Common pediatric infestations: update on diagnosis and treatment of scabies, head lice, and bed bugs.

PURPOSE OF THE REVIEW: This review will update pediatric providers on the recent data regarding the epidemiology, diagnosis, and treatment of common skin infestations affecting children and adolescents. RECENT FINDINGS: Standard superficial skin biopsy for scabies and the vacuum method for head lice can increase diagnostic accuracy and efficiency. There is growing resistance to some of the traditional treatments for scabies and head lice, and progress has been made in finding newer and potentially more effective treatments, such as oral moxidectin for scabies and abametapir for head lice. Recent studies have established the safety of traditional treatments, such as permethrin and oral ivermectin in infants and small children. SUMMARY: Permethrin and ivermectin are both considered safe and effective for children and adolescents with scabies. Permethrin is generally considered safe in infants less than two months of age. Proper application of permethrin is critical, and providers should emphasize proper application technique. Treatment of head lice should only be initiated with active infestations. Resistance to permethrin continues to increase and other options are now available, including an over-the-counter topical ivermectin formulation. Identification and eradication of bed bug infestations are crucial in preventing bedbug bites.

Eight New Species of Sucking Lice (Psocodea: Phthiraptera) From Endemic Murine Rodents in Australia and an Updated Identification Key.

Based on a comprehensive study of museum specimens, eight new species of sucking lice of the genus Hoplopleura Enderlein, 1904 (Psocodea: Phthiraptera: Hoplopleuridae), are described from six genera of Australian Old Endemic rodents: Conilurus Ogilby, 1838 (Rodentia: Muridae), Leggadina Thomas, 1910 (Rodentia: Muridae), Leporillus Thomas, 1906 (Rodentia: Muridae), Mesembriomys Palmer, 1906 (Rodentia: Muridae), Pogonomys Milne-Edwards, 1877 (Rodentia: Muridae), and Xeromys Thomas, 1889 (Rodentia: Muridae). The description of these new species increases the number of sucking louse species from endemic Australian rodents from 13 to 21 and extends the records of sucking lice to all of the 14 genera of endemic rodents in Australia. Our results show that sucking lice are much more diverse among rodents in Australia than previously known. Furthermore, the Australian Hoplopleura species are host specific-each Hoplopleura species, including the eight new species described in the present study, parasitizes only a single host species, except Hoplopleura irritans Kuhn and Ludwig, 1967 (Psocodea: Phthiraptera: Hoplopleuridae) and Hoplopleura melomydis Weaver, 2017 (Psocodea: Phthiraptera: Hoplopleuridae), each of which is found on two host species. An updated dichotomous key for identifying Australian Hoplopleura species is included.

Pediculosis capitis among school-age students worldwide as an emerging public health concern: a systematic review and meta-analysis of past five decades.

Pediculosis by Pediculus humanus capitis is still an important health issue in school-age students worldwide. Although pediculicidal agents effectively kill head lice, the re-infestation rate is still high. This study was conducted to provide a summary of evidence about the prevalence of pediculosis capitis among school-age students worldwide. Different databases including MEDLINE/PubMed, Scopus, and Web of Science were searched for publications related to pediculosis capitis in school-age students from 1977 to 2020. All peer-reviewed original research articles describing pediculosis capitis among school-age students were included. Statistical heterogeneity of the different years among studies was assessed using the standard chi squared and I2 tests. Due to the significant heterogeneity, a random effect model was adopted to estimate the pooled, continent, and gender-specific prevalence of pediculosis. Two hundred and one papers met the inclusion criteria of this review and entered into the meta-analysis including 1,218,351 individuals. Through a random effect model, the prevalence of pediculosis capitis among school students was estimated as 19% (CI 95% = 0.18-0.20%, I2 = 99.89%). The prevalence of pediculosis capitis among boys was 7% (CI 95% = 0.05-0.10) compared to 19% (CI 95% = 0.15-0.24) in girls. The highest prevalence was in Central and South America (33%, CI 95% = 0.22-0.44, I2 = 99.81%) and the lowest was in Europe (5%, CI 95% = 4-6, I2 = 99.28%). Relatively high pediculosis capitis prevalence among school-age students observed in this study emphasizes the need for implementing screening and prophylaxis tailored to the local context.

Two New Species of Sucking Lice (Phthiraptera: Anoplura: Hoplopleuridae and Polyplacidae) from Grant's Rock Mouse, Micaelamys granti, in South Africa.

