Lifestyle Recommendations for Management of Pediculosis from the Viewpoint of Persian Medicine

Introduction: Pediculosis Capitis (head lice infestation) is the most common disease of the bloodsucking insect which affects approximately six to twenty million cases and results considerable economic burden annually. In this study we aim to investigate some medieval Persian views on the role of non-pharmacological treatment strategies for prevention and control of pediculosis and compare their prescriptions with current findings. Materials and methods: In this qualitative study, we reviewed some well-known Persian medicine (PM) textbooks based on the selected keywords (Shepesh, Reshk, Ghamal and Seyban) to collect the viewpoint of PM scholars for pediculosis and its treatments. Also, we searched in the databases such as PubMed, Science direct and Scopus about the topic. Results: Persian medicine scientists believed that there are six essential health principles (SetteZaroorieh), which can affect human health and prevent diseases including air, nutrition, exercise, sleep and wakefulness, exertion of unnecessary materials from the body and finally psychological concepts. Proper management of these essential factors can improve lifestyle of people affected with pediculosis and also play a key role in prevention of head lice infestation. Conclusion: There are several suitable recommendations for prevention and control of pediculosis according to essential health principles in PM which can consider beside current drug treatments and the individual health recommendations for complete control of the disease

Pediculosis capitis grave en una niña inscrita en una guardería / Severe pediculosis capitis in a nursery school girl

La pediculosis capitis es la ectoparasitosis más frecuente a nivel mundial. La infestación es causada por Pediculus humanus capitis (piojo de la cabeza) y afecta el cabello, el cuero cabelludo y la piel. Rara vez se manifiesta con otro tipo de sintomatología y, por lo general, su curso es benigno si se trata adecuadamente. Se presenta el caso de una menor con pediculosis capitis de 18 meses de evolución, asociada con forúnculos, lesiones cutáneas, múltiples adenopatías y anemia, que no mejoró tras la aplicación del champú. Inicialmente, llamó la atención la presencia de forúnculos, alopecia y adenopatías. La persistencia de la pediculosis capitis y el rascado intenso alteraron la integridad de la epidermis y facilitaron las infecciones secundarias por bacterias patógenas y oportunistas que produjeron impétigo, forunculosis, excoriaciones, costras hemáticas, anemia, alopecia y linfadenopatías. La pediculosis capitis afectó notoriamente a la paciente al causarle problemas psicológicos y de salud, agudizados por su condición económica y social. La paciente presentó manifestaciones clínicas poco frecuentes (forunculosis, anemia, fiebre, alopecia y adenopatías), lo cual se vio facilitado por la persistencia de los factores de riesgo y el hecho de que no se le inspeccionaba la cabeza ni se removían los insectos. La educación sobre los factores de riesgo y el control sanitario es indispensable para controlar la infestación.

Pediculosis capitis is the most frequent ectoparasitosis around the world. The infestation is caused by Pediculus humanus capitis (head louse), which affects hair, scalp, and skin. It rarely presents with more symptoms and in the majority of the cases, it shows a benign course if treated properly. We present the case of a nursery school girl with head lice infestation for 18 months. She did not improve after the shampoo treatment. This case was associated with furunculosis, skin lesions, multiple adenopathies, and anemia. Initially, the presence of boils, alopecia, and lymphadenopathy was evident. The persistence of pediculosis capitis and intense scratching induced changes on skin integrity, facilitating opportunistic bacterial superinfection that led to impetiginization, furunculosis, excoriations, hematic scabs, anemia, alopecia, and lymphadenopathies. Pediculosis capitis affected the patient triggering psychological, economic, social, and other health problems. The patient presented uncommon symptoms (furunculosis, anemia, fever, alopecia, and adenopathies) resulting from the persistence of risk factors and the absence of head inspection and mechanical removal of insects. The education about the risk factors, as well as sanitary controls, are essential to contain the infestation.

