The effect of educational intervention on efficacy of 1% permethrin shampoo and 4% dimeticone lotion to treat head lice infestation using propensity score matching (PSM).

BACKGROUND: Head lice are a main public health problem and the most important human ectoparasites and the use of pediculicides is the most common way to control it. One of the possible causes of treatment failure is the lack of improper application of pediculicide. The aim of this study was to assess the effect of education on efficacy of 1% permethrin or 4% dimeticone lotion to treat head lice infestation. METHODS: This quasi-experimental study included 100 individuals with head lice infestation from comprehensive urban health centers in Ardabil as the intervention group, and 400 individuals from East Azerbaijan and West Azerbaijan provinces as the control group, from April to March 2019. The data collection tools included a demographic questionnaire and an examination recording sheet, which documented the presence of adult lice or nits. Due to the inability to perform random assignment and control for numerous observed covariates, propensity score matching (PSM) was used. RESULTS: The outcome of treatment included elimination of head lice infestation on is 7, and in the case of recurrence, it was considered on days 14 and 30 after treatment. The results showed that the educational intervention program had a significant positive effect on the efficacy of both treatments. The likelihood of improvement was approximately three times greater in the intervention group compared to the control group. CONCLUSION: Participants who received the training intervention (OR = 3.29; CI 95%: 2.21-4.88) were more likely to have a successful treatment than control group. In the case of providing proper training on the use of pediculicides and observing hygiene tips to patients with pediculosis, could help to successful treatment of pediculosis.

Association between living in the endemic area and level of knowledge of visceral leishmaniasis.

BACKGROUND: Iran is a country with a high prevalence of visceral leishmaniasis (VL) and seven endemic provinces. In this study, we tried to identify unobserved classes of knowledge among Iranians toward VL and assess the predictors of each latent class. METHODS: This cross-sectional study was conducted among randomly selected participants from endemic and non-endemic areas of VL in Iran in 2020 and 2021. The collected data included demographic characteristics and questions about knowledge, attitude, and practice toward VL. We performed latent class analysis using a procedure for latent class analysis (PROC LCA) in SAS to identify the class membership of knowledge of participants toward VL. RESULTS: Five latent classes were identified: very low (38.9%), low (15.5%), moderate (6.2%), high (14.1%), and very high (25.2%) knowledge about VL. Living in endemic areas significantly increased the odds of belonging to the low (adjusted OR (AOR = 7.23; 95% confidence interval (CI):4.52-11.58), high (AOR = 2.71; 95%CI: 1.73-4.23), and very high (AOR = 8.47; 95%CI: 5.78-12.41) classes compared to the very low class. Also, having academic education increased the odds of membership in the very high class (AOR = 2.36; 95%CI: 1.61-3.47) compared to the very low class. CONCLUSION: This study revealed that more than 50% of the participants fell into the latent classes of very low and low knowledge toward VL. Some educational workshops in the endemic areas could be effective in enhancing knowledge about VL.

Resilience and spirituality mediate anxiety and life satisfaction in chronically Ill older adults.

BACKGROUND: Spirituality and psychological resilience can be considered as a protective factor for coping with anxiety in geriatric populations. The aim of the study was to investigate the structural model related to the mediating role of spirituality and psychological resilience in predicting the relationship between anxiety and life satisfaction in older adults with chronic illness. METHODS: In a cross-sectional study, one hundred patients over sixty years of age from one university hospital were selected by convenience sampling. Data were collected using the Spiritual Health Scale, the Anxiety Module of the Hospital Anxiety and Depression Scale, the Connor-Davidson Resilience Scale, the Life Satisfaction Scale, and a sociodemographic questionnaire. Data analysis was performed using Partial Least Squares (PLS) structure modeling. RESULTS: There was a positive and significant relationship between resilience, spirituality and life satisfaction of the samples. The structural model showed that spirituality, and psychological resilience mediated in the relationship between anxiety and life satisfaction directly and in indirectly in the older people with chronic disease, explaining approximately 34% of the variance in life satisfaction. CONCLUSIONS: The findings suggest that spirituality and psychological resilience can help older adults with chronic illness to negate the impact of anxiety on satisfaction, with the effect of spirituality being stronger than resilience in this relationship.

Comparing the Bacterial Flora of Insectary and Filed Strains of Supella longipalpa (Blattaria: Ectobiidae) and Their Antibiotic Resistant Pattern in Qom Province, Central Iran.

