Epidemiological aspects of pediculosis by Pediculus humanus capitis (Phthiraptera: Pediculidae) in Minas Gerais: a systematic review / Aspectos epidemiológicos da pediculose por Pediculus humanus capitis (Phthiraptera: Pediculidae) em Minas Gerais: uma revisão sistemática

Abstract Background Head lice, or head pediculosis, is a parasitosis considered a serious public health problem that affects mainly resource-limited countries. Objective To describe epidemiological aspects of the pediculosis capitis in Minas Gerais, in Brazil. Method This systematic review was conducted through the standards established by the Preferred Reporting Items in Systematic Reviews and Metanalyses (PRISMA). PubMed, LILACS, and SciELO databases, as well as the gray literature, were searched. Results Nine of 1,167 studies were included, published between 1988 and 2019. These studies reported a total prevalence of parasitosis that ranged from 1.4% to 57.4%. The prevalence of head lice ranged from 0.0% to 66.7% for males and 2.3% to 57.4% for females, thus being higher in black-skinned people (1.4% to 40.3%). Regarding age, the highest prevalence was 10-12 years old (45.3%). As for the characteristics of the hair, there was a greater infestation in people with long (16.0% to 79.5%), wavy (0.0% to 44.7%), dark (0.0% to 36.6%), with low capillary density (35.4%), and thick hair (39.2%). Conclusion Head pediculosis affects both sexes, different ages, and races, representing an important health problem in Minas Gerais, not only due to the presence of ectoparasite but also to the secondary complications that can be generated from this parasitism.

Resumo Introdução A pediculose de cabeça é uma parasitose considerada um sério problema de saúde pública, afetando principalmente países com recursos limitados. Objetivo Descrever os aspectos epidemiológicos da pediculose de cabeça em Minas Gerais, Brasil. Método Revisão sistemática conduzida por meio dos padrões estabelecidos pelo Preferred Reporting Items in Systematic Reviews and Metanalyses (PRISMA). Foram pesquisadas as bases de dados PubMed, LILACS e SciELO, bem como a literatura cinza. Resultados Nove de 1.167 estudos foram incluídos, publicados entre 1988 e 2019. Relatou-se uma prevalência total da parasitose que variou de 1,4% a 57,4%. Ela variou de 0,0% a 66,7% para homens e 2,3% a 57,4% para mulheres, sendo maior em pessoas de cor negra (1,4% a 40,3%). Em relação à idade, a maior prevalência foi de 10 a 12 anos (45,3%). Quanto às características dos cabelos, houve maior infestação em pessoas com cabelos longos (16,0% a 79,5%), ondulados (0,0% a 44,7%), escuros (0,0% a 36,6%), com baixa densidade capilar (35,4%) e fios grossos (39,2%). Conclusão A pediculose atinge ambos os sexos, diferentes idades e raças, representando um importante problema de saúde em Minas Gerais, não só pela presença do ectoparasita, mas também pelas complicações secundárias que podem ser geradas desse parasitismo.

Molecular survey of head lice (Pediculus humanus capitis) infestation among disadvantaged children in Klang Valley, Malaysia

@#Ectoparasitic infestations including pediculosis capitis are common in people of disadvantaged communities as they live in overcrowded institutions, a condition that often favourable for disease transmission. In this study, we evaluated the prevalence of head lice infestation among disadvantaged children aged between five to 14 years-old living in five poor conditions located across the Klang Valley, Malaysia. Of total 335 children examined, 14% were positively infected with head lice. Molecular analysis using the universal cytochrome c oxidase subunit I (COI) barcoding gene on total of 167 head lice collected in this study indicated they are belonging to the A and C clades; confirming the global distribution of clade A and expansion of clade C in Southeast Asia, which is reported for the first time in Malaysia.

