[Translated article] Spanish Academy of Dermatology and Venereology (AEDV) expert recommendations for the management of sexual transmitted parasitosis. Scabies, and pediculosis pubis.

Sexually transmitted infections are communicable diseases where the pathogen is transmitted through sexual contact. The Sexually Transmitted Infections Working Group of the Spanish Academy of Dermatology and Venereology (AEDV) is engaged in the drafting of documents to guide dermatologists and health care personnel who treat Spanish patients with these infections. This document analyzes the epidemiological, clinical, therapeutic, and control characteristics of 2 sexually transmitted parasitosis: scabies due to Sarcoptes scabiei var. hominis, and pubic pediculosis due to Phthirus pubis. Both parasitoses share a sort of mixed spread through sexual and community transmission regardless of the route through which the infection was initially acquired. This specific feature creates particularities in the management and control of the infestation.

Isolated Pediculosis Presenting With Hypereosinophilia and Iron Deficiency Anemia: A Case Report and Review of Literature.

In recent years, there has been growing recognition of the association between lice infestation and iron deficiency anemia (IDA). The head lice, known as Pediculosis humanus capitis, and the body lice, known as Pediculosis humanus corporis, are responsible for causing these infestations. This case report focuses on the clinical findings of a 63-year-old woman who sought medical attention in the emergency department because of severe pruritus and generalized pain. Upon initial physical examination, the patient was found to have a severe lice infestation, and laboratory findings revealed IDA (Hb: 6.8 g/dL, MCV: 70 fL, iron: 21 mcg/dL) and hypereosinophilia (3,500/µL). Treatment involved the administration of Permethrin 1% lotion, Ivermectin, and intravenous iron sucrose supplementation. On the fifth day of presentation, the patient's hemoglobin level improved to 8.6 g/dL, and the eosinophil count decreased to 2,000/µL. Despite extensive investigation of the patient's IDA and hypereosinophilia, no clear etiology of IDA was identified. Consequently, the patient was diagnosed with hypereosinophilia and IDA, secondary to severe chronic pediculosis. This case report aims to raise awareness of the possibility of severe pediculosis as a risk factor for iron deficiency and hypereosinophilia.

Pediculosis capitis risk factors in schoolchildren: hair thickness and hair length.

The human head lice is a cosmopolitan ectoparasite that causes pediculosis. The main way of spreading lice is through direct head-to-head contact. It is popular knowledge that some individuals are more susceptible to contracting head lice than others. Reports of individuals who have never been affected by the disease are common, even living in the same environment and under the same conditions as people who regularly have lice infestations. Previous research has been carried out on the risk of this infection associated with different human factors like gender or age. However, studies on the influence of the individual hair characteristics are scarce. The objective of the study was to analyze the pediculosis risk using geographical location, gender, age and individual hair characteristics as variables. Pediculosis was diagnosed through the detection of living lice in the hair. This cross-sectional school-based epidemiological study was conducted in 310 schoolchildren aged 1 to 13 years of schools in 4 municipalities situated in the State of Paraná, Brazil. The prevalence of head louse infection in primary school students was 49.35 %. The Odds Ratio of presence of pediculosis (OR) was estimated using multivariate logistic regression analysis. The results obtained indicate that hair length and thickness increase the risk of infection. Furthermore, the inclusion of hair color, hair shape, kind of hair-scale as covariates increases the risk of pediculosis, indicating that these variables partly explain this susceptibility and that pediculosis is independent of gender. A smaller hair diameter may favor insect fixation to the hair in the nymphal phases. These results may explain why girls are a greater risk as they let their hair grow for cultural reasons, i.e., being of female gender is an agglutinating variable. The conclusions drawn may explain the discrepancies obtained in previous analyses.

Spanish Academy of Dermatology and Venereology (AEDV) expert recommendations for the management of sexual transmitted parasitosis. Scabies, and pediculosis pubis. / Recomendaciones de expertos de la Academia Española de Dermatología (AEDV) para el manejo de las ectoparasitosis de transmisión sexual. Escabiosis y pediculosis púbica.

Sexually transmitted infections are communicable diseases where the pathogen is transmitted through sexual contact. The Sexually Transmitted Infections Working Group of the Spanish Academy of Dermatology and Venereology (AEDV) is engaged in the drafting of documents to guide dermatologists and health care personnel who treat Spanish patients with these infections. This document analyzes the epidemiological, clinical, therapeutic, and control characteristics of 2 sexually transmitted parasitosis: scabies due to Sarcoptes scabiei var. hominis, and pubic pediculosis due to Phthirus pubis. Both parasitoses share a sort of mixed spread through sexual and community transmission regardless of the route through which the infection was initially acquired. This specific feature creates particularities in the management and control of the infestation.