Two new species of sucking lice (Phthiraptera: Anoplura), Hoplopleura granti n. sp. (Hoplopleuridae) and Polyplax megacephalus n. sp. (Polyplacidae), are described from Grant's rock mouse, Micaelamys granti (Wroughton), from Northern Cape Province, South Africa. Adults of both sexes are illustrated via line drawings and differential interference contrast microscopy images, and are compared with previously described related species that parasitize related hosts: Hoplopleura patersoni Johnson from Aethomys chrysophilus (de Winton) (red veld rat), Aethomys kaiseri (Noack) (Kaiser's aethomys), and Micaelamys namaquensis (A. Smith) (Namaqua rock mouse); Hoplopleura aethomydis Kleynhans from M. namaquensis; Polyplax praomydis Bedford from A. chrysophilus and M. namaquensis; and Polyplax solivaga Johnson from A. chrysophilus. It is not known if these new species of lice are vectors of any pathogens.

So happy together: juvenile crabeater seal behavior improves lice transmission.

Lice from family Echinophthiriidae are of the few insects that have successfully colonized marine environment living as ectoparasites of pinnipeds, i.e., sea lions, seals, and the walrus. They have developed unique adaptations to cope with the amphibious lifestyle of their hosts. Because eggs do not survive underwater, lice could only reproduce when their host remains on pack ice enough time. Consequently, lice generations per year are limited by host haul-out behavior. The objective of this work is to study the effect of host sex and age class, and the annual variation on the prevalence and mean abundance of Antarctophthirus lobodontis in crabeater seals from the Antarctic Peninsula. During three consecutive field-seasons, we collected lice from 41 crabeater seals (23 females, 16 males, 2 indeterminate, being 24 adults, and 17 juveniles). We investigated this effect on the prevalence and mean abundance by a generalized linear model formulation in a Bayesian framework. According to the lowest Deviance Index Criterion model, sex host does not affect prevalence nor mean abundance. We found that juveniles present greater abundance and prevalence than adults, possibly due to foraging habits. They spent more time on the ice than adults in groups of dozens of animals. This behavior would favor both egg development and lice transmission. We do not find adult females with lice, which suggests that transmission of A. lobodontis should be horizontal. The high mean abundance of lice in 2014 could be associated with an unusual increase in Lobodon carcinophaga population, probably related to the pack-ice availability and zooplankton abundance.

A New Species of Sucking Louse from the Mandrill from Gabon with a Review of Host Associations and Geographical Distributions, and Identification Keys to Members of the Genus pedicinus (Phthiraptera: Anoplura: Pedicinidae).

Members of the sucking louse genus Pedicinus are ectoparasites of cercopithecid primates in Africa, Asia, and Gibraltar. Pedicinus gabonensis n. sp. is described on the basis of adult male and female specimens collected from the mandrill (Mandrillus sphinx) in Gabon. The new species is compared morphologically with other members of the genus Pedicinus, and a nuclear elongation factor 1 alpha gene sequence is provided. Host associations and geographical distributions of the 18 previously recognized species of the genus and of P. gabonensis n. sp. are reviewed. Updated identification keys are provided for males and females of all known valid species of Pedicinus.

Infestation rate of lice on donkeys in Northeast Tunisia.

The present survey was carried out during autumn 2013 (September, October and November) in five localities of Jendouba district. A total number of 300 donkeys were examined and all present ectoparasites found on animals were collected and examined under stereomicroscope. The infestation rate by lice was estimated to 12.7% (38/300) there was no difference between infestation rates in males (11.5%; 22/192) and females (14.8%; 16/108). The highest infestation rate was observed in donkeys aged between 10 and 14 years, they represented 19.6% of the infested donkeys. Two lice species were collected with no statistically difference between the two infestation rates: Haematopinus asini (4%; 12/300) and Bovicola ocellatus (5.3%; 16/300). The lice were collected from donkeys of the five regions with no statistically difference between the infestation rates. A specific programme to control these parasites is recommended to improve the welfare of the working donkeys in Tunisia and in other North African countries.

Ectoparasites: Pediculosis and tungiasis.

