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.

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

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.

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.

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.

Tratamiento eficaz con tintura de añil 5 por ciento de una paciente infestada por Pediculus capitis / Effective treatment of a patient infested with pediculus capitis by using 5 percent Indigofera suffruticosa Mill tincture

Introducción: en Cuba se reportaron altas frecuencias de pediculosis capitis desde finales de los años noventa, particularmente en algunos grupos de escolares y sus convivientes. Estos últimos se involucran en la cadena de transmisión de esos insectos y pueden desempeñar, en la actualidad, una función importante como reservorios del parásito. Objetivo: reportar la eficacia del tratamiento con añil cimarrón en una paciente infestada de Pediculus capitis. Métodos: se describe un caso de infestación persistente con pediculosis capitis en una paciente de 55 años de edad, tratada con solución de permetrina 1 por ciento y posteriormente con tintura de añil cimarrón 5 por ciento. Resultados: la identificación microscópica de adultos y estadios pre-adultos del parásito confirmaron la presencia de Pediculus capitis. El tratamiento del cabello con permetrina 1 por ciento no fue eficaz en 2 aplicaciones realizadas. Como alternativa de tratamiento, se aplicó tintura de añil 5 por ciento, lo que permitió disminuir la población de ectoparásitos adultos y logró eliminar la infestación después de una segunda aplicación, con la constante extracción de las liendres realizada por el personal paramédico encargado del caso. Conclusión: la aplicación de este procedimiento inocuo podría servir como alternativa terapéutica para esta afección.

Introduction: pediculosis capitis was very frequently reported in Cuba since the end of the 90's, particularly in some groups of school children and their relatives. The latter are involved in a chain of transmission of these insects and may play an important role at present as parasite reservoirs. Objective: to report on the efficacy of the treatment of one female patient suffering from Pediculus capitis by using 5 percent Indigofera suffruticosa Mill (añil cimarrón) tincture. Methods: a case of persistent infestation with pediculosis capitis was described in which a 55 years-old patient was firstly treated with 1 percent permethrin solution and later with 5 percent Indigofera suffruticosa Mill tincture. Results: the microscopic identification of adult parasites and pre-adult stages of the parasite confirmed the presence of pediculus capitis. The hair treatment with 1 percent permethrin was not effective after two applications. As an alternative, 5 percent Indigofera suffruticosa Mill tincture was used and then the population of adult ectoparasites was reduced and the infestation was eliminated after the second application, with the paramedical staff continuously taking the nits out from the patient's hair. Conclusion: the use of this innocuous method may become a therapeutic alternative to treat this illness.

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.

Uso deliberado de diversos productos para el control de Pediculus capitis (De Geer, 1778 ) por padres o tutores de niños de escuelas primarias / Deliberate use of several products for Pediculus capitis (De Geer, 1778 ) control by parents or tutors of elementary school children

INTRODUCCIÓN: la automedicación y el uso de diversos productos como pediculicidas parece ser frecuente entre los convivientes para tratar de eliminar los piojos de la cabeza en los escolares. OBJETIVO: analizar el uso deliberado, por los convivientes con educandos de primaria, de diversos productos para controlar la pediculosis capitis en los niños. MÉTODOS: se realizó una encuesta por cuestionario e intercambio de opiniones con 896 convivientes con niños entre 5 y 10 años, que estudiaban en 19 escuelas urbanas y semiurbanas de primera enseñanza, de las provincias de las zonas occidental, central y oriental de Cuba, sobre los productos utilizados para controlar o eliminar los piojos de la cabeza. RESULTADOS: la población encuestada cita más de 40 productos. Entre las sustancias más reportadas se encuentra el alcohol, el DDT y el lindano, que fueron anteriormente rechazados por su toxicidad e ineficacia. Se reportan en uso productos empleados en la agricultura, la salud pública y la medicina veterinaria para el control de plagas; entre ellos, temephos, esteladón, malathion, parathión, baytex; también derivados del petróleo como el líquido de freno, keroseno y la gasolina. CONCLUSIÓN: en el trabajo se refieren numerosas sustancias tóxicas utilizadas en la terapéutica para el control de Pediculus capitis en niños, cuyo riesgo supera los beneficios esperados. Resulta bajo el porcentaje de personas que utilizan la extracción manual como único tratamiento, no obstante ser el método menos dañino y más eficaz.