Epidemiological aspects of head lice in children attended to at a public hospital in Uberlândia, Minas Gerais state, Brazil

Pediculosis capitis is a public health problem not only in Brazil, but also in many countries worldwide. Children are the most likely population group to be infested. The purpose of this study was to verify the prevalence of head lice in children seen at the public hospital in Uberlândia, Minas Gerais State, and factors associated with ectoparasitosis in this group. In addition, data about the transmission, prevention and control were obtained from the children's parents or guardians. The scalp and hair of every child aged 2 to 12, attended to at the hospital pediatric outpatient clinic from 2015 to 2017, were examined. Questionnaires and characterization sheets were also used to obtain and record the information. The overall prevalence rate observed was 2.8%. The highest prevalence rates were observed in girls with medium length hair. Children presented a relatively low prevalence of head lice in the parasitological examinations. However, the answers to the questionnaires indicated that this ectoparasitosis is common in this population group. All the children examined were of school age, and their parents or guardians indicated the school environment as the main source of infestations. The responses to the questionnaires also highlighted evidence of negligence on the part of guardians of positive children regarding the occurrence of this ectoparasitosis. The information obtained indicates that authorities should design/improve their plans of action regarding guidelines for parents or guardians for adequate prevention and control of this ectoparasitosis

Head lice in school children in Uberlandia, Minas Gerais state, Brazil

School-aged children have shown to be the group most susceptible to Pediculus capitis infestation, possibly due to their habits and behaviors. The purpose of the study was to verify the prevalence of head pediculosis in preschool children from Uberlândia, MG, and factors associated with infestation. The children's parents or guardians were also evaluated regarding socioeconomic status, knowledge of symptomatology and control of this ectoparasitosis. Data were obtained by direct examination of each child's head and a questionnaire answered by parents/guardians. The overall prevalence rate was 7.5% among the 372 children examined, and 4 to 5-year-old girls with long hair presented significantly higher prevalence rates. Information from the questionnaires indicated that 45% of the children had already been infested at least once and the main symptom mentioned was intense itching on the scalp. Those responsible mostly used natural control measures to control infestations. The results indicated that children under the age of six should also be included in head pediculosis control programs

Pediculosis capitis among primary and middle school children in Asadabad, Iran: An epidemiological study

Objective: To investigate the prevalence of head lice in primary and middle school children in Asadabad, Iran. Methods: This study is an analytical descriptive cross-sectional one conducted among primary and middle school children in Asadabad during the academic year of 2013-2014. Data were collected at baseline via questionnaire, checklist and head examination. Results: A total of 600 students were examined (412 girls and 188 boys), and 14 students showed pediculosis. And the total prevalence rate was 2.3% (3.2% girls and 0.5% boys). The infestation was equal in public and private schools. The rate of pediculosis was higher in students of primary schools (4.0%) than those in middle schools (0.7%). The age of the students ranged from 6 to 14 years. The total number of infected group was 14 with mean age of 8.93 ± 2.43 years, and it was 586 with mean age of 10.98 ± 2.82 years for the uninfected group who were enrolled in the study (P 0.05). Conclusions: It is necessary to find the risk factors of the infection in order to understand how to control or decrease infection in students, considering the important role of health education in reduction of head lice infections.

Pediculosis de la cabeza en escolares de Ciudad Bolívar, estado Bolívar, Venezuela / Headlice in schoolchildren from Ciudad Bolívar, Bolívar state, Venezuela

Entre abril y julio de 2013 se realizó un estudio de tipo transversal, para determinar la prevalencia de pediculosis de la cabeza en niños de 6-15 años, matriculados en cuatro escuelas de Ciudad Bolívar, estado Bolívar, Venezuela. El diagnóstico parasitológico se realizó por observación directa de huevos, ninfas y/o adultos sobre el cuero cabelludo y/o el pelo. Se llenó una ficha clínico-epidemiológica a cada participante previa firma del consentimiento informado por parte de padres o representantes. Se evaluaron 697 niños (40,3%) de los 1730 escolares matriculados, determinándose una prevalencia de 25,1% (175/697). Las niñas resultaron significativamente más infectadas (42,4%) (OR: 9,35 p<0,05). Todos los grupos de edad fueron afectados (χ² (corrección de Yates)=6,90 g.l.: 4 p>0,05) aunque predominó el grupo de 8-11 años. Los factores asociados a una mayor prevalencia de pediculosis de la cabeza fueron: el género femenino (OR: 9,35 p<0,05), haber padecido anteriormente la enfermedad (OR: 5,76 p<0,05) y tener el pelo largo (OR: 7,12 p<0,05) y sucio (OR: 2,20 p<0,05). En conclusión, aunque la prevalencia de pediculosis de la cabeza fue relativamente baja (25,1%), se verifica que esta parasitosis sigue siendo un problema médico importante en escolares de Ciudad Bolívar.

