International recommendations for an effective control of head louse infestations

Abstract

Head louse infestations continue to be a concern of public health in most countries, including the most developed ones. The present recommendations are intended to inform and stress the role and impact of the different authorities, institutions, industry, and the public in the control of head lice in order to reduce the prevalence of this parasite. We encourage health authorities to pursue more effective methods to correctly identify such infestations, and evaluate existing and new pediculicides, medical devices, louse repellents, and louse‐ and nit‐removal remedies. Pediculicides and medical devices must have verifiable claims in the instructions for use and should be tested periodically to document current levels of resistance by lice to the active ingredients and to the formulated products. Where the prevalence of lice is claimed to be epidemic, children should be periodically evaluated objectively to document the actual level of prevalence. Continuing education for health providers and the general population promises to correct misinformation regarding the biology, prevention, and management of lice. Parents should regularly inspect their children for head lice and treat as necessary. Health authorities are encouraged to eliminate policies and practices that rely upon school exclusion as a means to reduce incidence and prevalence, e.g., the ‘no‐nit’ policy which lacks scientific justification, and are counterproductive to the health and welfare of children.

Presence of the knockdown resistance (kdr) mutations in the head lice (Pediculus humanus capitis) collected from primary school children of Thailand

“…Consequently, instead of the contemporary scientific drug store pediculicides, traditional methods were the mainstay treatment to eliminate the louse. Folk remedies are based on the use of herb like custard apple leaves, plant-based herbal shampoo, occlusion techniques as well as anti-louse medical devices [ 33 – 37 ]. In urban areas, pediculosis cases are more properly managed with higher number of pediculicides prescription as they are more accessible at either over-the-counter pharmacy or dermatology clinic.…”

“…The aforementioned explanation could possibly result in permethrin resistant head lice among samples of head lice collected from elementary school children in various area in Thailand. In order to help reduce the unnecessary permethrin or other pediculicides uses, the public health approach of the head lice infestation in the community and school health including educational programs of all related group of people for example parents, school staff, and local health care professionals should be done regularly [ 37 ]. In some areas with a high prevalence of pediculosis, the treatment might better lean towards pediculicide-free treatment choices formultiple different reasons as follows; 1) Better safety profile 2) Greater availability in the locals and the advantages of no risk of developing resistant.…”

“…In some areas with a high prevalence of pediculosis, the treatment might better lean towards pediculicide-free treatment choices formultiple different reasons as follows; 1) Better safety profile 2) Greater availability in the locals and the advantages of no risk of developing resistant. These treatments include occlusive agents, herbal medicine, and anti-louse devices; heated air, suction, or electronic comb [ 33 – 37 ]. All of which pose no risk of resistance and have the advantages over pediculicides in terms of long term uses.…”

Pediculose: fatos históricos sobre a doença e a busca persistente pelo tratamento ideal

“…A pediculose do couro cabeludo é uma infestação parasitária causada pelo parasita hematófago Pediculus humanus capitis, popularmente conhecido como piolho, tendo como único hospedeiro o homem (CANDY K, et al, 2020). Trata-se de uma ectoparasitose de grande impacto na saúde pública mundial, já que afeta centenas de milhões de pessoas em todo mundo, incluindo países desenvolvidos, como França, Reino Unido, Suécia, dentre outros, especialmente crianças em idade escolar e seus familiares, devido à facilidade de contágio (BOHL B, et al, 2015;MUMCUOGLU KY, et al, 2021).…”

“…Para alimentar-se, o piolho injeta na pele do couro cabeludo sua saliva, causando vasodilatação e reação anticoagulante nesse local, além da reação de sensibilização, provocando o principal sintoma, o prurido, principalmente na região occipital e retroauricular, embora existam relatos de pessoas assintomáticas. Sua transmissão acontece principalmente por contato direto entre cabelos, porém, esse contágio também pode ocorrer através de uso compartilhado de escovas de cabelo, pentes, chapéus, bonés e demais objetos de pessoas infestadas, além de compartilhamento de camas, principalmente em domicílios com número elevado de habitantes, condições socioeconômicas precárias e baixo acesso à assistência de saúde (CARVALHO VO, 2019; MUMCUOGLU KY, et al, 2021).…”