Abametapir for the Treatment of Head Lice: A Drug Review.

OBJECTIVE: This article reviews the pharmacology, safety, efficacy, and clinical importance of abametapir 0.74% (Xeglyze) for the treatment of head lice. DATA SOURCES: From 2020 to May 2021, a systematic review of the MEDLINE and EMBASE databases was conducted using the terms abametapir, Xeglyze, Ha44, and head lice. Bibliographies, Food and Drug Administration (FDA) drug package inserts, and ClinicalTrials.gov were searched for further information. STUDY SELECTION AND DATA EXTRACTION: All relevant full-text articles in English were considered for inclusion, with a final article date range of 1999 to 2020. DATA SYNTHESIS: Abametapir chelates heavy metal cations and inhibits metalloproteinases critical to louse ova development, hatching, and adult survival. In phase II, abametapir had direct ovicidal activity inhibiting 100% of treated louse eggs from hatching, compared with 64% in the vehicle-treated group. In two identical phase III clinical trials, subjects treated with a single 10-minute application of abametapir had greater treatment success compared with vehicle-treated subjects, with 81.1% success versus 50.9% in study 1 (P = 0.001) and 81.8% versus 47.2% in study 2 (P < 0.001). Abametapir was well tolerated, with only mild adverse effects. RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE: Abametapir is a newly FDA-approved, single-application treatment for head lice in patients aged 6 months and older. This review highlights the safety and efficacy of abametapir in the treatment of head lice. CONCLUSIONS: In the wake of increasing widespread resistance to first-line treatment options, abametapir offers a safe and effective new treatment option for head lice infestations.

Effect of Environmental Conditions and Toxic Compounds on the Locomotor Activity of Pediculus humanus capitis (Phthiraptera: Pediculidae).

In this work, we evaluated the effect of environmental variables such as temperature, humidity, and light on the locomotor activity of Pediculus humanus capitis. In addition, we used selected conditions of temperature, humidity, and light to study the effects of cypermethrin and N,N-diethyl-3-methylbenzamide (DEET) on the locomotor activity of head lice. Head lice increased their locomotor activity in an arena at 30°C compared with activity at 20°C. When we tested the influence of the humidity level, the locomotor activity of head lice showed no significant differences related to humidity level, both at 30°C and 20°C. Concerning light influence, we observed that the higher the intensity of light, the slower the movement of head lice. We also demonstrated that sublethal doses of toxics may alter locomotor activity in adults of head lice. Sublethal doses of cypermethrin induced hyperactivated responses in adult head lice. Sublethal doses of DEET evocated hypoactivated responses in head lice. The observation of stereotyped behavior in head lice elicited by toxic compounds proved that measuring locomotor activity in an experimental set-up where environmental conditions are controlled would be appropriate to evaluate compounds of biological importance, such as molecules involved in the host-parasite interaction and intraspecific relationships.

In Vitro and In Vivo Evaluation of Infestation Deterrents Against Lice.

The human head louse is a cosmopolitan ectoparasite and frequently infests many people, particularly school-age children. Due to widespread pyrethroid resistance and the lack of efficient resistance management, there has been a considerable interest in the protection of uninfested people and prevention of reinfestation by disrupting lice transfer. In this study, two nonclinical model systems (in vitro and in vivo) were used to determine the efficacy of the infestation deterrents, Elimax lotion and Elimax shampoo, against human head lice or poultry chewing lice, respectively. With in vitro assessments, female head lice exhibited significantly higher avoidance responses to hair tufts treated with either of the test formulations, which led to significantly higher ovipositional avoidance when compared with female lice on control hair tufts. Additionally, both formulations were determined to be competent infestation deterrents in a competitive avoidance test in the presence of a known attractant (head louse feces extract). In in vivo assessments using a previously validated poultry model, Elimax shampoo was determined to be an efficacious deterrent against poultry chewing lice within Menopon spp. and Menacanthus spp.

Head Lice Infestation in Schoolchildren, in Poland-Is There a Chance for Change?

Pediculosis capitis is a current and neglected health issue worldwide. The lack of screening programs contributes to the marginalization of the problem and delays therapeutic measures. Our study aimed to analyze the occurrence of this parasitosis in primary schools in Poland and to determine factors contributing to the persistence of its foci. The research tools were two questionnaires: one for primary school children and the other for school managers. While children answered questions about the epidemiology of pediculosis capitis and expressed their opinion on the hygienic condition of infested persons, the school directors were asked about the occurrence of head lice in schools, preventive measures, and institutions supporting schools in combating the infestation. The survey covered the period 2014-2018. Pediculosis capitis was reported in 87.5% of the schools. The greatest number of cases was reported in the group of 6-9 year-olds (68%). Among 4970 children, 16.7% had no knowledge of head lice; however, 57.1% wanted to increase their awareness of the problem. Campaigns on lice were conducted mainly as a result of emerging pediculosis capitis cases, and most schools could not rely on institutional support. Screening programs and preventive educational campaigns should be part of pediculosis capitis control in Poland.