Between April and July 2013 a cross sectional study was conducted to determine the prevalence of headlice in children aged 6-15 years enrolled in four schools in Ciudad Bolívar, Bolivar State, Venezuela. The parasitological diagnosis was made by direct observation of eggs, nymphs and/ or adults on the scalp and/or hair. After signing the informed consent, we filled a clinical and epidemiologic record to each participant. 697 children (40.3%) of the 1730 school enrollment were evaluated, determining a prevalence of 25.1% (175/697). Girls were significantly more infected (42.4%) (OR: 9.35 p<0.05). All age groups were affected (χ2 (Yates correction) = 6.90 d.f.: 4 p> 0.05), but the group of 8-11 years was predominant (70.3%). Factors associated with a higher prevalence of headlice were female (OR: 9.35 p<0.05), having previously had the disease (OR: 5.76 p<0.05) and have long hair (OR: 7.12 p<0.05) and dirty (OR: 2.20 p<0.05). In conclusion, although the headlice prevalence was relatively low (25.1%), we verified that this parasitoses remains a major medical problem in schoolchildren in Ciudad Bolivar.

Head lice in harr samples from youths, adults ad the elderly in manaus, amazonnas state, Brazil / Pediculose da cabeça em amostras de cabelos de jovens, adultos e idosos em Manaus, Estado do Amazonas, Brasil

A study of head lice infestations among young people, adults and elderly individuals was conducted from August 2010 to July 2013 in Manaus, AM, Northern Brazil. Hair samples collected from 1,860 individuals in 18 barber shops and beauty parlors were examined for the ectoparasite. The occurrence of pediculosis and its association with factors, such as sex, age, ethnicity, hair characteristics and the socioeconomic profile of salon customers, salon location and seasonal variation were determined. The overall occurrence rate was 2.84%. Occurrence was higher in hair samples from non-blacks and the elderly. Higher occurrence was also observed during kindergarten, elementary and junior education school holidays. The results indicate that the occurrence of head lice among young people, adults and the elderly in Manaus is relatively low compared to that determined in children and in other regions of the country. After children, the elderly were the most affected. The study also indicated the need to adopt additional procedures to improve surveys among the population with low or no purchasing power, which is usually the most affected by this ectoparasitic disease.

Estudo sobre a pediculose do couro cabeludo em jovens, adultos e idosos foi realizado de agosto de 2010 a julho de 2013 em Manaus - AM, região norte do Brasil. Amostras de cabelos obtidas de 1.860 indivíduos em 18 barbearias e salões de beleza foram examinadas à procura do parasito. Procurou-se verificar a ocorrência da pediculose e sua associação com fatores tais como: sexo, idade, etnia, características dos cabelos e perfil socioeconômico dos clientes dos salões, localização dos salões e variação sazonal. A taxa de ocorrência encontrada foi 2,84%. Ela foi maior em amostras de cabelos de não negros e dos idosos. Também se observou maior prevalência no período de férias escolares do ensino fundamental e médio. Os resultados indicam que a ocorrência da pediculose em jovens, adultos e idosos em Manaus é relativamente baixa em comparação com as encontradas em crianças e as encontradas em outras regiões do país. Depois das crianças, os idosos seriam os mais acometidos. O estudo também indica a necessidade de adotar procedimentos adicionais para melhor amostrar a faixa da população com menor ou com nenhum poder aquisitivo, a qual geralmente é a mais acometida por esta ectoparasitose.

PREHISTORICAL Pediculus humanus capitis INFESTATION: QUANTITATIVE DATA AND LOW VACUUM SCANNING MICROSCOPY / Infestação pré-histórica por Pediculus humanus capitis: análise quantitativa e por microscopia de varredura de baixo vácuo

A pre-Columbian Peruvian scalp was examined decades ago by a researcher from the Oswaldo Cruz Foundation. Professor Olympio da Fonseca Filho described nits and adult lice attached to hair shafts and commented about the origin of head lice infestations on mankind. This same scalp was sent to our laboratory and is the subject of the present paper. Analysis showed a massive infestation with nine eggs/cm2 and an impressive number of very well preserved adult lice. The infestation age was roughly estimated as nine months before death based on the distance of nits from the hair root and the medium rate of hair growth. A small traditional textile was associated with the scalp, possibly part of the funerary belongings. Other morphological aspects visualized by low-vacuum scanning electron microscopy are also presented here for adults and nits.

