Treatment of head lice (Pediculus humanus capitis) infestation: is regular combing alone with a special detection comb effective at all levels?

Head lice infestation (HLI) caused by Pediculus humanus capitis has been a public health problem worldwide. Specially designed combs are used to identify head lice, while anti-lice products are applied on the scalp for treatment. In the present study, we aimed to test whether combing only by precision detection comb (PDC) or metal pin comb (MPC) could be effective alternatives to the use of anti-lice products in children. A total of 560 children from two rural schools in Turkey were screened. In the PDC trial, children were combed every second day for 14 days, while in the MPC trial, combing was performed once in every four days for 15 days. Children were divided into two groups (dry combing and wet combing) for both trials and results were compared. The results showed no significant differences between dry and wet combing strategies for both combs for the removal of head lice (p > 0.05). The number of adult head lice declined significantly on each subsequent combing day in both approaches, except on day 15 in the MPC trial. In the end, no louse was found in 54.1 and 48.9% of children in the PDC and MPC trials, respectively. Since family members of infested children were not available, they were not checked for HLI. Four times combing within 2 weeks with MPC combs was found effective for both treatment of low HLI and prevention of heavy HLI. In conclusion, regular combing by special combs decreases HLI level in children and is safely applicable as long-term treatment.

Synthesis and antileishmanial activity of novel pyridinium-hydrazone derivatives.

A series of substituted phenylethylidenehydrazinylpyridinium derivatives bearing methyl, ethyl, propyl, and propylphenyl groups on the pyridinium nitrogen were synthesized and evaluated for in vitro antileishmanial activity against Leishmania tropica by using the microdilution method. Among the tested compounds, 3d, 5c, 3b, and 3c were found to be the most active derivatives against the promastigotes of L. tropica (IC50 values are 6.90, 9.92, 11.69 and 12.03 µM, respectively) and to be more active than reference drug meglumine antimonaite (glucantime) (IC50 value: 20.49 µM). The derivatives investigated in this study may have the potential to be lead compound against leishmanial infection.

The Toxicity of Essential Oils From Three Origanum Species Against Head Louse, Pediculus humanus capitis.

PURPOSE: Pediculosis caused by human head louse, Pediculus humanus capitis De Geer (Anoplura: Pediculidae) is a public health problem with a high prevalence, especially among children in school age. Different chemical pediculicides (insecticides) are used against lice but the repeated application of these pediculicides for the treatment of P. humanus capitis infestation in the past decades has resulted in the development of resistance. The plant essential oils have been used as alternative sources of lice treatment agents. Pediculicidal activity of the essential oils of three Origanum species (O. onites, O. majorana and O. minutiflorum) against P. humanus capitis adults was examined in this study. METHODS: Essential oils from aerial parts of three Origanum species were obtained by hydrodistillation using a Clevenger-type apparatus. P. humanus capitis specimens used were obtained from infested children by combing method at primary schools. Adult lice were exposed to three dilutions (1%, 0.5% and 0.1% w/v) of tested oils for 5 min using the adult immersion test. RESULTS: According to the results, all Origanum essential oils at 1% concentration have been shown to significantly decrease the rate of limb, bowel and abdomen movements, producing more than 90% mortality after 12 h. CONCLUSION: Our results indicated that Origanum essential oils can be used for the development of new pediculicides against head louse.

Entomological Survey for the Detection of Sand Fly Fauna and Vector Species in the Cutaneous Leishmaniasis Endemic Area in East Mediterranean Region of Turkey, Mersin Province.

