Although pediculosis capitis is the most frequent parasitosis in childhood, reliable data on its epidemiology and morbidity are scarce. In Germany population-based data do not exist. During the routine medical examination of 5-6-year-old pre-school children in Braunschweig city (n=1 890) the children were also examined for the presence of head lice and head lice-associated pathology. Visual inspection of five predilection sites was used to diagnose head lice infestation. Knowledge of careers on head lice infestation and disease perception were analysed using a standardised questionnaire. Socio-demographic variables of the households to which the children belonged were correlated to current or historical head lice infestation. Head lice infestation was diagnosed in 14 out of the 1 890 children (0.7%). Considering the low sensitivity of visual inspection the true prevalence should be higher by a factor 3 to 4. In addition, 5.6% of the children examined had suffered from a head lice infestation in the previous 12 months. This results in an incidence of 598 cases per 10,000 children aged 5 to 6 years per year. Households with a low educational level of the parents and without a background of migration were significantly more often affected by pediculosis capitis during the previous 12 months. The analysis of the questionnaires showed a rather low level of knowledge about pediculosis capitis, a tendency towards polypragmatic therapeutic approaches and partially aberrant reactions such as hysteria. The knowledge about pediculosis capitis was significantly lower in parents with a low educational level. Our study provides for the first time reliable data on the prevalence, incidence and disease perception of head lice infestation as well as concerning the knowledge parents have about this parasitic skin disease.
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