Background: Cockroaches play a role in the mechanical transmission of microbial pathogens. This study was designed to determine the isolated bacteria and their susceptibility to conventional antibiotics from brown-banded cockroach, Supella longipalpa, in Qom province, central Iran. Methods: In this cross-sectional study, brown-banded cockroaches were bred in an insectary and caught from hospitals of Qom. The samples were taken from the surface and alimentary canal and then cultured on microbial culture media; next, grown specimens were identified using differential culture media. Finally, after performing diagnostic tests and identifying the bacteria species, their susceptibility to various antibiotics was evaluated. Results: A total of 120 adult cockroaches from the insectary and hospitals were included in the study. Ten bacterial genera were found; nine were Gram-negative and one was Gram-positive. The genus Klebsiella, Enterobacter, Staphylococcus, Citrobacter and Hafnia were isolated only from the hospital strain. On the other hand, Pseudomonas and Escherichia from both groups and other species such as Salmonella, Proteus and Shigella were isolated only from laboratory strains. The highest antibiotic resistance among Gram-positive cocci and Gram-negative bacilli were 100.0% and 98.1% for ampicillin and Ceftazidime, respectively. Conclusion: The results of this study showed that various pathogenic bacteria harbored by brown-banded cockroaches. Moreover, it was found that most of these bacteria belong to the Enterobacteriaceae family, which can be pathogenic and thus threaten human health.

New data on medically important scorpion species of Iran based on seven physiographic areas.

There are 2612 and 80 scorpion species in the world and Iran, respectively. Iran is rich in climatic conditions and biodiversity. In this study, new data on scorpion fauna of different physiographic areas of Iran were obtained from various databases, including plains and deserts, eastern area of the Caspian Sea, western and central areas of the Caspian Sea, heights and foothills, the west coast of the Persian Gulf and the east coast of the Persian Gulf. Then, spatial distribution maps for scorpion species in different physiographic areas were prepared using ARC GIS software. There are three families (Buthidae, Hemiscorpiidae, and Scorpionidae), 19 genera, and 80 species and subspecies. In plains and deserts, there are three families, 15 genera, and 37 scorpion species; in the Caspian Sea area, there is only one family with four scorpions; in heights and foothills, there are three families, 14 genera, and 35 scorpion species; in the west coast of the Persian Gulf, there are three families, 13 genera, and 31 scorpion species, and finally, in the east coast of the Persian Gulf, there are three families, 14 genera, and 35 scorpion species. The Buthidae is the most prevalent family in Iran. Because of good climatological conditions on the east and west coast of the Persian Gulf, there are three families of scorpions, 18 genera, and 45 species. The majority of scorpion species inhabit this region, and the highest rate of scorpionism and death due to scorpion sting occurs in this part of Iran.

Measles Elimination Successful and Its Relevant Challenges in Iran.

Measles is an infectious childhood disease with some death annually. The expansion of the coverage of vaccination plan has significantly reduced the mortality rate of this disease. Given that the endemic measles virus is not transmitted in the country and based on Regional Verification Commission (RVC) for Measles and Rubella Elimination has declared that measles and rubella have been eliminated in three countries of Eastern Mediterranean Region including Islamic Republic of Iran, Bahrain, and Oman. Therefore, to continue and preventing from reemerging of measles in Iran, it is essential to maintaining the immunization programs, diagnose, and investigate all suspicious cases and outbreaks. This article investigates the challenges facing to measles after elimination declaration in Iran. However, the elimination of these diseases to be sustainable needs a vigorous case identification protocol and contact follow up.

Health beliefs and behaviors of livestock industry workers regarding Crimean-Congo hemorrhagic fever in Northwest of Iran.

BACKGROUND: Crimean-Congo hemorrhagic fever (CCHF) is an acute, feverous disease that is caused by tick bites or humans' direct contact with the blood and tissues of infected livestock and humans. The transmission of the disease is also possible via human-to-human contacts and nosocomial transmission is well described. The majority of patients suffering from this disease are slaughterhouse workers (including butchers), farmers, veterinarians and hospital staff. Thus, this study aimed to investigate the health behaviors of butchers regarding CCHF and study factors affecting such behaviors based on the health belief model. METHODS: This is a descriptive cross-sectional study conducted on 500 butchers in Ardabil Province in 2020 by a multistage sampling method. The participants of the study completed the researcher-made questionnaire of health belief model and health behaviors model relevant to CCHF. The collected data were then analyzed by descriptive statistical tests and linear regression analysis. RESULTS: The mean (SD) age of the participants was 44.4 (10.5) years, and 96% were males. Only 11.1% of the participants displayed acceptable disease-preventive behaviors. The validity and reliability of the developed questionnaire were confirmed. The results of the exploratory factor analysis showed that the constructs of the model explained 84% of the total variance. The results of the study revealed that among the variables of the health belief model, perceived susceptibility (p-value = 0.006, ß = 0.152) and perceived barriers (p-value = 0.023, ß = 0.14) were the strongest factors predicting disease-preventive behaviors regarding CCHF. CONCLUSION: The results of the study showed that the health belief model can predict preventive behaviors for CCHF. Therefore, designing and executing interventions based on the results of this study may encourage such preventive behaviors in butchers.