INTRODUCTION: self-medication and use of several products as peliculicides seem to be common procedures for those persons living with schoolchildren, in order to eliminate head lice. OBJECTIVE: to analyze the deliberate use of several products by the people living with elementary school children, so as to control their pediculosis capitis. METHODS: a questionnaire- and exchange of opinion-based survey on the products used to control or eliminate head lice was administered to 896 people who lived with children aged 5 to 10 years. These children studied in 19 elementary schools in urban and suburban areas located in the western, central and eastern provinces of Cuba. RESULTS: the surveyed population mentioned more than 40 products. Among the most reported substances were alcohol, DDT and lindano which were previously rejected owing to their toxicity and ineffectiveness. There were also reports on products from agricultural, public health and veterinary medicine, including those devoted to plague control such as temephos, steladon, malathion, parathion, baytex; also oil derivatives like brake fluid, kerosene and gasoline. CONCLUSIONS: the paper mentioned a number of toxic substances used in treating Pediculus capitis in children, the risks of which outweighted the expected benefits. The percentage of persons who manually remove lice from the head as the only treatment is low; however, this is the less harmful and more effective method.

Utilidade do pente metálico com dentes microcanaliculados no diagnóstico da pediculose / Metal microchanelled fine-toothed comb use in the diagnosis of pediculosis

Fundamentos: Os métodos para diagnosticar Pediculus humanus var. capitis são controvertidos e a maioria dos estudos tem usado o exame visual direto. Objetivos: O objetivo deste estudo foi comparar a eficácia no diagnóstico do exame visual direto em contraposição ao uso do pente metálico de aço com dentes microcanaliculados. Métodos: Investigaram-se 946 crianças e adolescentes de quatro a 19 anos. O cabelo de cada criança foi examinado duas vezes, para detectar infestação pelos diferentes estádios, por meio da observação visual direta e com o pente metálico. Resultados: O diagnóstico visual apontou infestação em 30,7 por cento dos casos, enquanto que o pente metálico indicou um resultado de 51,5 por cento. O sexo feminino foi o mais acometido, de acordo com ambos os métodos. As formas parasitárias detectadas com o exame visual direto foram: somente piolhos (adultos e/ou ninfas); 1,4 por cento; somente lêndeas vivas, 64,8 por cento; e lêndeas vivas mais piolhos, 33,8 por cento; com o pente metálico, foram 6,4 por cento, 23,6 por cento e 70 por cento, respectivamente. A média de tempo para descobrir um piolho foi de 57 segundos com o pente metálico e de 116,4 segundos com a observação visual direta. Conclusões: O diagnóstico é duas vezes mais rápido e 3,6 vezes mais eficiente com o pente metálico microcanaliculado. O método visual leva a uma subestimação das infestações ativas e revela as passadas não ativas.

Background: Methods for the diagnosis of Pediculus humanus var. capitis are controversial and most studies are based on direct visual exam. Objective: The objective of this study was to compare the diagnosis efficacy of both direct visual exam and the use of a metal microchanelled fine-toothed comb. Methods: 946 children and teenagers 4 to 19 years of age were examined. Each individual’s hair was examined twice to determine whether there was infestation by lice or nits, through direct visual exam and the use of a metal microchanelled fine-toothed comb. Results: The visual diagnosis detected infestation in 30.7 percent of the cases, while the metal comb detected infestation in 51.5 percent. Females were the most affected. The forms of parasites detected through direct visual exam were: only lice (adults and/or nymphs) 1.4 percent, only live nits 64.8 percent and live nits and lice, 33.8 percent; with the metal comb the percentages were 6.4 percent, 23.6 percent and 70 percent, respectively. The average time to find a louse was 57 seconds with the fine-toothed comb and 116.4 seconds through the direct visual exam. Conclusions: Diagnosis with the microchanelled fine-toothed comb is twice as fast and 3.6 times more efficient than through direct visual exam.The direct visual exam detects non-active, past infestations, and underestimates active ones.

