings support the construct validity of CPS-HLI for use in studies on children’s perception of head lice infestation risk factors, the effectiveness of personal preventive measures, and the disease implications for their health and well-being. Further cross-cultural and cross-national validation studies are recommended for using the instrument in a wider range of populations and settings.

The Effect of Educational Intervention on Efficacy of 1% Permethrin Shampoo and 4% Dimeticone Lotion to Treat Head Lice Infestation Using Propensity Score Matching (PSM)

Background Head lice are a main public health problem and the most important human ectoparasites and the use of pediculicides is the most common way to control it. One of the possible causes of treatment failure is the lack of improper application of pediculicide. The aim of this study was to assess the effect of education on efficacy of 1% permethrin or 4% dimeticone lotion to treat head lice infestation. Methods This quasi-experimental study was performed on 100 people infected with head lice in comprehensive urban health centers of Ardabil (intervention group) and 400 people of East Azerbaijan and West Azerbaijan (control group) provinces from April to March 2019. The data collection tool included demographic questionnaire and examination evidence recording sheet in terms of presence of hits or adult lice. Results The outcome of treatment included elimination of head lice infestation on days 7, and in the case of recurrence, it was considered on days 14 and 30 after treatment. Data were analyzed using R software and Generalized Estimating Equation method. GEE analysis showed there is significant difference in evaluating head lice over time. Conclusion Participants who received the training intervention (OR = 3.29; CI 95%: 2.21–4.88) were more likely to have a successful treatment than control group. In the case of providing proper training on the use of pediculicides and observing hygiene tips to patients with pediculosis, could help to successful treatment of pediculosis.

Topical ivermectin in the treatment of pediculosis capitis

Background: Head lice infestation is considered a prominent issue because of its worldwide distribution, especially among children. Millions of children are infested with pediculosis capitis every year. The increasing rate of lice infestation has been reported even in the developed countries due to the resistance to known pediculicides. Besides, the louse is a vector for serious diseases, such as epidemic typhus fever. Objective: The aim of this work was the search for a new cheap and effective drug for pediculosis capitis. 2% ivermectin solution, a promising novel drug used for endoparasite and ectoparasite infections, was used in this study. Materials and Methods: This was a clinical trial study. The in vitro study was carried out in a period of five months. Samples of nits and lice were collected from female patients of the Department of Dermatology and Venereology, Baghdad Teaching Hospital. The study was conducted during a period from October 2002 through November 2003. One hundred fifty children from four primary schools in Hayy Al-A’amel, Baghdad, participated in this part of the study. The preparation was applied to the children by the author. One hundred children were tested with ivermectin solution and fifty children with rectified spirit. The first part of the study involved a parasitological evaluation (in vitro study) of pediculicidal and ovicidal activity, in which 4% ivermectin solution was discontinued because of contact dermatitis. Therefore, 2% ivermectin solution was used instead. Pediculicidal and ovicidal activity was examined half an hour afterward. The second part of the study involved a clinical evaluation (in situ study) of 2% ivermectin solution for half an hour. Results: Topical 2% ivermectin solution in rectified spirit is a good pediculicidal (100%) and a good ovicidal (88%) drug with good therapeutic efficacy (82% after the first application, 90% after the second application) against pediculosis capitis. Conclusion: The study described a novel topical preparation for pediculosis capitis, which was proven effective and safe.

Occurrence of Tetracycline Residue in Table Eggs and Genotoxic Effects of Raw and Heated Contaminated Egg Yolks on Hepatic Cells

Background: This study measured tetracycline residue in table eggs sampled from Isfahan markets in 2015 and assessed the toxic effects of heated egg yolk on hepatic cells Methods: Forty commercial and six locally produced eggs were randomly collected and tested for tetracycline resides using competitive ELISA with a mean recovery value of 65.22% and limit of detection (LOD) of 4 ng/g. For the seven most contaminated samples, albumen and yolk were examined individually and, despite the very low detected level in the yolk, the samples were subjected to boiling for 10 min. Finally, the DNA damaging properties of the raw or treated egg yolks on hepatic cells were investigated using the comet assay. Results: The incidence rate of head lice infestation in Iran was 500,002/79,926,270 (625.5 per 100,000 populations). Economic burden of head lice in the country was calculated at 5,790,143$. Direct and indirect costs, governmental cost, out of pocket and total costs of head lice were included 3.14$, 2.84$, 5.98$, 5.60$ and 11.58$ per case respectively. Conclusion: The direct and indirect costs associated with treatment of infestations were relatively high. Therefore, the creation of medical facilities such as availability of diagnostic and treatment strategies can be effective in the control of infestation. The adoption of infestation prevention methods, such as health education to people at risk of infestation, reduces the incidence of head lice and imposition of related treatment costs on governmental health care system and head lice cases.

Eco-epidemiological factors' of Head Lice in 10-12 year-old girls in Birjand City in 2017

Introduction: Lice are external parasites found in all socioeconomic classes around the world, which infect millions of people, especially children aged 5-14 years. Considering the growing and epidemiological trend of head lice in recent years, despite careful health care, more prognosis is needed. Therefore, this study aimed to study eco-epidemiological factors of head lice in 10-12 year-old girls in Birjand City in 2017. Methods: This cross-sectional study with descriptive-analytic approach was conducted in Birjand City in the 2017. The participants were selected using cluster sampling method from girl primary schools in Birjand City and its suburb areas. Data were entered into SPSS version 22 and analyzed by logistic regression test at significant level of 0.0.5 Results: Head lice was evaluated in 2417 elementary school girls. The prevalence of head lice infection was 13.6% (n=329) in the population. The prevalence of contamination in urban areas was two times higher than the suburb areas. Significant correlations were observed between head lice infestation and father's education, mother's education, parent's job, family income, nationality, presence of foreigners in a class, habitat, history of previous student infections, presence of an infected person in the family, use of common Chador (piece of cloth worn by Muslim women to cover their body and hair) for praying at school. (p<0.05) Conclusion: The prevalence of head lice infection in the present study was higher than other studies. The prevalence of head lice infection was also higher in the suburbs. So, preventive measures, especially in the suburbs are required with regard to factors associated with infection by the health system.