Structure and Antibacterial Activity of Chitosan from the American Cockroach, the German Cockroach and the Mealworm Beetle.

Background: Owing to chitosan properties such as biocompatibility and antimicrobial activities, and several applications in biomedical field, some physicochemical and anti-bacterial properties, and the level of chitosan from three species of American cockroach, Periplaneta americana (Dictyoptera: Blattidae), the German cockroach, Blattella germanica (Dictyoptera: Ectobiidae) and the Mealworm beetle, Tenebrio molitor (Coleoptera: Tenebrionidae) were investigated. Methods: The cuticle of adults derived from specimens was dried and grounded. The powders were demineralized as well as deproteinized after deacetylation via NaOH. At last, the chitosan yields from insects were studied for antibacterial activity on Gram-positive bacteria (Proteus mirabilis, Klebsiella pneumoniae), and Gram-negative bacteria (Enterococcus faecalis and Staphylococcus epidermidis). The Fourier transform infrared spectroscopy (FTIR) was used to analyze the chitosan composition. Results: The chitosan ratios of the American and German cockroaches and the mealworm beetle were 5.80, 2.95, and 1.70% per 3 g of the dried bodies respectively. The chitin DD's for the American cockroach, the German cockroach and the mealworm beetle were 36.8%, 31.5% and 27.3%, respectively. The bactericidal activity of chitosan obtained from the American cockroach at a concentration of 1% had the greatest effect on P. mirabilis compared to other concentrations, while chitosan obtained from the German cockroach at a concentration of 0.01% had the greatest effect on K. pneumoniae compared to other concentrations. Conclusion: According to the results, the anti-bacterial influence of the chitosan is based upon the insect species and chitosan concentration. Probably, the variation relates to the changes in the chitin structure among the three insect species.

Mapping and Spatial Pattern Analysis of COVID-19 in Central Iran Using the Local Indicators of Spatial Association (LISA).

BACKGROUND: Using geographical analysis to identify geographical factors related to the prevalence of COVID-19 infection can affect public health policies aiming at controlling the virus. This study aimed to determine the spatial analysis of COVID-19 in Qom Province, using the local indicators of spatial association (LISA). METHODS: In a primary descriptive-analytical study, all individuals infected with COVID-19 in Qom Province from February 19th, 2020 to September 30th, 2020 were identified and included in the study. The spatial distribution in urban areas was determined using the Moran coefficient in geographic information systems (GIS); in addition, the spatial autocorrelation of the coronavirus in different urban districts of the province was calculated using the LISA method. RESULTS: The prevalence of COVID-19 in Qom Province was estimated to be 356.75 per 100,000 populations. The pattern of spatial distribution of the prevalence of COVID-19 in Qom was clustered. District 3 (Imam Khomeini St.) and District 6 (Imamzadeh Ebrahim St.) were set in the High-High category of LISA: a high-value area surrounded by high-value areas as the two foci of COVID-19 in Qom Province. District 1 (Bajak) of urban districts was set in the Low-High category: a low-value area surrounded by high values. This district is located in a low-value area surrounded by high values. CONCLUSIONS: According to the results, district 3 (Imam Khomeini St.) and district 6 (Imamzadeh Ebrahim St.) areas are key areas for preventing and controlling interventional measures. In addition, considering the location of District 1 (Bajak) as an urban district in the Low-High category surrounded by high values, it seems that distance and spatial proximity play a major role in the spread of the disease.

Study on Efficacy of 1% Permethrin Shampoo and Some Traditional Physical Treatment for Head Lice Infestation.