[Randomised clinical trial to evaluate the efficacy and safety of a new pediculicide made with saponified olive oil in the eradication of Pediculus humanus capitis]. / Ensayo clínico aleatorizado para evaluar la eficacia y seguridad en la erradicación del Pediculus humanus capitis de un nuevo pediculicida elaborado con aceite de oliva saponificado.

INTRODUCTION: The aim of the study was to evaluate the efficacy and safety of a new pediculicide in the eradication of Pediculus humanus capitis infestation. MATERIAL AND METHODS: A randomised clinical trial was designed, in which children aged between 5 and 15 years diagnosed with pediculosis were selected. Treatment was administered on days 1 and 7 after selection, and they were evaluated in 4 visits (day 2, 7, 9, and 14). The product under evaluation with saponified olive oil was Inex Pediculicide Soap®, which was compared with Paranix®, with a similar mechanism of action. The primary efficacy endpoint was the eradication of the parasite by day 14 (louse-free rate), using an intention to treat analysis. RESULTS: Six paediatricians from 5 Primary Health Care centres in the Community of Madrid (Spain) and one private clinic participated in the study. A total of 45 children were included, of which 75.6% were girls (n=34). The mean age was 7.1 years (95% CI 6.3-7.9). The large majority (80%) were middle class, and 82.2% had a history of previous pediculosis. The efficacy at 14 days was 76.2% (95% CI 52.8-91.8) in the group treated with Inex Pediculicide Soap® group, and 79.2% (95% CI 57.9-92.9) in Paranix® group (NNT=33.3). No adverse effects were observed with treatment. CONCLUSIONS: The 2 products were effective and safe in the eradication therapy Pediculus humanus capitis, with no statistical differences.

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)

Determinantes sociocomportamentais e vulnerabilidade de crianças da educação infantil à pediculose / Socio-behavioral determinants and the vulnerability of children during early childhood education to pediculosis / Determinantes sociocomportamentales y vulnerabilidad de niños de la educación inicial a la pediculosis

O espaço escolar é associado à alta infestação pelo piolho de cabeça. Este trabalho objetivou caracterizar os determinantes sociocomportamentais e a vulnerabilidade de pré-escolares à infestação por Pediculus humanus capitis no município de Aracaju, estado de Sergipe. A pesquisa de campo exploratória foi realizada de junho a agosto de 2014, na microrregião do bairro Augusto Franco, no domínio familiar (unidades domésticas) e escolar (Escola Municipal de Ensino Infantil). A análise dos dados utilizou a estatística descritiva, teste Qui-quadrado de Pearson e Odds Ratio. Aproximadamente de 64% (30/47) dos entrevistados recebem até 1 salário mínimo e possuem residência própria, a quantidade de filhos foi entre 2 e 3 crianças. 30% tiveram piolho, destas, 40% realizaram tratamento medicamentoso e 13,3% catação manual. Questões como a pediculose devem ser consideradas no contexto da situação, com metodologia participativa e dialógica no contexto familiar e escolar (AU).

Schools have a high rate of head lice infestations. The aim of this study was to characterize the socio-behavioral determinants and the vulnerability of early childhood education students to infestations by Pediculus humanus capitis in the city of Aracaju, Sergipe state. The exploratory field study was conducted from June to August 2014, in the micro region of the Augusto Fanco neighborhood, in the family domain (households) and school (Municipal Early Childhood Education Center). Data analysis used descriptive statistics, Pearson's Chi-square test and Odds Ratio. Approximately 64% (30/47) of respondents receive up to 1 minimum wage and have their own residence, the number of children was between 2 and 3 per interviewee. 30% had lice, of these, 40% were treated with medication and 13.3% used manual removal. Issues such as lice infestation should be considered in the context of the situation with dialogue and a participatory methodology in the family and school context (AU).

El espacio escolar está asociado a alta infestación por el piojo de cabeza. Este trabajo tuvo la finalidad de caracterizar los determinantes ociocomportamentales y la vulnerabilidad de preescolares a la infestación por Pediculus humanus capitis en el municipio de Aracaju, estado de Sergipe. La investigación de campo exploratoria fue realizada de junio a agosto de 2014, en la microrregión del barrio Augusto Franco, en el dominio familiar (unidades domésticas) escolar (Escuela Municipal de Enseñanza Inicial). El análisis de los datos utilizó la estadística descriptiva, test Chi- cuadrado de Pearson y OddsRatio. Aproximadamente 64% (30/47) de los entrevistados ganan hasta 1 salario mínimo y poseen vivienda propia; la cuantidad de hijos está entre 2 y 3 niños. Aproximadamente 30% tuvieron piojo, de estas, 40% realizaron tratamiento medicamentoso y 13,3% quitaron manualmente. Cuestiones como la pediculosis deben ser consideradas en el contexto de la situación, con metodología participativa y dialógica en el contexto familiar y escolar (AU).