Prevalence and Alternative Treatment of Head-Lice Infestation in Rural Thailand: A Community-Based Study

Head-lice infestation, pediculosis capitis, remains a public-health burden in many countries. The widely used first-line pediculicides and alternative treatments are often too costly for use in poor socio-economic settings. Ivermectin has been considered an alternate treatment for field practice. This study was composed of 2 parts, a cross-sectional survey and an intervention study. The main objectives were to determine the prevalence and potential factors associated with head-lice infestation, and to evaluate the effectiveness and safety of oral ivermectin administration. A community-based cross-sectional survey was conducted among 890 villagers in rural areas along Thai-Myanmar border. Females with infestations were eligible for the intervention study, and 181 participated in the intervention study. A post-treatment survey was conducted to assess acceptance of ivermectin as a treatment choice. Data analysis used descriptive statistics and a generalized-estimation-equation model adjusted for cluster effect. The study revealed the prevalence of head-lice infestation was 50% among females and only 3% among males. Age stratification showed a high prevalence among females aged <20 years, and among 50% of female school-children. The prevalence was persistent among those with a history of infestation. The major risk factors were residing in a setting with other infected cases, and sharing a hair comb. The study also confirmed that ivermectin was safe and effective for field-based practice. It was considered a preferable treatment option. In conclusion, behavior-change communication should be implemented to reduce the observed high prevalence of head-lice infestation. Ivermectin may be an alternative choice for head-lice treatment, especially in remote areas.

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

Pediculus capitis en niños de escuelas de la zona urbana de Nuevo León, México: análisis de factores asociados / Pediculus capitis in schoolchildren of the urban area of Nuevo León, México: Analyses of associated factors

Resumen Introducción. La pediculosis capitis es un problema recurrente que afecta anualmente de 6 a 12 millones de niños; no existen datos epidemiológicos en el estado de Nuevo León, y en México son escasos, por lo cual se necesitan estudios fundamentados para diseñar estrategias de control basadas en los factores que predisponen a la infestación por piojos. Objetivo. Determinar la prevalencia de Pediculus capitis en niños de educación primaria para detectar factores de riesgo y conocer las características individuales y las condiciones socioeconómicas asociadas estadísticamente con la infestación. Materiales y métodos. Se incluyeron 840 escolares de seis municipios, previa firma del consentimiento informado por parte de los padres y de los niños. Los ectoparásitos se recolectaron en cada niño infestado utilizando un peine fino. Los participantes contestaron una encuesta que incluía variables individuales y socioeconómicas, como la edad, el sexo, el grado escolar, las características del cabello, el hacinamiento y la pediculosis en hermanos, entre otras. Resultados. La prevalencia de pediculosis capitis en los niños fue de 28 % (235/840), con una mayor prevalencia en las niñas (33,7 %; 140/417); los niños del quinto grado (10 a 11 años) fueron los más afectados (6,2 %; 52/840). El sexo femenino, el cabello largo y el nivel escolar de los padres se asociaron significativamente con la pediculosis capitis. Conclusiones. Los resultados demostraron que la prevalencia de pediculosis capitis en Nuevo León es una de las más altas de México y que es un problema real de salud pública,por lo cual es importante establecer programas de prevención en la escuela y en el hogar para disminuirla o controlarla con la ayuda de las autoridades de salud pública.

