Treatment of head lice with dimeticone 4% lotion: comparison of two formulations in a randomised controlled trial in rural Turkey.

BACKGROUND: Dimeticone 4% lotion was shown to be an effective treatment for head louse infestation in two randomised controlled trials in England. It is not affected by insecticide resistance but efficacy obtained (70-75%) was lower than expected. This study was designed to evaluate efficacy of dimeticone 4% lotion in a geographically, socially, and culturally different setting, in rural Turkey and, in order to achieve blinding, it was compared with a potential alternative formulation. METHODS: Children from two village schools were screened for head lice by detection combing. All infested students and family members could participate, giving access to treatment for the whole community. Two investigator applied treatments were given 7 days apart. Outcome was assessed by detection combing three times between treatments and twice the week following second treatment. RESULTS: In the intention to treat group 35/36 treated using dimeticone 4% had no lice after the second treatment but there were two protocol violators giving 91.7% treatment success. The alternative product gave 30/36 (83.3%) treatment success, a difference of 8.4% (95% CI -9.8% to 26.2%). The cure rates per-protocol were 33/34 (97.1%) and 30/35 (85.7%) respectively. We were unable to find any newly emerged louse nymphs on 77.8% of dimeticone 4% treated participants or on 66.7% of those treated with the alternative formulation. No adverse events were identified. CONCLUSION: Our results confirm the efficacy of dimeticone 4% lotion against lice and eggs and we found no detectable difference between this product and dimeticone 4% lotion with nerolidol 2% added. We believe that the high cure rate was related to the lower intensity of infestation in Turkey, together with the level of community engagement, compared with previous studies in the UK. TRIAL REGISTRATION: Current Controlled Trials ISRCTN10431107.

[Evaluation of mosquito species (Diptera: Culicidae) identified in Manisa province according to their breeding sites and seasonal differences]. / Manisa Il ve Ilçelerinde Saptanan Sivrisinek Türlerinin (Diptera: Culicidae) Yasam Alanlari ve Mevsimsel Degisikliklere Göre Degerlendirilmesi.

OBJECTIVE: To identify the mosquito species and the potential mosquito-related infectious diseases in Manisa province, mosquito larvae were collected from aquatic habitats in Manisa between October 2008 and October 2009. METHODS: Mosquito larvae were collected from the surface water of study sites with a standard larvae collection spoon. The 1st and 2nd stage larvae brought to the laboratory were kept until they become adults, and their species were identified during 3rd or 4th larvae stages. In addition, species identification was made for 3rd or 4th stage larvae as well as pupae in aquatic samples, as well. RESULTS: A total of 8098 larvae samples were collected during the study and Culex (Culex) pipiens and Culex (Neoculex) martini were found to be the predominant species in Manisa. Three Culex [Culex (Culex) pipiens, Culex (Neoculex) martini, Culex (Maillotia) deserticola], two Culiseta [Culiseta (Culiseta) annulata, Culiseta (Allotheobaldia) longiareolata] and one Anopheles [Anopheles (Cellia) superpictus] species were identified. CONCLUSION: Anopheles superpictus, the vector of malaria; Culex pipiens, Culiseta annulata, Culiseta longiareolata, the vectors of tularemia and arbovirus infections such as West Nile Virus infection, were identified in Manisa province. Conduction of similar larger-scale studies will contribute to the prevention of vector-borne diseases in our region.

Comparison of two combs in the detection of head lice in school children.

The diagnostic efficacies of two metal pin lice combs having different spacing between their teeth were compared in two cohorts of school children, aged between 7 and 15 years, from different villages of Manisa, Turkey. Head lice infestation was evaluated with comb A (0.18 mm of distance between the teeth) in 95 children in Cavusoglu village, and with comb B (0.15 mm of distance between the teeth) in 146 children in Yesilköy village, compared to visual inspection. Five of 95 (5.3%) children in Cavusoglu village and 5 of 146 (3.4%) children in Yesilköy village were found to harbor live head lice with combing, while none was detected during the visual inspection. The difference between the infestation rates of two cohorts was statistically insignificant (p > 0.05). With visual screening, 15 and 16 children with louse eggs were identified in Cavusoglu and Yesilköy villages, respectively. With combing in these villages, 5 and 8 children, respectively, with louse eggs were identified and 3 and 5 children, respectively, were detected only with combing, not with visual screening. In conclusion, combing is more effective than visual inspection in head lice detection, but there were no significant difference between the two combs either in lice detection or in usage.