POPULATION STRUCTURE AND BARTONELLA QUINTANA IN HEAD AND BODY LICE IN POKHARA, NEPAL (ANOPLURA: PEDICULIDAE).

This study examined the population structure of head and body lice infesting a random sample of people in Pokhara, Nepal during 2003, 2004, and 2005. A total of 106 participants (6 to 72 yr old, median = 12) volunteered to have lice collected from their heads and clothing. Most participants (70%) harbored only head lice, some (15%) had only body lice, and some (15%) had concurrent infestations of head and body lice (dual infestations). A total of 1,472 lice was collected. Significantly more nymphs were collected than adult lice. Louse populations were generally small (geometric mean = 8.8 lice per person) but a few participants harbored larger louse populations (maximum = 65 lice). People with dual infestations harbored significantly more lice than people with single infestations; however, there was no difference in the infestation intensities between people infested with head lice only vs. those infested with body lice only. Male participants harbored significantly more lice than did females. There were no significant differences in infestation intensity due to participant age or their socioeconomic level. The sex ratio of adult lice was increasingly female biased with increasing adult louse density. Infection of lice with Bartonella quintana was low (ca. 1.5%). Pediculosis is a common problem in urban Nepal.

Phylogenetic and network analysis of Pediculus humanus in Nigeria reveal the presences of clade E body lice and novel haplotypes.

An investigation was conducted for the first time to determine the prevalence and genetic diversity of human lice, for the first time in Nigeria, using conventional PCR and sequencing methods. Three mitochondrial genes, cytochrome oxidase subunit 1 (cox1), cytochrome b (cytb), and 12S rRNA of Nigerian human lice, were amplified, sequenced, and analyzed. Overall, high prevalence (72.5%; 103/142) of lice infestation was recorded among the examined volunteers. Head lice infestation was more common 63 (61.2%) than body lice infestation 34 (33.0%). Co-infestation with both head and body lice was recorded in six humans (5.8%). The Nigerian human lice specimens were placed mostly into clade A with few in clade E, including body lice for the first time. Six, three, and eight haplotypes of Nigerian human lice were obtained for the cytb, cox1, and 12S rRNA genes, respectively. Additionally, one (E51), three (A31, A32, and E5), and six (A20, A21, A23, A24, A30, and E1) novel haplotypes were recorded for cox1, cytb, and 12S rRNA, respectively, from the Nigerian specimens which were corroborated by the ML phylogenetic trees and MJ network analyses. Genetic diversity indices indicate minimal variation in the parameters analyzed among the clades of the three genes. However, a statistically significant Snn test, negative Tajima's D test for clade A (cox1 and 12S rRNA genes), and negative Fu and Li's D test in clade A for cox1 gene indicate a geographical structure and the signature of population expansion of the Nigerian human lice. The findings from this study provide additional data on the human lice structure in Africa.

Treatment Modalities of Pediculosis Capitis: A Narrative Review.

The review has been done to find out the best-suited treatment modality for pediculosis capitis. Pediatric patients frequently experience pediculosis capitis, a head louse infestation brought on by the Pediculus humanus var. capitis. The primary sign of head lice infestation is a scratchy scalp, and the presence of living nits confirms this diagnosis. When a doctor diagnoses pediculosis as a primary bacterial infection, a bacterial impetignization and secondary infection, and cervical and occipital lymphadenopathy might make the clinical diagnosis more difficult. A proper therapy of pediculosis requires screening and treatment of all close contacts. The careful use of topical pediculicidal treatments, especially permethrin lotion and wet combing with a fine tooth comb, is required for the medical treatment of a head louse infestation. We've tried to outline the key points of treating head lice infestations. There are several treatment alternatives suggested, including over-the-counter permethrin and pyrethrin as well as prescription medications including malathion, lindane, benzyl alcohol, and spinosad.

Increased Risk of Surgical Field Contamination from Acute Pre-operative Treatment of Pediculosis Capitis (Lice) Infestation - A Case Report of Two Twin Pediatric Patients.