Abstract Introduction: Pediculosis capitis is a recurring problem affecting 6 to 12 millions of children annually; there are no epidemiological data on this subject in the state of Nuevo León, and there are few in México. Therefore, new contributions are needed to design control strategies based on factors that may predispose to head lice infestation. Objective: To determine the prevalence of Pediculus capitis in primary school children and to evaluate risk factors and individual or socioeconomic characteristics statistically associated with infestation. Materials and methods: We included 840 schoolchildren from six municipalities after parents and children signed an informed consent. Ectoparasites were collected from infested children using a fine-toothed comb. Participants were interviewed using a questionnaire on individual and socioeconomic variables including age, gender, education, hair characteristics, overcrowding, and siblings with pediculosis, among others. Results: The overall prevalence of head lice in schoolchildren was 28% (235/840), the highest prevalence was among girls (33.7%, 140/417), and children from the fifth grade (10-11 years old) were the most affected (6.2%; 52/840). Female gender, long hair and the father's education level were significantly associated with P. capitis. Conclusion: Our results showed that the P. capitis prevalence in Nuevo León is one of the highest in Mexico, that it constitutes a real public health problem,and that there is need to establish prevention programsat home and school to decrease or to controlP. capitis with the support of public health authorities.

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

Piedra blanca en pacientes de centros dermatológicos de Pereira / Report of cases of white stone in patients of dermatological centers from Pereira

La piedra blanca es una micosis superficial crónica y asintomática poco frecuente del pelo causada por Trichosporon spp. (T. asahii, T. cutaneum o T. beigelii, T. inkin y T. mucoides), caracterizada por presentar nódulos blandos, blanquecinos, adheridos a los tallos pilosos, preferentemente del cuero cabelludo, axilas, cejas, pestañas y con menor frecuencia, en la barba, el bigote, el pubis y el perineo. Suele aparecer con mayor frecuencia en población de climas templados y tropicales. En los tres casos reportados se tomó muestra de los cabellos con los nódulos sospechosos, se le realizaron pruebas diagnósticas que permitieron confirmar la presencia de estructuras levaduriformes compatibles con Trichosporon spp. La sospecha de pediculosis es el motivo de consulta de los pacientes con piedra blanca, confundiendo los nódulos con liendres; por consiguiente es importante que el médico tenga claro las enfermedades micóticas con las cuales se debe hacer el diagnóstico diferencial para poder orientar y establecer el adecuado tratamiento para el paciente

The white stone is a rare, superficial, chronic and asymptomatic mycosis of the hair caused by Trichosporon spp. (T asahii, T. cutaneum or T. beigelli, T. inkin, and T. mucoid), which is characterized by the presence of white soft nodules, adhered to the hair shafts, preferably the scalp, armpits, eyebrows, eyelashes, and less frequently, in the beard, moustache, pubic area and perineum. It usually appears with greater frequency in areas of temperate and tropical climates. In the three reported cases, the sample of hair was taken from suspect hair, and then a series of diagnostic tests were performed to allow the confirmation of the presence of yeast shaped structures compatible with Trichosporon spp. Often, a possible pediculosis was the main reason of consultation of the patients who suffer white stone, and it can be confused with nodules of nits. Therefore, it is important that the physician has a better understanding of the fungal diseases that will be part of the differential diagnosis in order to guide and establish a proper treatment for the patients

Safety, Efficacy, and Physicochemical Characterization of Tinospora crispa Ointment: A Community-Based Formulation against Pediculus humanus capitis

The high prevalence of pediculosis capitis, commonly known as head lice (Pediculus humanus capitis) infestation, has led to the preparation of a community-based pediculicidal ointment, which is made of common household items and the extract of Tinospora crispa stem. The present study aimed to evaluate the safety, efficacy, and physicochemical characteristics of the T. crispa pediculicidal ointment. The physicochemical properties of the ointment were characterized, and safety was determined using acute dermal irritation test (OECD 404), while the efficacy was assessed using an in vitro pediculicidal assay. Furthermore, the chemical compounds present in T. crispa were identified using liquid-liquid extraction followed by ultra-performance liquid chromatography quadruple time-of-flight mass spectrometric (UPLC-qTOF/MS) analysis. The community-based ointment formulation was light yellow in color, homogeneous, smooth, with distinct aromatic odor and pH of 6.92±0.09. It has spreadability value of 15.04±0.98 g·cm/sec and has thixotropic behavior. It was also found to be non-irritant, with a primary irritation index value of 0.15. Moreover, it was comparable to the pediculicidal activity of the positive control Kwell®, a commercially available 1% permethrin shampoo (P>0.05), and was significantly different to the activity of the negative control ointment, a mixture of palm oil and candle wax (P<0.05). These findings suggested that the community-based T. crispa pediculicidal ointment is safe and effective, having acceptable physicochemical characteristics. Its activity can be attributed to the presence of compounds moupinamide and physalin I.