Pediculosis is an infestation of lice on the body, head, or pubic region that occurs worldwide. Lice are ectoparasites of the order Phthiraptera that feed on the blood of infested hosts. Their morphotype dictates their clinical features. Body lice may transmit bacterial pathogens that cause trench fever, relapsing fever, and epidemic typhus, which are potentially life-threatening diseases that remain relevant in contemporary times. Recent data from some settings suggest that head lice may harbor pathogens. The epidemiology, clinical manifestations, and management of body, head, and pubic louse infestation are reviewed. New therapies for head lice and screening considerations for pubic lice are discussed. Tungiasis is an ectoparasitic disease caused by skin penetration by the female Tunga penetrans or, less commonly, Tunga trimamillata flea. It is endemic in Latin America, the Caribbean and sub-Saharan Africa and seen in travelers returning from these regions. Risk factors for acquiring tungiasis, associated morbidity, and potential strategies for prevention and treatment are discussed.

Pediculosis humanus capitis Prevalence as a Health Problem in Girl's Elementary Schools, Southwest of Iran (2017-2018).

BACKGROUND: Head lice as obligated ectoparasite is a public health concern. We aimed to determine the prevalence of Pediculus humanus capitis as public health concern among girl's primary school in southwest of Iran. STUDY DESIGN: A cross-sectional study. METHODS: This study was conducted in Karoon County, south-west of Khuzestan Province in Iran in 2017-2018. Totally, 851 students were interviewed randomly, examined by a medical entomologist and completed a questionnaire containing 18 questions based on individual, social, economic, cultural and health information. Results were presented as prevalence and percentages for qualitative variables and also, the data were analyzed by univariate logistic and multivariate regression models. RESULTS: About 199 (23.38%) girls were infected by head lice. Univariate logistic regression indicated that the prevalence of pediculosis was directly associated with the grade of education, father's job, shared personal hygiene products, number of combing, having permanent head cover at home, infection in other members of the family and previous infection. Multivariate logistic regressions for predicting of head lice infection in girl students were reported permanent head cover at home (OR: 1.399, 95% CI: 0.934, 2.097, P=0.104), grade of education (OR: 1.948, 95% CI: 1.307, 2.905, P=0.001), father's job (OR: 2.385, 95% CI: 1.518, 3.750, P<0.001), shared personal hygiene products (OR: 1.817, 95% CI: 1.224, 2.698, P=0.003) and using hair oil (OR: 1.904, 95% CI: 1.279, 2.836, P=0.002) had significant relation with head lice infestation CONCLUSION: Head lice remind as serious health problem in Karoon County, southwest of Iran. Due to high infestation, periodic screening of the student is recommended for early detection and treatment.

A New Species of Sucking Louse from the Long-tailed Ground Squirrel, Urocitellus undulatus, from Mongolia, with a Key to Species, and a Review of Host Associations and Geographical Distributions of Members of the Genus Linognathoides (Psocodea: Anoplura: Polyplacidae).

Members of the genus Linognathoides are ectoparasites of ground squirrels and marmots (Rodentia: Sciuridae) in the Nearctic, Palearctic, and Afrotropical regions. Linognathoides urocitelli n. sp. is described based on adult male and female and third-instar nymphal specimens collected from the long-tailed ground squirrel (Urocitellus undulatus) in Mongolia. The new species is compared morphologically to other members of the genus Linognathoides. Additionally, DNA sequences of a 610-base pair (bp) fragment of the nuclear 18S rDNA gene, a 452-bp fragment of the mitochondrial 12S rrnS gene, and a 363-bp fragment of the mitochondrial 16S rrnL gene are provided. Host associations and geographical distributions of the 11 previously recognized species of the genus, and of Linognathoides urocitelli n. sp., are reviewed. A dichotomous identification key to adults of all known species in the genus Linognathoides is provided.

Epidemiological characterization and risk evaluation associated with the presence of Phthirapterain poultry farms from Minas Gerais, Brazil

Phthirapteraare lice highly adapted to living as permanent and obligatory ectoparasites of birds and mammals. High infestations by biting lice contribute to the low productivity, loss quality of the eggs, besides weight decrease of chickens. Therefore, this study aimed to evaluate and to characterize the risks involved with the presence of biting lice in laying chicken from Minas Gerais, Brazil, throught a Multiple Correspondence Analysis (MCA). A secondary database with information regarding 402 chicken houses from 42 properties of laying hens from the same region was used and adapted for this study. The variables that composed the correspondence model were selected through Chi-square tests (p ≤ 0.05). A risk index was designed to relate the presence of biting lice out of variables such as risk factors related to the presence of these ectoparasites. The MCA graphic designed to conduct the epidemiological characterization of the presence of biting lice presented a Chi-square accumulated value of 53.59%. There was an association between the risk index and the synanthropic birds, subsistence hens, presence of lice and other ectoparasites in shelters and ectoparasites control. These results provide knowledge about the Phthirapteraepidemiology. Besides that, this information may contribute to the decision-making process in order to reduce the risk of possible infestations in poultry farms and the negative effects of the infestations.