BACKGROUND: There is an increase in the prevalence of head lice among urban communities with high density in recent years. This study was aimed to determine the efficacy of 1% permethrin shampoo and some traditional physical treatment for head lice infestation in Qom Province, central Iran. METHODS: This analytical cross-sectional study was carried out on all 11,223 cases in six categories that were referred to Qom health care system from 2016 to March of 2017. The infested people were treated with 1% permethrin shampoo, twice at a 1-week interval and other recommended therapeutic categories, such as the use of physical treatments such as wooden fine-toothed combs impregnated with a mixture of water and white vinegar on infested hair for 30 min and secondly, carrier oils such as olive oil, bitter almond on infested hair over a therapeutic period. After completing the course of treatment, treatment success was checked by questionnaires. RESULTS: A total of 11,223 cases with head lice infestation were confirmed and were enrolled for study. Out of six categories, three therapeutic categories were utilized as follows: (a) 1% permethrin shampoo and the use of physical treatments; (b) 1% permethrin shampoo and the use of carrier oils; (c) the above-mentioned therapeutic categories combined had high treatment success. It was estimated to be 82.00%, 87.31%, and 94.33%, respectively. CONCLUSIONS: According to the findings, in addition to the application of 1% permethrin shampoo, the use of physical treatments and carrier oils such as olive oil, bitter almond can increase the treatment success of head lice infestation.

The Granger causality analysis of the impact of climatic factors on visceral leishmaniasis in northwestern Iran in 1995-2019.

Visceral leishmaniasis (VL) as a vector-borne disease, is an endemic in the northwest and south of Iran and sporadic in other areas in the country. This study was performed to investigate the Granger causality analysis of the impacts of climatic factors on VL in northwestern Iran throughout the period from 1995 to 2019. In a longitudinal study, the epidemiological data of patients suffering from VL were collected from the health centers and hospitals in Meshkinshahr County, Ardabil province, between 1995 and 2019. Moreover, the environmental and climatic data of each location, such as temperature, humidity, rainfall, the number of frost and warm days in the year, were obtained from the meteorological center of the county and put into the Excel software. The incidence rate of VL was modeled by time series analysis and to compare its relationship with other time series covariates, the Granger causality analysis was used. The results of Granger causality analysis showed that some climatic variables including daily mean temperature, absolute minimum temperature, maximum and minimum temperature and maximum humidity were the main factors affecting the prevalence of VL in northwestern Iran. The findings greatly demonstrated that the potential of Granger causality in epidemiologic status of VL in northwestern Iran. Moreover, the results suggest that in addition to patient-related and biological factors, environmental and climatic factors such as temperature and humidity also play a major role in completing the transmittance cycle of VL in an endemic focus.

Epidemiological features of brucellosis and factors affecting its treatment failure and relapse in Qom Province, Iran.

Background: Brucellosis is one of the major health problems in many areas of the world, especially in the Mediterranean and the Middle East regions. Objective: To determine the epidemiological characteristics, clinical signs, and risk factors of relapse rate in patients with brucellosis, Qom Province, Iran. Methods: A descriptive-analytic study was conducted on 410 confirmed brucellosis cases in Qom Province, central Iran, from 2015 to 2019, based on epidemiological checklists and according to the Iran Ministry of Health and Medical Education (MOHME). Univariate and multiple logistic regression analyses were conducted using Stata software version 14. Results: The relapse rate of brucellosis was 6.6% until nine months after starting the treatment, and all recurrent cases were infected by Brucella melitensis. Based on univariate logistic regression analysis, the delayed treatment and type species of Brucella were significant factors affecting the relapse of brucellosis. The relapse rates were 5.4%, 6.2%, and 20.0% in patients whose delayed treatments were <50, 51-150, and >151days, respectively. Based on the multiple logistic regression, it was observed that delayed treatment >50 days increased the rate of relapse more than four times. Conclusion: The delayed initiation of treatment was a significant factor influencing the relapse of brucellosis; therefore, it is necessary to provide enough diagnostic and laboratory facilities, and people need to be educated about the signs and symptoms of the disease. Funding: Funding for this research was provided by the Research and Technology Center of Qom University of Medical Sciences, Qom, Iran.

An investigation of the effects of environmental and ecologic factors on cutaneous leishmaniasis in the old world: a systematic review study.