Cutaneous (CL) and visceral (VL) forms of leishmaniasis, transmitted by sand flies, are seen in all countries located in Mediterranean Basin including Turkey. In this study, we aimed to conduct an entomological survey for the detection of sand fly fauna and vector species in Mersin province, one of the important endemic areas for CL in Turkey. In total, 912 sand fly specimens were collected in 2010 and 2011 using CDC light traps. Nine Phlebotomus (Diptera: Psychodidae) and three Sergentomyia (Diptera: Psychodidae) species were detected. Of the collected Phlebotomus sand flies, P. sergenti Parrot, 1917 (30.1%) was the most dominant followed by P. alexandri Sinton, 1928 (18.2%), P. neglectus/syriacus Tonnoir Adler (12.0%), P. tobbi Adler & Theodor, 1930 (11.7%), and P. papatasi Scopoli, 1786 (10.2%), while S. minuta Rondani, 1843 (11.3%) was the dominant species among Sergentomyia. During the field work in 2011, female specimens (n = 81) were screened for the presence of Leishmania promastigotes by midgut dissection, and all were found negative. The rest of the collected female specimens (n = 334) were pooled according to species (P. alexandri, P. neglectus/syriacus, P. papatasi, P. sergenti, P. simici, and P. tobbi) and location (Mut, Silifke, and Anamur). In total, 29 pools were generated and real-time ITS1 PCR assay was performed to detect and identify natural Leishmania Ross, 1903 (Kinetoplastida: Trypanosomatida) infection. Two pools, both from Mut town, containing P. sergenti specimens were found positive and Leishmania tropica Ross, 1903 was identified as an infectious agent for both pools. In conclusion, the sand fly fauna was determined in an endemic area for CL. The detection of L. tropica DNA in P. sergenti specimens showed the possible vectorial role of this species in Mersin province.

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.

The prevalence of intestinal parasites and nasal S. aureus carriage among food handlers.

Food handlers play a major role in the transmission of foodborne diseases. Nasal Staphylococcus aureus (S. aureus) carriage and intestinal parasitism are important risk factors in contamination. The purpose of the authors' study was to determine the prevalence of intestinal parasites and nasal S. aureus carriage among food handlers in Manisa, Turkey. The authors investigated 8,895 people for nasal S. aureus carriage and intestinal parasites. Nasal swab materials and stool samples were examined, and anal cellophane band method was performed. The authors found that S. aureus was isolated in 69 (0.77%) samples. All S. aureus strains were oxacilline sensitive. Intestinal parasites were found in 784 (8.8%) samples. The most common parasites were Entamoeba histolytica (69.9%) and Giardia intestinalis (24.6%). The authors conclude that food handlers should be screened and treated from time to time and that a periodic program of health education on food safety and hygiene should be given.

Rural life, lower socioeconomic status and parasitic infections.

This study was conducted both to assess the prevalence of parasitic infections in two neighboring villages of Manisa province in Turkey, with different socioeconomic levels and investigate the influences of some individual and environmental factors on these infections. A total of 100 school children were enrolled and their cellophane tape and stool samples were examined for parasites. Pediculus capitis infestation was diagnosed by visual inspection of the hair. Although the prevalences of both intestinal parasitosis and pediculosis were high in both villages, there was a statistically significant difference for pediculosis, but not for intestinal parasitosis. Lack of social security and father's regular job were found to be highly correlated with all parasitic infections. Pediculosis was more common in younger children, girls and those in crowded families. These results indicate not only the high prevalence of parasitic infections, but also the urgent need for the improvement of basic health services and infrastructure in the rural areas, crowded with poorer immigrant population.

Health inequities: lower socio-economic conditions and higher incidences of intestinal parasites.

BACKGROUND: Intestinal parasitic infections affect child health and development and slow down growth, while reducing adults' productivity and work capacity. The aim of the present study was to determine and compare the incidences of intestinal parasitic infections and the socio-economic status of two near primary school children in Manisa, a western city of Turkey. METHODS: A total of 352 children were involved a questionnaire study from a private school (Ulkem Primary School - UPS, 116 children) and a community-based school (Sehzadeler Primary School - SPS, 236 children). Of these, stool samples could be obtained from a total of 294 students; 97 (83.6%) from UPS, and 197 (83.5%) from SPS. The wet mount preparations of the stool samples were examined; samples were also fixed in polyvinyl alcohol and examined with modified formalin ethyl acetate sedimentation and trichrome staining techniques. Data were analyzed using SPSS for Windows version 10.0. The chi-squared test was used for the analytic assessment. RESULTS: The percentages of the students found to be infected with intestinal parasites, were 78 (39.6%) and 13 (13.4%) in SPS and UPS, respectively. Totally 91 (31.0%) of the students from both schools were found to be infected with at least one intestinal parasite. Giardia lamblia was found to be the most common pathogenic intestinal parasite and Blastocystis hominis was prevalent independently from the hygienic conditions. The factors which significantly (p < 0.05) increase the incidence of intestinal parasites were uneducated and unemployed mother, lower social status of father, living in crowded houses with insufficient indoor spaces, using the tap water as drinking water, and living at shanty areas. CONCLUSION: Intestinal parasitic infections in school children were found to be a public health problem that increased due to lower socio-economic conditions. We conclude that organization of education seminars including the topics such as prevention of the infectious diseases, improving general hygienic conditions, and application of supportive programs for the parents may be suggested not only to reduce intestinal parasitic infections, but also to elevate the socio-cultural levels.