Aspectos clínico-epidemiológicos sobre pediculosis capitis en arenales, Estado Falcón, Venezuela / Clinical and epidemiological aspects on pediculosis capitis in, Falcon State, Venezuela

la pediculosis capitis humana es una infestación del cuero cabelludo y del pelo, ocasionada por el Pediculus humanus capitis, la que puede producir infecciones bacterianas secundarias en el sitio del rascado, anemia y estrés social y psicológico con alteración en la calidad de vida y consternación. Entre Marzo y Julio de 2011, se realizó un trabajo para estudiar aspectos epidemiológicos y clínicos de la pediculosis capitis en 199 personas (79 varones y 120 mujeres), habitantes de diferentes grupos etéreos (0-75 años; ? ± D.S= 21,28 ± 17) de la población rural Arenales, zona semiárida del estado Falcón, región nor-occidental de Venezuela. El diagnóstico ectoparasitológico se realizó por observación directa con peine "ad hoc" de huevos (liendres), estados imaginales y/o pre-imaginales sobre el cuero cabelludo. Los insectos se clarificaron y montaron en medio de Hoyer para observación microscópica. Los resultados revelaron una prevalencia global de pediculosis capitis del 10,10% (20/199), con porcentajes de infestación significativamente mayores en las niñas (90 vs 10%) [Odds Ratio (OR) = 3,04; p = 0,01] en edad escolar (OR= 1,02; p =0,015;) con longitudes de cabello mayores de 3 cm (OR = 2,44; p = 0,004) y de tipo lisotrico (OR = 2,25; p = 0,015), sin embargo, no fueron diferentes entre grupos étnicos y color de pelo (P > 0,05). Se detectó un predominio de liendres (65%) desde 1 hasta 64/individuos, ubicadas entre 0,1 y 9 cm del cuero cabelludo en todas las regiones de la cabeza, teniendo los individuos de menor edad las mayores cargas ectoparasitarias. Los síntomas significativamente asociados a pediculosis fueron el prurito (6,53% en individuos infestados y 12,06% en los no infestados; OR =11,99; p = 0,000) y las excoriaciones (1,51% en niños infestados y 3,52% en los no infestados; OR =4,34; p = 0,03). Otros posibles factores de riesgo significativamente involucrados en la dinámica de transmisión y mantenimiento de la infestación fueron: jugar en piso de tierra (OR = 2,20; p = 0,012) y lavarse el cabello ≥2 /semana (OR = 1,01; p = 0,002). A la luz de los resultados obtenidos, es recomendable mejorar las condiciones socio-sanitarias del sector y mantener campañas de promoción y educación para la salud.

The human pediculosis capitis is a scalp and hair infestation caused by head lice Pediculus humanus capitis, which may result in bacterial secondary infections by intense scratching as well as anemia, anxiety and embarassment which are increased by children' exclusion from school under "no-nit" policy. From March to July 2011, a cross-sectional study was designed to determine the prevalence and clinical and epidemiological profiles of head lice infestation among 199 (79 males and 120 females) inhabitants of all age groups (0-75 years; ? ± D.S= 21.28 ± 17) of a rural and small town Arenales, from the semiarid region of Falcon state, north-western Venezuela.The diagnosis of head lice infestation was made by clinical naked eye inspection of scalp and hair for the presence of adult lice, nymphal stage, or eggs (nit) by line-toothed head lice comb. Lice was cleared and mounted in Hoyer’s medium for microscopic observation. All individuals were evaluated by physical examinationand a detailed, structured questionnaire. The overall prevalence of head lice infestation was 10.10% (20/199). The prevalence of infestation was significantly higher in girls (90%) than in boys (10%) [Odds Ratio (OR) = 3.04; p = 0.01] and school-aged children (OR= 1.02;p=0,015;) with hair length >3cm (OR = 2,44; p = 0.004) and lissotrichic type (OR = 2.25; p = 0.02), (OR= 2.25; 0.98 - 5.18), however, these were not significantly different among races or hair colours (P > 0.05). 65% of the individuals had only nits with 1 up to 64 per individuals, found between 0.1 and 9 cm from scalp on all anatomical regions of the head, and having school-aged children the higher ectoparasitic loads. Among clinical signs and symptoms, head pruritus (6.53 vs. 12.06%; OR =11.99; p =0.000) and excoriations (1.51% vs. 3.52%; OR =4.34; p = 0.03) showed significantly higher percentages in infested children than in uninfested ones. Other independent risk factors by logistic regression analysis signficantly associated with pediculosis captitis were playing on dust floor (OR = 2.20; p = 0.012), and frequency of hair washing ≥2 /week (OR = 1.01; p = 0.002). These results suggest that pediculosis capitis remains as a common and endemic public health problem in Venezuelan northwestern semiarid region. Thus, education campaigns by health care officials, physicians and teachers, as well as improving standards of living and personal hygiene might significantly reduce pediculosis capitis in those human populations endemically exponed.