Prevalence and treatment of sexually transmitted infections in men followed by urologists in Germany - a cross sectional study with 347,090 men.

Aim: The goal of this retrospective analysis was to study the prevalence and treatment of the most common sexually transmitted infections (STI) in men followed by urologists in Germany. Methods: This study included a total of 347,090 men followed in 71 urology practices in Germany between 2013 and 2015. The first outcome was the prevalence of individuals diagnosed with STI between 2013 and 2015. The following eight types of STI infections were included in the analysis: chlamydial infection, gonococcal infection, anogenital warts, anogenital herpes infection, trichomoniasis, ulcus molle, phthiriasis, and syphilis. The second outcome was the prevalence of individuals with STI who received an appropriate therapy within 90 days of their initial STI diagnosis. Results: The most frequent STI was anogenital warts (0.64%), whereas the least frequent STI was syphilis (0.03%). The median age at diagnosis ranged from 30.3 years for chlamydia infection to 47.5 years for trichomoniasis. The proportion of individuals receiving treatment was the highest for trichomoniasis (90.6%) and the lowest for anogenital warts (49.9%). Conclusions: Overall, approximately 1.25% of men followed in urology practices in Germany between 2013 and 2015 were diagnosed with at least one STI. Further research is needed to gain a better understanding of the factors potentially associated with the risk of being diagnosed with STI in this setting in Germany. Moreover, there is a need for enabling higher rates of diagnosis and thus treatment of infected persons.

A new species of sucking louse Hoplopleura villosissima n. sp. (Psocodea: Phthiraptera: Hoplopleuridae) and a new host record of the spiny rat louse Polyplax spinulosa Burmeister, 1839 (Psocodea: Phthiraptera: Polyplacidae) from the long-haired rat Rattus villosissimus Waite (Rodentia: Muridae) in Australia.

BACKGROUND: The sucking louse fauna of endemic Australian rodents has been under-studied for decades. Sixty-five species of native rodents have been recorded in Australia. However, only 11 species of lice have been reported from 11 species of endemic Australian rodents. RESULTS: We describe a new species of sucking louse, Hoplopleura villosissima Wang (Psocodea: Phthiraptera: Hoplopleuridae), and report a new host record of the spiny rat louse, Polyplax spinulosa Burmeister, 1839 (Psocodea: Phthiraptera: Polyplacidae), from the long-haired rat, Rattus villosissimus Waite (Rodentia: Muridae), which is endemic to Australia. CONCLUSIONS: This study is the first record of sucking louse from R. villosissimus and the first record of a species of Polyplax Enderlein, 1904 from an endemic Australian rodent. This study brings the total number of sucking louse species in endemic Australian rodents from 11 to 13. Previously, only the introduced brown rat, Rattus norvegicus Berkenhout and the black rat, Rattus rattus Linnaeus were recorded as the hosts of P. spinulosa in Australia. Because R. villosissimus overlaps with R. rattus in distribution but not with R. norvegicus, we propose that P. spinulosa transferred to R. villosissimus from R. rattus.

Prevalence and risk factors associated with ectoparasite infestation of buffaloes in an Amazonian ecosystem.

BACKGROUND: The water buffalo (Bubalus bubalis) is well adapted in some regions of the Amazon. Of all Brazilian states, Pará contains the largest number of this species, with 510,000 animals, approximately 38% of the Brazilian buffaloes. Despite the socioeconomic importance of bubaline farming in the northern region, little is known about the prevalence of ectoparasites that affect buffalo herds. This study aimed to identify the species of buffalo ectoparasites in the municipality of Santarém, Pará, and to determine possible risk factors related to ectoparasitic infestation. A cross-sectional study was conducted by sampling 60 rural properties and 621 buffaloes for ectoparasites. When present, ectoparasites were collected for subsequent identification. RESULTS: Of all the animals sampled, 18.5% (115/621) had ectoparasites, 7.8% (49/621) had ticks from the species Rhipicephalus (Boophilus) microplus and Amblyomma cajennense (sensu stricto), and 11.5% (72/621) had lice from the Haematopinus tuberculatus species. Six animals presented mixed infestations of ticks and lice. Among the sampled farms, 51.6% (31/60) had at least one animal infested with ectoparasites. The prevalence of ticks and lice on buffaloes was associated with the farm site, with higher prevalence (11.5% ticks, 15.4% lice) in animals at dry land (OR: 16.7 and 5.7 for ticks and lice, respectively) when compared with floodplains (0.5% ticks, 3.4% lice). Buffaloes aged 1 to 12 months had more ticks whereas buffaloes aged 13 to 24 months had more lice (P < 0.05). CONCLUSIONS: Buffaloes bred in the municipality of Santarém present different levels of tick and lice infestation according to the direct influence of Amazon ecosystem characteristics. The floodplain environment, widely used for buffalo farming, contributes toward minor ectoparasite infestations in these animals.