Introduction: Little is known about the perioperative management of Pediculus capitis (lice) infestations, including risk of contamination to the sterile field, whether to delay surgery, and optimal time to treat and/or operate. Case Report: Two identical twin patients presented for elective in situ percutaneous pinning of chronic slipped capital femoral epiphyses. Active pediculosis capitis was noted intraoperatively by the anesthesia team during the first patient's surgery. Meticulous examination of the sterile field at that time demonstrated no organisms or other sources of contamination. The second patient's surgery was delayed to discuss her case with the infectious disease team. Scant literature exists to guide recommendations. Ultimately, a single permethrin treatment immediately before surgery was recommended and followed by our team. After careful prepping and draping, a louse was observed on the sterile field near the planned pin insertion site. The case was immediately canceled and delayed indefinitely. After two additional treatments over the next 4 days, only eggs (but no active insects) were observed in the patient's hair. We elected to proceed to surgery at that time, which concluded without issue. Conclusion: The surgical implications of an active lice infestation are numerous. Administration of antiparasitic medication in the immediate pre-operative period causes increased movement in pediculosis capitis, which may increase risk of sterile field contamination. Elective procedures should be postponed to complete multiple rounds of permethrin. In cases of urgent/emergent surgery, or in which treatment delay is unfeasible, foregoing delousing treatment in the immediate pre-operative period may be recommended.

Efficacy and Safety of Neem Oil for the Topical Treatment of Bloodsucking Lice Linognathus stenopsis in Goats under Field Conditions.

The aim of the present study was to evaluate the efficacy and safety of neem oil on caprine pediculosis and on kids' growth performances. The neem (Azadirachta indica) belongs to the Meliaceae family, and in Eastern countries it is mainly considered for the insecticidal activities of the kernel oil. The neem seeds contain bioactive principles, such as azadirachtin A, salannin, nimbin, and nimbolide. The trial was carried out on 24 kids, 120 days old, maintained in open yards. Animals were divided in 4 homogeneous groups (n = 6 animals/group) based on age, louse count, body condition score (BCS) and live body weight: Control Group (C, saline NaCl, 0.9%), Neem Group 1 (NO-100, 100 mL of neem oil per 10 kg), Neem Group 2 (NO-200, 200 mL/10 kg), Neem Group 3 (NO-300, 300 mL/10 kg). The treatments were performed by spraying the insecticide on the goat's body. The study lasted 56 days, and weekly, the kids underwent louse count, BCS and body weight determination, and FAMACHA score. Data were analyzed by ANOVA for repeated measures. The species of lice identified was Linognathus stenopsis. Kids belonging to NO-200 and NO-300 showed a stronger reduction of louse count throughout the study (>95%). The daily weight gain recorded was significantly higher (p < 0.05) in NO-300 than C. No differences were found for BCS and FAMACHA scores. The results of this trial showed that the administration of neem oil to control caprine pediculosis caused by sucking lice represents an alternative to synthetic compounds.

Pediculosis pubis presenting as pediculosis capitis, pediculosis corporis, and pediculosis ciliaris in a case of Alport syndrome.

Pediculosis is an infestation of lice on the human body. Pediculosis pubis is primarily found in the pubic region and is usually transmitted by sexual contact. Diagnosis is done by visualization of mites which can be aided by the use of dermoscope. Hereby, we report a case of an Alport syndrome patient having extensive pubic lice infestation with no sexual history and probable transmission from cattle.

Pediculosis humanus capitis in 6-7 years old schoolchildren in Valencia, Spain.

OBJECTIVES: Pediculosis humanus capitis is a worldwide public health concern that affects mostly school-aged children. The aim of this study is to determine the rate of pediculosis and to determine possible risk factors in a group of primary school children in Valencia, Spain; 227 children, 6-7 years old, were selected from 7 schools. METHODS: A self-reported questionnaire completed by the parents/guardians about the presence of pediculosis in their children and their knowledge about pediculosis. The results recorded in the questionnaire were analysed by SPSS® software. RESULTS: 30.4% of the children had pediculosis. The results showed significant variation (p < 0.05) in prevalence depending on the following factors: sex, hair length, level of parental education, family size, presence of affected family member in the home, and frequency of hair washing. Less than half of parents/guardians showed an appropriate level of knowledge on pediculosis. Pediculosis remains a health problem in Valencian schoolchildren. The family size and existence of another member with pediculosis were shown to be the main potentiating factors. CONCLUSIONS: Parents are not sufficiently informed about pediculosis and adopt inappropriate practices. There is a need to promote studies with the objective of determining risk factors for pediculosis as well as the need for actions to increase the knowledge of parents and healthcare professionals on this parasitosis to prevent outbreaks in the community, assure correct treatment and maintain effective epidemiological surveillance.

The Impact of the COVID-19 Pandemic on the Prevalence of Head Lice Infestation among Children Attending Schools and Kindergartens in Poland.