In vitro and in vivo activities of Haplophyllum myrtifolium against Leishmania tropica.

This study aimed to evaluate the in vitro and in vivo leishmanicidal activity of an endemic Turkish plant and compare its efficacy with a reference drug. In addition to the in vitro activities of the ethanol, acidified and alkaloid extracts and furoquinoline alkaloids skimmianine and gamma-fagarine, in vivo antileishmanial activitiy of the acidified extract of Haplophyllum myrtifolium Boiss. (Rutaceae) were investigated against Leishmania tropica (L. tropica), a causative agent of cutaneous leishmaniasis. All the extracts and pure compounds showed in vitro inhibitory activity against the promastigotes of. L. tropica. The in vitro 50% inhibitory concentrations of y-fagarine, acidified extract, ethanol extract, skimmianine and alkaloid extract against promastigotes were determined as 8.7, 9.4, 10.9, 25.7 and 25.8 microg/ml respectively. In vivo results of Haplophyllum myrtifolium acidified extract showed that this plant has a limited effect on decreasing the lesion size of experimental mice infected with Leishmania tropica. To the best of our knowledge, this is the first time both the in vitro and in vivo antileishmanial activity of Haplophyllum mrytifolium have been reported in the same research.

In vitro Investigation of the Pediculicidal Activities of the Volatile Oil Components of Some Medical Plants Raised in Turkey.

OBJECTIVE: The human head louse Pediculus capitis has recently acquired resistance to commercially available insecticides, which has expanded the search concerning the pediculicidal activities of some herbal products. The present study aimed to assess the in vitro pediculicidal activities of volatile oils extracted from 10 medical plants raised in Turkey: Rosa damascena (red provins rose), Pelargonium graveolens (geranium), Lavandula angustifolia (lavender), Salvia triloba (salvia), Rosmarinus officinalis (rosemary; two different chemotypes), Citrus bergamia (citrus tree), Cymbopogon nardus (citronella), Citrus limonum (lemon), and Cymbopogon flexuosus (lemongrass). METHODS: Head lice obtained from school children in Manisa Province were initially grouped as adults and nymphs and were then kept under optimal conditions (temperature of 27°C and humidity of 50%). A pinch of hair and filter paper were placed in Petri dishes and seven adults and seven nymphs were separately put in Petri dishes. The extracts obtained from each volatile oil were dropped on the lice specimens. RESULTS: The active movement of the external (antenna and legs) and internal (midgut and intestine) organs of the lice was monitored and recorded starting from 5th min for 24 hours by 10 to 30 minutes intervals. The time of death was defined as the loss of active movement and cessation of intestinal activities of lice. The results were analyzed using Statistical Packages for the Social Sciences (SPSS) version 15. CONCLUSION: The results showed that the volatile oil of Rosmarinus officinalis (two different chemotypes) was more effective than the other oils.

Comparing the Efficacy of Commercially Available Insecticide and Dimeticone based Solutions on Head Lice, Pediculus capitis: in vitro Trials.