Efecto pediculicida de una formulación en base a Eucaliptus globulus L / Pediculicide effect of a Eucaliptus globulus L formulation

Introduction: Pediculosis capitis is a public health problem with a high prevalence. The emergence of parasite resistance to conventional pediculicide is of great concern worldwide. Objective: To develop alternatives pediculicide, effective and safe, based on the essential oil of Eucaliptus globulus. Method: Through bioassays active concentrations ranges of the essential oil were established, and proceeded to develop a standardized, stable, pharmaceutical form, evaluating its effects on our population. Results: The results showed 100% effectiveness; short time of death, ovicidal action, activity on the adhesion of the egg, and low toxicity. Discussion: In addition to great effect, the inability of the parasite to become resistant to the chemical composition of the essential oil makes this formulation an alternative to the problem of head lice solution.

Introducción: La pediculosis capitis es un problema de salud pública con una alta prevalencia. La aparición de resistencia del parásito a los pediculicidas convencionales es de gran preocupación a nivel mundial. Objetivo: Desarrollar alternativas pediculicidas, efectivas y seguras, en base al aceite esencial de Eucaliptus globulus. Método: A través de bioensayos se establecieron rangos de concentraciones activas del aceite esencial, y se procedió al desarrollo de una forma farmacéutica, estandarizada, estable, evaluando sus efectos en nuestra población. Resultados: Los resultados mostraron 100% de efectividad; corto tiempo de muerte, acción ovicida, actividad sobre la adherencia del huevo, y baja toxicidad. Discusión: Además de la gran efectividad, la imposibilidad del parásito de adquirir resistencia a la composición química del aceite esencial hace de esta formulación una solución alternativa al problema de la pediculosis.

Randomized controlled trial on the effect of coconut oil, vinegar plus cooking coconut oil versus 1% permethrin shampoo in the treatment of pediculosis

Objective@#To determine the efficacy of cooking coconut oil and vinegar as compared to 1% Permethrin shampoo in the treatment of Pediculosis humanus capitis in children 3 – 12 years old. @*Methodology@#The study was conducted in Barangay 704, Zone 77 in Malate among children 3 – 12 years old. Two hundred forty-five subjects were screened and the computed sample size was 150. Subjects were randomized to three treatment groups: coconut oil (CO) group; vinegar plus coconut oil (CV) group; and 1% permethrin shampoo (PS) group. Treatments were given on the 1st and 8th day. The final level of infestation was determined on the 14th day. Cure rates, failure rates, and expenses were also determined. @*Results@#Permethrin achieved superiority over plain coconut oil (X2=18.77 p-value = 0.00). There was no sufficient evidence to prove the superiority of permethrin over coconut-vinegar solution (X2=1.04 p-value = 0.30). Twenty-two percent (11) of the participants from the PS group developed itching and irritation. No adverse effect was reported from the CO and CV groups. Permethrin was 14 times and five times more expensive than coconut oil and vinegar plus coconut oil, respectively. @*Conclusion@#Permethrin shampoo had a cure rate of 98%. Plain coconut oil and vinegar plus coconut oil had cure rates of 68% and 94%, respectively. Plain coconut oil had the highest failure rate at 36%, vinegar plus coconut oil at 6%, and permethrin shampoo with 2%. Adverse effects were exclusive to the PS group. Plain coconut oil was the most economical but coconut oil with vinegar with its significant cure rate can be an alternative therapy to permethrin shampoo in the treatment of head lice in children.