The role of chewing lice (Phthiraptera: Philopteridae) as intermediate hosts in the transmission of Hymenolepis microps (Cestoda: Cyclophyllidea) from the willow ptarmigan Lagopus lagopus (Aves: Tetraonidae).

The cestode Hymenolepis microps is an intestinal parasite of tetraonid birds, including the willow ptarmigan (Lagopus lagopus). This parasite is able to maintain a high prevalence and intensity throughout the year, even in a subarctic environment in bird populations with relatively low host densities, indicating effective transmission routes. Willow ptarmigan consume mainly vegetal material and active consumption of invertebrates is confined to the first two or three weeks of life. Ptarmigan are infected by different species of ectoparasites, of which two species of feather lice, Lagopoecus affinis and Goniodes lagopi, are the most abundant. In this study, we explored the hypothesis that feather lice may be suitable intermediate hosts for H. microps. We applied histological techniques and light microscopy to investigate lice for the presence of larval cestode stages (cysticercoids). We found 12 cysticercoid-like structures inside chewing lice collected on L. lagopus hosts harbouring H. microps. In addition, a polymerase chain reaction (PCR) screening of Ischnocera lice DNA, targeting the 18S rRNA gene of the cestode, showed positive results for two different short fragments of the 18S rRNA gene of H. microps which were sequenced from lice collected on birds. Both independent lines of evidence support the hypothesis that Ischnocera lice might be suitable intermediate hosts in the life cycle of H. microps in L. lagopus.

Changing Demographics and Prevalence of Body Lice among Homeless Persons, Marseille, France.

The prevalence of body lice among 2,288 sheltered homeless persons in the city of Marseille during 2000-2017 was 12.2% and significantly decreased over time. We report a positive association between body lice infestations and older age, duration of stays in France for migrants, frequent consumption of alcohol, and tobacco smoking.

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.

European guideline for the management of pediculosis pubis.

Pediculosis pubis is caused by Phthirus pubis. The disease can be sexually transmitted. Patients main complain is of itch in the pubic area. The parasite can be spotted with the naked eye and blue macules can be observed in the pubic area. First line therapy consists of permethrin or pyrethrins with piperonyl butoxide. Second line therapy contains phenothrin, malathion and oral ivermectin. Partner management needs a look-back period of time of 3 months. Pubic lice incidence is increased in populations groups living in crowded spaces with scarce sanitary conditions as in time of war or disaster.

Exotic pediculosis and hair-loss syndrome in deer (Odocoileus hemionus) populations in California.

Infestation with nonnative, "exotic" lice was first noted in Washington black-tailed deer (Odocoileus hemionus columbianus) in 1994 and has since then spread throughout the western United States. In California, infestation with the exotic louse Damalinia (Cervicola) sp. was first detected in black-tailed deer from northern California in 2004, and, in 2009, the exotic louse species Bovicola tibialis and Linognathus africanus were identified on mule deer (Odocoileus hemionus californicus) in central Sierra Nevada in association with a mortality event. Exotic lice have since been detected in various locations throughout the state. We describe the geographic distribution of these exotic lice within California, using data from 520 live-captured and 9 postmortem-sampled, free-ranging mule deer examined between 2009 and 2014. Data from live-captured deer were used to assess possible associations between louse infestation and host age, host sex, migratory behavior, season, and blood selenium and serum copper concentrations. Damalinia (Cervicola) sp. and B. tibialis lice were distinctively distributed geographically, with D. (Cervicola) sp. infesting herds in northern and central coastal California, B. tibialis occurring in the central coastal mountains and the Sierra Nevada, and L. africanus occurring only sporadically. Younger age classes and low selenium concentrations were significantly associated with exotic louse infestation, whereas no significant relationship was detected with serum copper levels. Our results show that exotic lice are widespread in California, and younger age classes with low blood selenium concentrations are more likely to be infested with lice than older deer.