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Comparative efficacy of three pediculicides to treat head lice infestation in primary school girls: a randomised controlled assessor blind trial in rural Iran.
BMC Dermatol. 2019 09 12; 19(1):13.BD

Abstract

BACKGROUND

Head lice infestation (Pediculosis) is one of the most important health challenges particularly in primary school-aged children. It is often present among 6-11-year-old students in various tropical and temperate regions of the world. The aim of this study was to examine epidemiologic indices and comparative analysis of two pyrethroid-based and one non-chemical pediculicide products on head lice treatment of primary school girls in a rural setting of Fars province, south Iran, as part of a randomized controlled assessor blind trial.

METHODS

Before treatment, infested students were screened using plastic detection combs to find live head lice. Three independent parallel groups, each with about 25 participants (#77) were eventually twice with a week apart treated with either 1% permethrin, 0.2% parasidose (d-phenothrin) or 4% dimeticone lotion preparations. In each case, a questionnaire form was completed on epidemiologic factors. Data were registered after a fortnight from primary scalp treatment and re-inspection on days 2, 6, 9 and 14. Data analyses were performed using Chi-square test with a P-value < 0.05 being taken as statistically significant.

RESULTS

From 3728 inspected students, 87 (2.33%) girls were infested with head lice, Pediculus humanus capitis De Geer, 1778. Ten students dropped out pertaining to exclusion criteria. No significant correlation was found between head lice infestation level and hair length, hair style, itching, nationality, age, settlement site and baths; but there was a significant relationship between age and hair style (P = 0.027). The efficacy values on each of the above re-inspection days from each of the three treatments were 81, 74, 70 and 63% for permethrin; 83, 92, 100 and 100% for dimeticone; and 96, 88, 96 and 92% for d-phenothrin; respectively. A quartile difference in efficacy of permethrin relative to dimeticone on day 14 represented the scale of head lice resistance to permethrin treatment. There were significant statistical differences in case re-inspection days 9 (P = 0.008) and 14 (P = 0.003) post treatment. Only two dropout cases, one non-compliant and the other lost before the second-week treatment, from permethrin trial were observed following two applications a week apart.

CONCLUSIONS

Dimeticone lotion had the fullest efficacy (100%) among all treatments. This high cure rate was attributed to the low level of infestation and the extent of patients' involvement. Parasidose swiftly ameliorated the infested cases by the second day since initial treatment. Female third grade students were the most infested cohort.

TRIAL REGISTRATION

Current Controlled Trials- IRCT2016041627408N1 , Dated: 21-08-2017.

Authors+Show Affiliations

Department of Medical Entomology and Vector Control, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.Research Center for Health Sciences, Institute of Health, Department of Medical Entomology and Vector Control, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.Research Center for Health Sciences, Institute of Health, Department of Medical Entomology and Vector Control, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.Research Center for Health Sciences, Institute of Health, Department of Medical Entomology and Vector Control, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran. momenbf@sums.ac.ir.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31510998

Citation

Kalari, Hadi, et al. "Comparative Efficacy of Three Pediculicides to Treat Head Lice Infestation in Primary School Girls: a Randomised Controlled Assessor Blind Trial in Rural Iran." BMC Dermatology, vol. 19, no. 1, 2019, p. 13.
Kalari H, Soltani A, Azizi K, et al. Comparative efficacy of three pediculicides to treat head lice infestation in primary school girls: a randomised controlled assessor blind trial in rural Iran. BMC Dermatol. 2019;19(1):13.
Kalari, H., Soltani, A., Azizi, K., Faramarzi, H., & Moemenbellah-Fard, M. D. (2019). Comparative efficacy of three pediculicides to treat head lice infestation in primary school girls: a randomised controlled assessor blind trial in rural Iran. BMC Dermatology, 19(1), 13. https://doi.org/10.1186/s12895-019-0093-5
Kalari H, et al. Comparative Efficacy of Three Pediculicides to Treat Head Lice Infestation in Primary School Girls: a Randomised Controlled Assessor Blind Trial in Rural Iran. BMC Dermatol. 2019 09 12;19(1):13. PubMed PMID: 31510998.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative efficacy of three pediculicides to treat head lice infestation in primary school girls: a randomised controlled assessor blind trial in rural Iran. AU - Kalari,Hadi, AU - Soltani,Aboozar, AU - Azizi,Kourosh, AU - Faramarzi,Hossein, AU - Moemenbellah-Fard,Mohammad Djaefar, Y1 - 2019/09/12/ PY - 2019/02/02/received PY - 2019/08/19/accepted PY - 2019/9/13/entrez PY - 2019/9/13/pubmed PY - 2020/4/14/medline KW - D-phenothrin KW - Dimeticone KW - Head lice KW - Iran KW - Pediculosis KW - Pediculus capitis KW - Topical treatment SP - 13 EP - 13 JF - BMC dermatology JO - BMC Dermatol VL - 19 IS - 1 N2 - BACKGROUND: Head lice infestation (Pediculosis) is one of the most important health challenges particularly in primary school-aged children. It is often present among 6-11-year-old students in various tropical and temperate regions of the world. The aim of this study was to examine epidemiologic indices and comparative analysis of two pyrethroid-based and one non-chemical pediculicide products on head lice treatment of primary school girls in a rural setting of Fars province, south Iran, as part of a randomized controlled assessor blind trial. METHODS: Before treatment, infested students were screened using plastic detection combs to find live head lice. Three independent parallel groups, each with about 25 participants (#77) were eventually twice with a week apart treated with either 1% permethrin, 0.2% parasidose (d-phenothrin) or 4% dimeticone lotion preparations. In each case, a questionnaire form was completed on epidemiologic factors. Data were registered after a fortnight from primary scalp treatment and re-inspection on days 2, 6, 9 and 14. Data analyses were performed using Chi-square test with a P-value < 0.05 being taken as statistically significant. RESULTS: From 3728 inspected students, 87 (2.33%) girls were infested with head lice, Pediculus humanus capitis De Geer, 1778. Ten students dropped out pertaining to exclusion criteria. No significant correlation was found between head lice infestation level and hair length, hair style, itching, nationality, age, settlement site and baths; but there was a significant relationship between age and hair style (P = 0.027). The efficacy values on each of the above re-inspection days from each of the three treatments were 81, 74, 70 and 63% for permethrin; 83, 92, 100 and 100% for dimeticone; and 96, 88, 96 and 92% for d-phenothrin; respectively. A quartile difference in efficacy of permethrin relative to dimeticone on day 14 represented the scale of head lice resistance to permethrin treatment. There were significant statistical differences in case re-inspection days 9 (P = 0.008) and 14 (P = 0.003) post treatment. Only two dropout cases, one non-compliant and the other lost before the second-week treatment, from permethrin trial were observed following two applications a week apart. CONCLUSIONS: Dimeticone lotion had the fullest efficacy (100%) among all treatments. This high cure rate was attributed to the low level of infestation and the extent of patients' involvement. Parasidose swiftly ameliorated the infested cases by the second day since initial treatment. Female third grade students were the most infested cohort. TRIAL REGISTRATION: Current Controlled Trials- IRCT2016041627408N1 , Dated: 21-08-2017. SN - 1471-5945 UR - https://www.unboundmedicine.com/medline/citation/31510998/Comparative_efficacy_of_three_pediculicides_to_treat_head_lice_infestation_in_primary_school_girls:_a_randomised_controlled_assessor_blind_trial_in_rural_Iran_ L2 - https://bmcdermatol.biomedcentral.com/articles/10.1186/s12895-019-0093-5 DB - PRIME DP - Unbound Medicine ER -