Electron Microscopic Alterations in Pediculus humanus capitis Exposed to Some Pediculicidal Plant Extracts

Head lice, Pediculus humanus capitis, infestation is an important public health problem in Egypt. Inadequate application of topical pediculicides and the increasing resistance to the commonly used pediculicides made the urgent need for the development of new agents able to induce irreversible changes in the exposed lice leading to their mortality. The aim of the present work is to evaluate pediculicidal efficacy of some natural products such as olive oil, tea tree oil, lemon juice, and ivermectin separately in comparison with tetramethrin-piperonyl butoxide (licid), as a standard pediculicide commonly used in Egypt. The effects of these products were evaluated by direct observation using dissecting and scanning electron microscopes (SEM). Results showed that after 1 hr exposure time in vitro, absolute (100%) mortalities were recorded after exposure to 1% ivermectin and fresh concentrate lemon juice. The mortalities were decreased to 96.7% after exposure to tea tree oil. Very low percentage of mortality (23.3%) was recorded after 1 hr of exposure to extra virgin olive oil. On the other hand, the reference pediculicide (licid) revealed only mortality rate of 93.3%. On the contrary, no mortalities were recorded in the control group exposed to distilled water. By SEM examination, control lice preserved outer smooth architecture, eyes, antenna, respiratory spiracles, sensory hairs, and legs with hook-like claws. In contrast, dead lice which had been exposed to pediculicidal products showed damage of outer smooth architecture, sensory hairs, respiratory spiracles and/or clinching claws according to pediculicidal products used.

Serie parasitosis en dermatología: pediculosis / Parasitosis in dermatology: pediculosis

La enfermedad producida por Pediculus humanus capitis, conocida como pediculosis, es una parasitosis específica del ser humano de distribución mundial. El contagio puede ser directo por contacto con el cuero cabelludo de una persona afectada, o por fómites contaminados con parásitos, por lo que no distingue raza, sexo, edad ni nivel socioeconómico. Presentamos el caso de una paciente de 80 años con una forma típica de pediculosis. (AU)

The disease caused by Pediculus humanus capitis, known as pediculosis, is a human specific parasitosis. It has a worldwide distribution. Transmission can be by direct contact with the scalp of an affected person or by contaminated fomites with parasites. This infestation makes no distinction of race, sex, age, or socioeconomic status. We present a case of an 80 years old patient with a typical case of pediculosis. (AU)

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.

Negligible Egg Positive Rate of Enterobius vermicularis and No Detection of Head Lice among Orphanage Children in Busan and Ulsan, Korea (2014)

To determine whether pinworm infections and head lice infestations spread among children in orphanages, 117 children from 4 orphanages in Busan-si and Ulsan-si, Korea, were examined for enterobiasis and head lice infestation between January and February 2014. The overall rate of Enterobius vermicularis egg positivity was 0.85%, whereas none of the children had head lice infestations. The rate of pinworm infection was much lower among the orphanage children compared to the rates observed in previous studies among kindergarten and primary school students. Moreover, the risk factors for enterobiasis were less frequent among these subjects than previously reported. The personal hygiene and health of the orphanage children were supervised by a regular, employed nurse through a health education program. In conclusion, pinworm infection was efficiently controlled among the children in orphanages, and this might be related to good personal hygiene practices in Korea.