Pediculosis capitis predominantly affects child populations. During the COVID-19 pandemic, various types of social limitations such as social isolation and limitations on educational facilities' functionalities were introduced worldwide, including in Poland. The impact of these pandemic restrictions on the prevalence of pediculosis capitis has not been extensively investigated so far. Existing data on this topic are limited mainly to indirect evaluation methods, such as online surveys or Internet analysis. In this study, we directly examined a cohort of over five thousand children to assess the influence of COVID-19 pandemic restrictions on the prevalence of head lice infestation among school and kindergarten attendees in Poland. Our findings demonstrate that the restrictions imposed during the COVID-19 pandemic led to a decrease in the number of children infested with head lice compared to pre-pandemic data. These results confirm that head lice infestations remain an ongoing epidemiological concern and warrant continued monitoring.

Pediculosis capitis and scabies in nurses from Eastern Poland - occupational risk and environmental determinants.

INTRODUCTION AND OBJECTIVE: Nurses are a group of healthcare professionals particularly vulnerable to infestations by Pediculus humanus capitis and Sarcoptes scabiei var. hominis contracted from patients under their medical care. MATERIAL AND METHODS: The cross-sectional study included 322 professionally active nurses within public healthcare units in eastern Poland. The research tool was a questionnaire collecting anonymized data on the occurrence of pediculosis capitis and scabies in nurses, and their patients, concerning the environmental determinants in the period 2001-2013. The study was retrospective and participation of nurses was voluntary. RESULTS: The obtained results indicated that 24.8% and 9.9% of the 322 respondents were infested by head lice and scabies mites, respectively. During their professional work, most nurses contracted head lice once (76.2%) while others (23.8%) were infested twice or more. The respondents did not declare repeated occupational scabies. The risk of contracting pediculosis capitis and scabies was not related to the length of service, but increased with the rise in the number of patients provided with nursing care. In the head lice-infested patients, the majority were aged 6-10 years (31.3%), while in the case of scabietic patients, children aged 0-5 years prevailed (26.4%). CONCLUSIONS: In medical care facilities, regular hygienic checks of both patients and medical staff, covering the condition of the skin and scalp, should be mandatory. The spread of pediculosis capitis and scabies among nurses can be reduced by the implementation not only of protective procedures mitigating occupational risk, but also the improvement of working conditions in medical facilities.

Scalp Infection, Inflammation, and Infestation.

Tinea capitis, folliculitis, seborrheic dermatitis, and pediculosis capitis are four common scalp conditions. Although tinea capitis and seborrheic dermatitis are found more commonly in patients with skin of color and highly textured hair, all of these conditions have special diagnostic or management considerations in these populations. This article reviews the diagnosis and management of these common scalp conditions.

First report of classical knockdown resistance (kdr) mutation, L1014F, in human head louse Pediculus humanus capitis (Phthiraptera: Anoplura).

There are at least three known knockdown resistance (kdr) mutations reported globally in the human head louse Pediculus humanus capitis De Geer (Phthiraptera: Anoplura) that are associated with reduced sensitivity to pyrethroids. However, the prevalence of kdr mutation in head lice is not known in the Indian subcontinent. To identify kdr mutations in the Indian head lice population, the genomic region of the voltage-gated sodium channel gene encompassing IIS1-2 linker to IIS6 segments was PCR-amplified and sequenced from P. humanus capitis samples collected from different geographic localities of India. DNA sequencing revealed the presence of four kdr mutations: M827I, T929I, L932F and L1014F. The presence of a classical kdr mutation L1014F, the most widely reported mutation across insect-taxa associated with the kdr-trait, is being reported for the first time in P. humanus capitis.

Estonian Parents' Awareness of Pediculosis and Its Occurrence in Their Children.

Background and Objectives: Pediculosis, or head lice infestation, is a widespread health problem that can affect anyone, regardless of gender, age, or social background. The purpose of this study was to clarify the occurrence of pediculosis among Estonian preschool- and primary school-aged children according to their parents and the parent's awareness of pediculosis and related behaviors. Materials and Methods: An online questionnaire was completed by the parents of the preschool children (n = 1141) in 2019 and the parents of the elementary school children (n = 362) in 2021. For the descriptive data, t-test, Mann−Whitney or χ2 test, linear regression, and logistic regression analyses were applied. Results: According to the parents, pediculosis had occurred in 34.7% of the children, and more than one-third of pediculosis patients had experienced it more than twice. Lice were mainly acquired from elementary school or preschool and less often from friends, relatives, or training environments. Parents' knowledge of head lice was rather good; the average score of the correct answers was 14.0 ± 3.4 (max. 20). In the multivariate analysis, higher age (coefficient 0.07, p < 0.001), healthcare education (coefficient 1.19, p < 0.001), and a previous occurrence of pediculosis in a family (coefficient 1.95; p < 0.001) were factors influencing better knowledge. In order to treat the infestation, antilice shampoo and combing were the most often used methods. Conclusion: Despite parents' awareness, pediculosis infestations continue to be common among our children.