OBJECTIVES: Leishmaniasis is a neglected and widespread parasitic disease that can lead to serious health problems. The current review study aimed to synthesize the relationship between ecologic and environmental factors (e.g., weather conditions, climatology, temperature and topology) and the incidence of cutaneous leishmaniasis (CL) in the Old World. CONTENT: A systematic review was conducted based on English, and Persian articles published from 2015 to 2020 in PubMed/Medline, Science Direct, Web of Science and Google Scholar. Keywords used to search articles were leishmaniasis, environmental factors, weather condition, soil, temperature, land cover, ecologic* and topogr*. All articles were selected and assessed for eligibility according to the titles or abstracts. The quality screening process of articles was carried out by two independent authors. The selected articles were checked according to the inclusion and exclusion criteria. SUMMARY AND OUTLOOK: A total of 827 relevant records in 2015-2020 were searched and after evaluating the articles, 23 articles met the eligibility criteria; finally, 14 full-text articles were included in the systematic review. Two different categories of ecologic/environmental factors (weather conditions, temperature, rainfall/precipitation and humidity) and land characteristics (land cover, slope, elevation and altitude, earthquake and cattle sheds) were the most important factors associated with CL incidence. CONCLUSIONS: Temperature and rainfall play an important role in the seasonal cycle of CL as many CL cases occurred in arid and semiarid areas in the Old World. Moreover, given the findings of this study regarding the effect of weather conditions on CL, it can be concluded that designing an early warning system is necessary to predict the incidence of CL based on different weather conditions.

Biodiversity Indices and Medically Importance of Ticks in North Khorasan Province, Northeast of Iran.

BACKGROUND: Ticks are considered as the main vectors for the transmission of various pathogens such as relapsing fever and CCHF to humans. This study was investigated the biodiversity indices and medically importance of ticks in North Khorasan Province, Northeast of Iran during 2015-2019. METHODS: Specimens were captured from infested ruminants including cows, sheep, and goats. Additionally, tick collections also were performed on non-domesticated creatures such as turtles, rodents, and hedgehogs. Specimens were identified using valid identification keys. Species diversity, species richness and evenness indices have been calculated to estimate species biodiversity of ticks. RESULTS: A total of 1478 adult ticks were collected. The specimens were from two families: Ixodidae (90.05%) and Argasidae (9.95%), 6 genera and 17 species including: Rhipicephalus sanguineus (55.9%), Rhipicephalus bursa (13.4%), Hyalomma marginatum (9.5%), Hyalomma anatolicum (9.5%), Hyalomma asiaticum (0.2%), Hyalomma aegyptium (0.5%), Hyalomma scupense (1.3%), Hyalomma sp (1.2%), Haemaphysalis sulcata (0.7%), Haemaphysalis erinacea (0.1%), Haemaphysalis inermis (0.1%), Haemaphysalis punctata (0.2%), Haemaphysalis concinna (0.1% Boophilus annulatus (1.2), and Dermacentor marginatus (6.1%) among hard ticks as well as Argas persicus (91.8%) and Argas reflexus (8.2%) amongst soft ticks. Rhipicephalus sanguineus, Rh. Bursa, Hy. marginatum and Hy. anatolicum were known as the most frequent species of hard ticks. Tick's species richness, Shannon diversity index and Simpson index in this area were S= 17, H'= 1.69, D= 0.294 respectively. CONCLUSION: Based on tick distribution veterinary authority, public health organizations and other officials should act for implementation of disease prevention.

Possible Synergistic Effect of Combined Metarhizium anisopliae and Fenitrothion for Control of German Cockroach (Blattella germanica) as a Novel Approach.

Background: Cockroaches are one of the most common pests in many residential areas. In this study, the simultaneous effects of fungi, Metarhizium anisopliae and fenitrothion-coated baits on the mortality rate of the German cockroach nymphs were investigated. Methods: To determine the lethal level of fenitrothion insecticide, a bioassay test was performed on the last instar nymphs of the German cockroach reared at insectarium conditions. Various toxic concentrations of fenitrothion (0.1%, 0.3%, 0.5%, 0.7%, 0.9%, 1.5%, and 2%) were used. Different concentrations of M. anisopliae (1×104, 1×105, 1×106, 1×107, 1×108 Conidia/ml) were also applied to nymphs. Eventually, we combined the effective dose of fenitrothion (0.93%) with the effective concentration of M. anisopliae (6.6 ×106 Conidia/ml) to provide the fungus-coated bait to attract insects. Mortality was recorded 24-96 hours after exposure to the toxic bait. The resulting data were subjected to Probit analysis. Results: The results of applying M. anisopliae spores with fenitrothion composition showed that the mortality rate of German cockroach nymphs was significant. Therefore, the optimal dose of fenitrothion used in combination with M. anisopliae seems essential to reduce the German cockroach nymphs. Conclusion: The results of this study can be considered a suitable method as a mixture with low cost and minimal damage to the environment and other organisms.