Comparison of school-based and home-based application of permethrin shampoo for the treatment of Pediculosis capatis - A pragmatic cluster-randomized trial

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Pediculosis continues to be a common yet neglected public health problem especially in children. Trials to test for effectiveness for head lice interventions are heterogeneous, and a recent systematic review recommended  the use of cluster randomization and centralized administration (e.g. school) of permethrin for pediculosis trials.</p> <p style="text-align: justify;"><strong>OBJECTIVE:</strong> To compare the effectiveness of a school-based to a home-based intervention using permethrin 1% shampoo in treating pediculosis capitis. </p> <p style="text-align: justify;"><strong>METHODS:</strong> We conducted a pragmatic, cluster-randomized trial at the Makati Elementary School. All Grade Four students  (n = 211), belonging to a total of five class sections, were invited to participate in the study. Students with a known allergic reaction to permethrin 1% shampoo, with open wounds on the scalp, or were absent on Days 1 or 10 of the intervention period were excluded. The five class sections were randomized to receive permethrin 1% shampoo to be applied either in school, or at home. The students were classified as having none, light, medium, or heavy infestation prior to Day 1 and after Day 10 treatment. Prevalence, incidence, and treatment outcomes were measured.</p> <p style="text-align: justify;"><strong>RESULTS:</strong> The baseline prevalence of pediculosis capitis was 58.4%. General characteristics of students were similar between groups. No significant clustering in pediculosis classification was observed. The school-based group had the same prevalence in pediculosis at Days 1 and 10, had no incident cases, and were limited to light infestation by Day 10, but had no treatment success outcomes. The home-based group had increased prevalence by Day 10, poor compliance with Day 1 and 10 shampoo,  incident cases, although it registered a higher treatment success rate.</p> <p style="text-align: justify;"><strong>CONCLUSION:</strong> Compared to standard home based intervention, a school-based strategy resulted in less incident cases (0% vs. 37%), reduction in pediculosis severity (p = 0.007), and higher compliance (100% vs. 58.3%). Control of pediculosis in this specific community is largely warranted because of its high prevalence rate of 59.7%.</p> <p style="text-align: justify;"> </p>

Dermoscopy applied to pediculosis corporis diagnosis

We report the case of a 47-year-old homeless male with a massive infestation of Pediculus humanus corporis on his entire body. Dermoscopy helped to diagnose pediculosis by showing the involvement of scalp, beard and the genital region in this disease.

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.

A double blind randomized clinical trial on the efficacy of citronella shampoo versus 5% permethrin lotion in the treatment of head lice infestation

@#<p style="text-align: justify;"><strong>BACKGROUND: </strong>Resistance to standard permethrin lotion has been reported. There is a continuing search for more natural and safe remedies for head lice infestation among children. Citronella, a natural repellant, has been reported as a pediculocide.<br /><strong>OBJECTIVE:</strong>To compare the efficacy of Citronella shampoo versus 5% permethrin lotion in controlling head lice (Pediculosis humanus capitis) among children between 5 years old.<br /><strong>METHODS:</strong> A double-blind randomized clinical trial was performed at the community outpatient department of MPI-Medical Center Muntinlupa Foundation, PNR (Phil. National Railway) Site Bgy. Putatan, City of Muntinlupa. Children living in areas endemic for head lice were screened, and if found positive, were randomized equally to daily citronella shampooing (CS) or permethrin lotion (PL). Subjects were manually 2nd, 7th and 14th day of treatment. Chi-square test was used to compare proportions, which considered p-values less than .05 as statistically significant.<br /><strong>RESULTS:</strong> Eighty-two children with head lice were included in the final analysis. Children in both groups were comparable in terms of age, sex, family size with head lice, anthropometric measures, frequency of bathing and shampooing and baseline severity of head lice infestation. Citronella shampoo was as effective as the standard 5% permethrin lotion in eradicating head lice in children. The cure rates were comparable for day 2 (CS=65.1% versus PL=72.1%, p=.76), day 7 (CS=65.1% versus PL= 79.1%, p=.30), and day 14 (CS=81.4% versus PL =90.7%, p=33) of treatment. There were no re-infestations and adverse reactions noted for the use of Citronella and the refragrance was more acceptable.<br /><strong>CONCLUSION:</strong> Citronella is a effective as Permethrin lotion in the eradication of headlice and Citronella shampooing can be an alternative natural remedy of headlice and Citrone for pediatric head lice.</p>