OBJECTIVE: Head lice infestation is a public health and social problem for almost all countries worldwide. For its treatment, insecticide and dimeticone-based solutions are currently available in the markets in many countries. We aimed to compare the efficacy of commercially available anti-head lice shampoos containing insecticide and physically effective products with different percentages of dimeticone using an in vitro technique. METHODS: Head lice specimens were collected from primary school children using special plastic and metal combs. Anti-head lice products were commercially purchased and used directly. The specimens were placed one by one in 5-cm Petri dishes containing a slightly wet filter paper and were kept in a plastic cage at 28±2°C and 50%±20% relative humidity. A standardized protocol was used for testing all the products, and mortality data were obtained after 24 h. Two control tests were performed with each batch of trials. For each product and control, 10-20 head lice specimens were used, and the results were statistically analyzed. RESULTS: Our study demonstrated that among all the tested products, two products containing mineral oils [5.5% dimeticone & silicone (patented product) and dimeticone (no percentage mentioned in the prospectus) & cyclopentasiloxane] were found to be more effective for killing head lice in vitro. CONCLUSION: Physically effective products can be repetitively used because they are non-toxic and resistance to them is not expected. To control the infestation at a public level, the use of these products needs to be encouraged with respect to their cost price.

Seroepidemiological and entomological survey in a new focus of zoonotic visceral leishmaniasis in Kars province, Northeastern Turkey.

Visceral leishmaniasis (VL) has now been recorded from 38 provinces of Turkey. Twenty-one VL cases were reported within six years from settlements located in most northeastern Turkey and we therefore aimed to carry out an entomological and seroepidemiological survey in this new focus for clarifying risk factors. Blood samples from 290 children and 165 dogs were collected. Sera samples were investigated for anti-Leishmania antibodies using indirect fluorescent antibody test. Sand fly collection for determining the fauna and seasonal activity was performed in all settlements by CDC light traps between June and September 2006. Although no seropositive child was detected during the survey the overall seroprevalence rate of canine leishmaniasis was found as 7.2%. A total of 4154 sand flies were collected and 10 species of genus Phlebotomus were identified belonging to Adlerius, Larroussius, Paraphlebotomus and Phlebotomus subgenera. Among them Phlebotomus kandelakii s.l. (55.44%), Phlebotomus balcanicus (12.62%) and Phlebotomus neglectus (4.40%) was detected as probable vector species for this new focus. The poor sanitation, very high population size of sand flies, probably because of very short season, no control measures for sand flies as well as dogs, and presence of microclimate suitable for sand flies were considered as main risk factors in the area.

[Isosporiasis in an immunocompetent child: case report]. / Bagisiklik sistemi saglam bir çocukta isosporiasis: Olgu Sunumu.

A 12-year old boy was presented as a case report. He had been diagnosed with isosporiasis during a field study, conducted in a village of Manisa province, during an investigation of the incidence of intestinal parasites.

[Evaluation of malaria cases in Manisa from 2002 to 2004]. / Manisa ilinde 2002-2004 yillari arasinda saptanan sitma olgularinin degerlendirilmesi.

The province of Manisa is a relatively well developed agricultural and industrial center in western Turkey. There is a regular and extensive influx of workers from malaria-endemic regions of Anatolia to the province of Manisa during certain periods of the year, leading to contact between the local people and incoming workers. Major seasonal elevations can be detected in the prevalence of malaria in the province of Manisa and therefore an active fight against malaria is still carried out. In the present study, malaria cases detected and reported by the Malaria Control Dispensary of the Manisa City Health Centre during the last 3 years in Manisa have been evaluated. Comparison of present and prior data of malaria prevalence in Manisa has shown a remarkable decrease in recent years. A total of 14, 5 and 5 cases were reported in 2002, 2003 and 2004, respectively. Classification of the cases according to their origin (local or immigrant), age and the time diagnosis was also presented.

[Incidence in Manisa of Trichomonas vaginalis in women with a vaginal discharge.]. / Manisa'da vajinal akintili kadinlarda Trichomonas vaginalis sikligi

Vaginal discharge caused by Trichomonas vaginalis is one of the most frequently encountered sexually transmitted infections in women. This study was planned to investigate the frequency of T. vaginalis in patients with a vaginal discharge. Vaginal specimens were collected from 233 women with a vaginal discharge and from 100 women without any discharge as a control group. Materials were taken with a speculum and sterile cotton swabs from the posterior fornix of the vagina; and inoculated into Trypticase-yeast extract-maltose (TYM) medium. T. vaginalis was detected in 11 (4.7%) samples out of the 233 specimens from women with a discharge using both diagnostic methods (direct examination and culture). No T. vaginalis trophozoites were detected in the control group.