Há décadas um escalpo peruano, datado do período pré-colombiano, foi examinado por um pesquisador da Fundação Oswaldo Cruz. O Professor Olympio da Fonseca Filho descreveu lêndeas e adultos fixos a fios de cabelos e fez comentários sobre a origem da infecção por piolhos na espécie humana. Este mesmo escalpo foi enviado ao nosso laboratório e é objeto deste artigo. Sua análise mostrou maciça infestação, com nove lêndeas/cm2 em impressionante número de adultos muito bem preservados. O tempo de infestação foi estimado em cerca de nove meses antes da morte, baseado na maior distância entre lêndeas e o couro cabeludo, levando em consideração taxa média de crescimento capilar de 1 cm por mês. Um pequeno pedaço de tecido tradicional peruano foi encontrado associado ao escalpo, provavelmente pertencente ao conjunto de peças usado no ritual funerário. Aqui, apresentamos alguns aspectos morfológicos de adultos e lêndeas vizualizados por microscopia eletrônica de varredura de baixo vácuo.

Spinosad: A Newer Anti-Lice Drug.

Head lice infestation is a common and highly contagious condition caused by pediculus humanus capitis. Therapy for head lice infestation has been traditionally combing out the live lice and the unhatched eggs (nits) by a fine toothed comb along with topical chemical treatments. Emergence of resistance to these therapies compromises their effectiveness. As a result, the search for newer agents has been a clinical necessity. Recently, spinosad, a newer anti-lice drug, has been approved by US FDA as 0.9% topical suspension. Spinosad provides a useful alternative for children above 4 years of age suffering from head lice infestation.

Prevalence of pediculosis capitis in children from a rural school in Yucatan, Mexico / Prevalência de pediculose em crianças de escola rural em Yucatan, Mexico

We conducted an analytical cross-sectional survey to estimate the prevalence of and factors associated with active head lice infestation. In total 140 children, aged 6 to 16-years, from a public school in rural Yucatan, Mexico, were examined by wet-combing. A structured questionnaire was used to collect information on individuals and the conditions in the surrounding environment. Head lice infestation was found in 19 out of the 140 children tested (13.6 percent) and this was associated with both lower income (OR 9.9, 95 percent CI 2.15-45.79, p = 0.003) and a higher frequency of hair washing (OR 8, 95 percent CI 1.58-50, p = 0.012). Intersectoral control programs that take into account the socioeconomic differences of children should be implemented.

Foi conduzido um estudo numa escola publica de área rural em Yucatan, Mexico com o objetivo de estimar a prevalência de pediculose e fatores de risco associados. Das 140 crianças incluídas 19 (13.6 por cento) apresentaram pediculose. A infestação de piolho foi associada com baixa renda (OR 9.9, 95 por cento CI 2.15-45.79, p = 0.003) e maior frequência de lavagem de cabelos (OR 8, 95 por cento CI 1.58-50, p = 0.012). Programas intersetoriais de controle da pediculose que levam em conta as características socioeconômicas das crianças deveriam ser executados.

Ectoparasitosis de importancia en Chile: Epidemiología y terapia / Ectoparasitosis of clinical importance in Chile

Several parasitic diseases affect the skin and appendages in humans, the most common are head lice and scabies. Both diseases have worldwide distribution with geographical variations. In Chile, the reported prevalence of head lice is 20-25 percent and of scabies 1-5 percent. Other ectoparasites include fleas and mite, causing transient parasitosis related to human and animal contact. These parasites are associated with various factors such as poor personal hygiene, promiscuity, long hair, crowding, and sharing of combs, among others. Various effective pharmacological therapies are available, which base on several active compounds. Important therapeutic options include topical treatments with pyrethroids, lindane, crotamiton, and malathion as well as oral medications such as ivermectin, which is used in case of drug intolerance, poor treatment response, infections with multiple parasites or concomitant bacterial infections. For some drugs, resistance has been reported in patients received multiple dosis.