Effect of Education and Regular Examination on the Prevalence of Head Louse Infestations in Adana

Objective: The current study provides training to parents and teachers about pediculosis in schools in three villages in Adana to measure their knowledge level by conducting surveys and to determine the prevalence of pediculosis in these foci. Methods: Pre- and post-questionnaires including 30 questions about pediculosis were handed to parents and teachers. The answers were analyzed with the Pearson correlation analysis. Overall, 418 school pupils s were examined for lice. The results of the head louse control were analyzed by the chi-square test and t-test. Results: We observed that the level of awareness increased in parents and teachers. Additionally, the gender of both teachers and parents was determined as the most important factor in increasing this awareness. Because of interventions for the control of head and lice, the prevalence of pediculosis decreased from 15.22% to 1.71%. Conclusion: It is very important that parents and teachers are aware of the health problems related to pediculosis, while regular combing of school children may be essential for the control of this common infestation.

Prevalence of Pediculus humanus capitis and associated risk factors among elementary school-aged girls in Paveh, West Iran.

INTRODUCTION: Head lice infestation is considered as a common dermatological health problem worldwide. This study was aimed to determine the pediculosis prevalence and associated risk factors among school-aged girls enrolled in public elementary schools of the city of Pave, Kermanshah province, West Iran. The study findings will provide an evidence base, upon which a multifaceted intervention against pediculosis can be formulated and implemented. METHODOLOGY: In this cross-sectional study, 361 elementary school-aged girls were recruited from October to December 2018 at the beginning of the school year. Diagnosis was made by visual inspection. A structured questionnaire was utilized to collect data about past history of infestation and associated factors. RESULTS: A total of 26/361 (7.2%; 95% CI: 4.50-9.90) suffered from pediculosis. Pediculosis was associated with the history of previous infestation (OR: 6.12; 95% CI: 2.68-13.99; p < 0.001), low frequency of bathing (OR: 7.90; 95% CI: 3.36-18.60; p < 0.001), low frequency of hair combing (OR: 3.64; 95% CI: 1.56-8.50; p = 0.004), screening of the student's hair by parents at home (OR: 0.39; 95% CI: 0.19-0.78; p < 0.001) and with the absence of screening by the school health officer in the schools (OR: 7.16; 95% CI: 2.91-17.61; p < 0.001). CONCLUSIONS: Synchronized efforts to enhance public knowledge, periodic examination of school-aged children for pediculosis, and proper treatment of infested patients are needed to control the disease in the Iranian elementary schools. The applied strategies in low and middle income countries is suggested to be focused mainly on low cost family-based and school-based initiatives for maximum effectiveness.

Prevalence of Pediculosis Among Primary School-Aged Students in Iran: an Updated Comprehensive Systematic Review and Meta-Analysis.

In this study, a systematic investigation was performed to estimate the prevalence of head lice infestation, and to determine the factors affecting the prevalence of heterogeneity among primary school-aged children in Iran. A comprehensive search was fulfilled in international databases, including MEDLINE, Scopus, Web of Science, and Embase, to identify the articles on the prevalence of pediculosis. So, all the cross-sectional epidemiological studies evaluating the prevalence of pediculosis were covered without any restrictions. A random-effects model was used to assess the pooled prevalence. A meta-regression method was applied to determine the factors affecting the heterogeneity among the studied population. An analysis was performed on 67 studies with a total sample size of 358,053. The total pooled estimate for the prevalence of pediculosis in boys and girls was 7.52% (95% CI: 6.15-9.03), 1.99% (95% CI: 1.25-2.89), and 8.97% (95% CI: 721-10.91), respectively. The highest and lowest pooled prevalence was in Hormozgan (southern Iran) (29.21%; 95% CI: 8.89-55.34) and Isfahan (Central Iran) (0.69%; 95% CI: 0.59-0.80), respectively. Based on the results of the univariate meta-regression, gender and father's job showed a significant direct association with the prevalence of pediculosis, but the sample size had significant inverse relations with the prevalence of pediculosis. This study demonstrated that pediculosis is a common public health problem affecting school-aged children with a relatively high prevalence in Iran, especially among girls.