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.

Pesquisa, tratamiento y resistencia en pediculosis capitis en comuna de la región metropolitana, Santiago, Chile / Investigation, treatment and resistance in pediculosis capitis in comune of metropolitan region, Santiago, Chile

Por la importancia médica que reviste, la ectoparasitosis más importante es la pediculosis humana variedad capitis, que podría definirse como la infestación de la cabeza por piojos. Dada la alta prevalencia de pediculosis, sobre todo en la población pediátrica, es vital el conocer las características epidemiológicas de esta patología. Por otra parte, son cada vez más los reportes tanto a nivel nacional coma internacional. de resistencia al tratamiento por parte de los parásitos, por lo que saber cuáles son los tratamientos más usados por la población, si estos tienen o no indicación médica y cuáles fueron sus resultados, es relevante. Se realizó un estudio descriptivo de corte transversal en el Consultorio Esmeralda, comuna de Colina, aplicando una encuesta prediseñada que consignaba los siguientes datos: numero de habitantes del hogar (especificando niños y adultos), grado de hacinamiento, probable fuente de contagio, tratamiento utilizado, quién indicó el tratamiento y efectividad de este. Los datos se tabularon y analizaron expresando los resultados en porcentajes. Un total de 320 encuestas consignó 951 casos de pediculosis. El grado de hacinamiento fue en promedia de 2,4 personas por dormitorio. El promedio de edad de los infestados fue de 13,03 alias (rango entre 0 y 53 años), observándose que un 78,65 por ciento correspondía a menores de 16 años. En cuanto a la probable fuente de contagio, un 93,7 por ciento consideraba que el origen de la infestación familiar era el establecimiento educacional de uno de las niños de la casa. Del total de los casos un 96,6 por ciento recibió tratamiento farmacológico, de los cuales solo un 35,9 por ciento tenía indicación por algún profesional de la salud. Destacó dentro del tratamiento farmacológico, el uso de Lindano (30,1 por ciento) y de champú pediculicida (69,90 por ciento).

By the medical importance that has, the most important ectoparasites is the human pediculosis variety capitis, that could be defined as the infestation of the head by lice. Given the high prevalence of pediculosis, coverall in the paediatric population, is vital knowing the characteristic epidemiologists of this pathology on the other hand, they are more and more the reports as much at national level as International, of resistance to the treatment on the part of the parasites, reason why to know which are the treatments more used by the population, if these has or medical indication and which were not their results, is excellent. A descriptive study was realised of cross section in the Emerald Health Consulting Institution, commune of Colina, applying a predesigned survey that bnefed the following data: number of inhabitants of the home (specifying young and adult), overcrowding degree, probable source of contagion, used treatment, who indicated the treatment and effectiveness of this one. The data were tabularon and analyzed expressing the results in percentage. A total of 320 surveys briefed 957 cases of pediculosis. The overcrowding degree was in average of 2.4 people by dormitory The average of age of the infested ones was of 13.03 years (rank between 0 and 53 years), being observed that a 78.65 percent corresponded to minors of 16 years. As far as the probable source of contagion, a 93.7 percent considered that the origin of the familiar infestation was the educational establishment of one of the children of the house. From the total of the cases a 96.6 percent received pharmacological treatment, of which a 35.9 percent only had indication by some professional of the health. It emphasized within the pharmacological treatment, the use of Lindane (30.7 percent) and pediculicide shampoo (69.90 percent).