Existen varias enfermedades parasitarias capaces de comprometer piel y fanéreos en el humano, siendo los más frecuentes la pediculosis y la escabiosis. Ambas enfermedades tienen distribución mundial variable según la localidad. En Chile, se describe una prevalencia de pediculosis capitis cercana a 20-25 por ciento y de escabiosis, entre 1 y 5 por ciento. Otras ectoparasitosis son la pulicosis y la acarosis, parasitosis transitorias relacionadas al contacto humano y animal. Estos agentes se asocian a diversos factores entre los que se encuentran escasa higiene personal, promiscuidad, uso de cabello largo, hacinamiento, intercambio de peines, entre otros. Las terapias farmacológicas disponibles son variadas y eficaces. Hay diversos compuestos activos entre los que destacan tratamientos tópicos como derivados piretroides, lindano, crotamitón y malatión; y medicamentos orales como ivermectina, utilizada en casos de mala tolerancia, escasa respuesta a tratamiento tópico, infestación múltiple o infección bacteriana concomitante. Se ha descrito resistencia a algunos compuestos en pacientes que han recibido múltiples dosis.

Eficácia do extrato concentrado contendo Saccharum officinarum L: Poaceae, Azadirachta indica A. Juss. Meliaceae, e Eucaliptus spp Myrtaceae, sobre Pediculus capitis De Geer, (Anoplura: Pediculidae) / Effectiveness of concentrate extract containing Saccharum Officinarum L: Poaceae, Azadirachta Indica A. Juss. Meliaceae, And Eucaliptus Spp Myrtaceae Against Pediculus Capitis De Geer, (Anoplura: Pediculidae)

O objetivo deste trabalho foi avaliar a eficácia do extrato concentrado contendo Saccharum officinarum L. Poaceae, Azadirachta indica A. Juss. Meliaceae, e Eucaliptus spp Myrtaceae sobre Pediculus capitis De Geer Pediculidae. Foram coletados mil e trinta e cinco piolhos da cabeça de crianças infestadas por Pediculus capitis de creches da Região Metropolitana do Recife, Estado de Pernambuco, Brasil. Para realização do teste utilizou-se três grupos com trezentos e quarenta e cinco piolhos cada referentes aos produtos, extrato concentrado (EC), inseticida piretróide (PI) e controle (C). Os piolhos foram imersos em solução dos produtos por três minutos e em seguida secos. A mortalidade foi monitorada em diferentes momentos, por um período de vinte e quatro horas. O extrato concentrado matou todos os piolhos antes de doze horas e uma média de 60,28 por cento (208/345) de mortalidade do EC ocorreu entre três e seis horas, a maior parte da mortalidade do PI foi observada 24 h após o tratamento. Os resultados mostraram que o extrato contendo Saccharum officinarum, Azadirachta indica, e Eucaliptus spp constitui-se como uma potente ferramenta no controle do Pediculus capitis.

The aim of this work was to evaluate the effectiveness of concentrate extract containing Saccharum officinarum L. Poaceae, Azadirachta indica A. Juss. Meliaceae, and Eucaliptus spp Myrtaceae against Pediculus capitis De Geer Pediculidae. A thousand and thirty five head lice were collected from children with Pediculus capitis infestation from some day care centers at Metropolitan Region of Recife, Pernambuco State, Brazil. The tests were performed in three groups with three hundred forty five lice each one according to product, concentrate extract (CE), pyrethroid insecticide (PI) and control (C). The immersing head lice in the diluted products for three minutes, washing off products and dry the insects were used. The mortality of lice was monitored at different points in time, for a period of twenty four hours. Concentrate extract killed all head lice after twelve hours and an average of 60.28 percent (208/345) of lice mortality of the CE occurred between three and six hours, while the mortality of PI was observed 24 h after treatment. The results showed the extract containing Saccharum officinarum, Azadirachta indica, and Eucaliptus spp could be a potent tool in the control of Pediculus capitis.

The Effect of Treating Head Lice on Residual Lindane Concentrations in Children / 대한피부과학회지