Molecular Evaluation of the Novel Coronavirus Infection of Cockroaches and Flies Collected from Kamkar-Arabnia Hospital in Qom City, Central Iran: With Innovated Internal Control.

Background: Due to the confirmation of the presence of the novel coronavirus in the feces and municipal sewerage system, and the feeding of domestic insects from fecal matter, as well as the ability of these insects to mechanically transmit microbes from the sewerage system. This study was aimed at molecular evaluation of the novel coronavirus infection isolated on cockroaches and flies collected from Kamkar-Arabnia Hospital in Qom City, Iran. Methods: Totally, 18 samples; (12 samples cockroaches and 6 flies) from the external surface of cockroaches and houseflies as well as their digestive system were prepared. After designed and synthetized exogenous heterologous internal control, the RNA was extracted to investigate the contamination of these samples with the novel coronavirus. To detect the virus, the E and RdRp genes were identified. Results: Investigation of coronavirus E gene using the multiplex one-step qPCR technique on the collected samples showed an amplification plot in CT= 35.70 related to the internal surfaces of cockroaches collected from the treatment and sick room of the hospital. Also, the design of internal control to ensure the accuracy of the extraction process was successful. Conclusion: According to the findings of the present study regarding detecting the presence of the coronavirus infection in the digestive system of domestic insects such as American cockroaches and considering their ability to mechanically transmit viruses, it is recommended to control the domestic insects that are in close contact with humans in crowded places such as hospitals and health centers during the Covid-19 pandemic.

Indirect and Potential Impacts of the COVID-19 Pandemic on the Public Health.

No abstract.

Spatial distribution of vaccine-preventable diseases in central Iran in 2015-2018: A GIS-based study.

Vaccination is the second most effective health measure to maintain public health and prevent diseases after providing safe drinking water. This study aimed to determine the geographical distribution of vaccine-preventable diseases (VPDs) in Qom Province in four years (2015-2018) using Geographic Information System (GIS). In this cross-sectional study, the indicators of VPDs surveillance were extracted from the VPDs surveillance system at the Centers for Disease Control and Prevention (CDC) in Qom University of Medical Sciences. They were further evaluated, and the incidences of VPDs in the study years were investigated. Finally, the spatial distribution map of VPDs was provided for surveillance quality in each Qom district by Arc GIS 10.3 software. The annual incidence rate (AIR) was estimated to be 18.47 for hepatitis B, 0.29 for measles, 0.13 for rubella, 0.09 for pertussis, 0.29 for diphtheria and 0.91 for acute flaccid paralysis (AFP). The highest incidences of AFP, rubella and measles were observed in Markazi district. Salafchegan was a district with the highest incidence of diphtheria, and the highest incidence rate of hepatitis B was observed in Khalajestan district. In addition, all pertussis cases were reported from Qom city. According to thematic maps of GIS, the annual incidence rate of VPDs in Qom Province was lower than the mean rate in Iran. Nevertheless, it is highly recommended that a high immunization coverage should be done in the childhood and good surveillance indicators such as non-disease discarded rate, and the proportion of suspected cases with an adequate investigation should be used to monitor VPDs.

Economic Burden Associated with Head Louse (Pediculus humanus capitis) Infestation in Iran.

BACKGROUND: The head louse infestation is a public health issue in the world especially, affecting most people who live in camps, school-aged children and their families. Head lice treatment has economic ramifications that often under calculated. The aim of this study was evaluation of economic burden associated with head louse infestation in Iran. METHODS: In a cross-sectional study, 500,002 infestations were diagnosed among suspected head lice infested people who referred to health care system in all provinces of Iran during 2017. Direct and indirect costs related to paid by patients and government systems were extracted by referring to accounting documents and interviews with patients and experts and were recorded in researcher-made forms. Microsoft Excel 2010 software was used for economic burden calculation. RESULTS: The incidence rate of head lice infestation in Iran was 500,002/79,926,270 (625.5 per 100,000 populations). Economic burden of head lice in the country was calculated at 5,790,143$. Direct and indirect costs, governmental cost, out of pocket and total costs of head lice were included 3.14$, 2.84$, 5.98$, 5.60$ and 11.58$ per case respectively. CONCLUSION: The direct and indirect costs associated with treatment of infestations were relatively high. Therefore, the creation of medical facilities such as availability of diagnostic and treatment strategies can be effective in the control of infestation. The adoption of infestation prevention methods, such as health education to people at risk of infestation, reduces the incidence of head lice and imposition of related treatment costs on governmental health care system and head lice cases.