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.

Efficacy of the Peganum Harmala Oil Versus 1% Permethrin Shampoo on the Treatment of Head Louse Infestation

Introduction: Head louse infestation is one of the major public health problems among children worldwide. Several drugs have been developed to treat the infestation. Side effects and drug resistance associated with these drugs limit their applicability. Increasing attention of scientific committees to alternative drugs along with greater effects and lower complications and costs, increase the hope of success for alternative drugs. Materials and Methods: 93 participants (11 men and 82 women) with positively diagnosed with head lice infestation were allocated into two groups using the stratified randomization method. The intervention in one group comprised of Peganum harmala oil applied onto the patient’s hair and scalp and the hair and scalp being washed after 20 minutes once a day. The procedure was performed on the first three days of week one of intervention (phase 1) and reiterated on the subsequent week (phase 2) in a similar manner. The other group applied permethrin shampoo once in the first week of intervention and once in the second week. Results: Permethrin shampoo recovered 7 (29.2%) in day 1, 2 (15.4%) in day 2, 2 (25.0%) in day 3 and 28 (73.7%) in day 11 but Peganum harmala oil recovered 17 (70.8%) in day 1, 11 (84.6%) in day 2, 6 (75.0%) in day 3 and 10 (26.3%) in day 11 (P-value <0.005). Conclusion: The clearing effects and side effects of Peganum harmala oil and permethrin shampoo are approximately similar in the two-phase application although the oil’s clearing and protective effect is greater than that of the shampoo with its effect occurring earlier than that of the shampoo.

Using human head lice to unravel neglect and cause of death

Despite the common association of human lice with abandoned or neglected people, no procedure to assess pediculosis, aimed to detect signs of neglect, exists. Investigating the two most common forms of head louse infestation, regular and severe, we define lice-markers of neglect and develop a protocol and survey form to record and assess pediculosis. The study of head lice from a deceased victim of neglect helped unravel time-length since death, frequency of exposure to neglect and the cause and circumstances related to the death. Nit-clusters are markers of neglect, indicating length and frequency of neglect episodes. In the case study used here that culminated in the death of the victim, sustained abandonment started circa 2 years before discovery. The lice suggested that death was caused by overconsumption of a powerful calcium channel blocker, an antihypertensive, an excess of which in lice food supply (blood) stops oogenesis. Despite hosting thousands of adult females on the hair, lice reproduction stopped and nits were no longer developed or deposited on the hairs at the root end. This short distance of the shaft with no nits provided a time estimation of overdosing of almost 2 months before death.

Physically acting products for head lice – the end of the beginning

Treatment of head louse infestation has evolved from widespread use of neurotoxic insecticides that have been extensively affected by resistance since the mid-1990s into the use of so-called physically acting treatments. It is widely believed that physically acting products are effectively “resistance proofed” because they do not act to inhibit any particular physiological mechanism and most have some kind of occlusive effect on the target organism. Over the past 20 years various new active materials have been utilized ranging from natural oils, synthetic oils, through to surfactants both as excipients and active substances. Relatively few of these products have been adequately tested clinically and, of those that have, there is now some indication that they are less effective than when first introduced. The question therefore arises whether lice can become resistant to these physically acting products. Only adequate testing both in the laboratory and in clinical trials can determine their real effectiveness and claiming efficacy based on the presence of a named chemical rather than demonstrated activity may result in acquired resistance to these types of product also.

Physically acting products for head lice – the end of the beginning

Treatment of head louse infestation has evolved from widespread use of neurotoxic insecticides that have been extensively affected by resistance since the mid-1990s into the use of so-called physically acting treatments. It is widely believed that physically acting products are effectively “resistance proofed” because they do not act to inhibit any particular physiological mechanism and most have some kind of occlusive effect on the target organism. Over the past 20 years various new active materials have been utilized ranging from natural oils, synthetic oils, through to surfactants both as excipients and active substances. Relatively few of these products have been adequately tested clinically and, of those that have, there is now some indication that they are less effective than when first introduced. The question therefore arises whether lice can become resistant to these physically acting products. Only adequate testing both in the laboratory and in clinical trials can determine their real effectiveness and claiming efficacy based on the presence of a named chemical rather than demonstrated activity may result in acquired resistance to these types of product also.