BACKGROUND: Organochloride pesticides are prohibited around the world due to their toxicity and environmental persistence. However, lindane, one organochloride pesticide, is still widely used to treat head lice and scabies in Korea. OBJECTIVE: For evaluation of the effect of lindane usage and blood lindane concentration, we conduct an evaluation of blood lindane concentrations among children who were treated for head lice. METHODS: The total study population of 80 was divided into rural and urban areas. Age, sex, parent's farming, sea food consumption and head lice treatment information were gathered using a structured questionnaire. Blood lindane concentrations were analyzed by a solid phase extraction(SPE) method. Quantitative analysis was done by GC/ECD. Non-parametric analysis was done for comparing blood lindane concentrations between the head lice treated group and the non treatment group. After a log transformation, regression analysis was done for controlling confounding variables. RESULTS: The median age of the study population was 11. The study population involved 38 (47.5%) male and 42 (52.5%) female children. Twenty (25.6%) children were infested by head lice. The blood concentration of lindane was higher in the head licetreatment group [N.D (N.D-78.9)] than in the non-treated group [N.D (N.D-43.4), P < 0.01]. The results were the same after regression analysis controlling for confounding variables. CONCLUSION: Lindane has toxicity to the endocrine system and nervous system and persists in the environment and in the human body. Therefore, careful usage of lindane shampoo is needed to treat head lice.

The Effect of Treating Head Lice on Residual Lindane Concentrations in Children / 대한피부과학회지

BACKGROUND: Organochloride pesticides are prohibited around the world due to their toxicity and environmental persistence. However, lindane, one organochloride pesticide, is still widely used to treat head lice and scabies in Korea. OBJECTIVE: For evaluation of the effect of lindane usage and blood lindane concentration, we conduct an evaluation of blood lindane concentrations among children who were treated for head lice. METHODS: The total study population of 80 was divided into rural and urban areas. Age, sex, parent's farming, sea food consumption and head lice treatment information were gathered using a structured questionnaire. Blood lindane concentrations were analyzed by a solid phase extraction(SPE) method. Quantitative analysis was done by GC/ECD. Non-parametric analysis was done for comparing blood lindane concentrations between the head lice treated group and the non treatment group. After a log transformation, regression analysis was done for controlling confounding variables. RESULTS: The median age of the study population was 11. The study population involved 38 (47.5%) male and 42 (52.5%) female children. Twenty (25.6%) children were infested by head lice. The blood concentration of lindane was higher in the head licetreatment group [N.D (N.D-78.9)] than in the non-treated group [N.D (N.D-43.4), P < 0.01]. The results were the same after regression analysis controlling for confounding variables. CONCLUSION: Lindane has toxicity to the endocrine system and nervous system and persists in the environment and in the human body. Therefore, careful usage of lindane shampoo is needed to treat head lice.

Self-diagnosis of active head lice infestation by individuals from an impoverished community: high sensitivity and specificity

To compare sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of self-diagnosis for head lice infestation with visual inspection, we conducted a study in an urban slum in Brazil. Individuals were asked about active head lice infestation (self-diagnosis); we performed visual inspection and thereafter wet combing (gold standard). Of the 175 individuals included, 77 (44 percent) had an active head lice infestation. For self-diagnosis, sensitivity (80.5 percent), specificity (91.8 percent), PPV (88.6 percent) and NPV (85.7 percent) were high. Sensitivity of visual inspection was 35.1 percent. Public health professionals can use self-diagnosis as a diagnostic tool, to estimate accurately prevalence of pediculosis in a community, and to monitor ongoing intervention strategies.

Foi conduzido um estudo em uma favela urbana no Brasil com o objetivo de comparar a sensibilidade, especificidade, valor preditivo positivo (VPP) e valor preditivo negativo (VPN) do auto-diagnóstico de pediculose com a inspeção visual. Dos 175 indivíduos incluídos, 77 (44 por cento) apresentavam pediculose. Para o auto-diagnóstico, a sensibilidade (80.5 por cento), a especificidade (91.8 por cento), o VPP (88.6 por cento) e o VPN (85.7 por cento) foram altos. A sensibilidade da inspeção visual foi 35.1 por cento. Profissionais de saúde podem utilizar o auto-diagnóstico como uma ferramenta diagnóstica para estimar de forma acurada a prevalência de pediculose em uma comunidade, como também para monitorar estratégias de controle da doença.

Survey on Infestaton Rates of Head Lice in Two Primary Schools in Dangjin-gun, Chungchongnam-do / 감염

We examined infestation state of head lice in 2 primary schools in 1998. Among the 382 subjects, 92 (24.1%) children were confirmed as having head lice infestation. Infestation rate of each school was 13.6% and 32.9%, respectively. Infestation rate of girls (42.2%) was higher than that of boys (5.8%) and the 5th grade had more infested children (35.7%) than any other.