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Concept: Louse

167

Body louse or head louse? Once removed from their environment, body and head lice are indistinguishable. Neither the morphological criteria used since the mid-18th century nor the various genetic studies conducted since the advent of molecular biology tools have allowed body lice and head lice to be differentiated. In this work, using a portion of the Phum_PHUM540560 gene from the body louse, we aimed to develop a multiplex real-time polymerase chain reaction (PCR) assay to differentiate between body and head lice in a single reaction.

Concepts: DNA, Gene expression, Polymerase chain reaction, Molecular biology, Louse

166

Head and body lice are strict obligate human ectoparasites with three mitochondrial phylotypes (A, B, and C). Using molecular methods for genotyping lice (Cytochrome b and multi-spacer typing), and comparing our results with all the sequences of human lice that were genotyped previously, we assessed the presence of a specific American genotype that most likely predates the Columbian era in head lice collected from Amazonia.

Concepts: DNA, Louse

162

Pediculosis capitis is a worldwide health problem. One of the most important factor in effective head lice eradication is to ensure that infestation is adequately recognized and treated. Our survey investigated the knowledge and practice among primary care Italian pediatricians regarding to the prevention and treatment of head lice.

Concepts: Health care, Public health, Head louse, Pediculosis, Body louse, Louse, Treatment of human head lice, Head-louse infestation

158

Phthiriasis palpebrarum is an infestation of the eyelashes caused by the louse Pthirus pubis (Linnaeus, 1758). We report a case of phthiriasis palpebrarum in a 6-year-old girl, which was initially misdiagnosed as allergic blepharoconjunctivitis. Parasites and their nits were found adhering to the eyelashes and eyelids of her right eye as well as scalp hairs. No abnormality was found in the left eye. The histopathology exam revealed the presence of adults and eggs of Pthirus pubis. We mechanically removed all the eyelashes of the right eye at their base, with lice and nits. The scalp was shaved and washed with phenothrin shampoo. No recurrence was found during 3 months of follow-up. Removal of the eyelashes, cutting of scalp hairs, and phenothrin shampoo may be effective in treating phthiriasis palpebrarum. In cases of blepharoconjunctivitis, eyelids and eyelashes should be carefully examined by slit lamp to avoid misdiagnosis.

Concepts: Parasites, Left-wing politics, Louse, Nit

29

Head lice transmit to new hosts when people lean their heads together. Humans frequently touch their heads to express friendship or love, while this behaviour is absent in apes. We hypothesize that this behaviour was adaptive because it enabled people to acquire head lice infestations as early as possible to provoke an immune response effective against both head lice and body lice throughout the subsequent periods of their life. This cross-immunity could provide some defence against the body-louse-borne lethal diseases like epidemic typhus, trench fever, relapsing fever and the classical plague. Thus the human ‘touching heads’ behaviour probably acts as an inherent and unconscious ‘vaccination’ against body lice to reduce the threat exposed by the pathogens they may transmit. Recently, the eradication of body-louse-borne diseases rendered the transmission of head lice a maladaptive, though still widespread, behaviour in developed societies.

Concepts: Infectious disease, Pediculosis, Louse

27

Head lice infestation, a worldwide head infestation caused Pediculus humanus capitis De Geer, is an important public health problem in Thailand. Several chemical pediculicides have lost in efficacy due to increasing resistance of lice against insecticide. Therefore, non-toxic alternative products, such as natural products from plants, e.g. plant extract pediculicides, are needed for head lice control. The aims of this study were to evaluate the potential of pediculicidal activity of herbal shampoo base on three species of Thai local plants (Accacia concinna (Willd.) DC, Averrhoa bilimbi Linn. and Tamarindus indica Linn.) against head lice and to compare them with carbaryl shampoo (Hafif shampoo®; 0.6 % w/v carbaryl) and non-treatment control in order to assess their in vitro. Doses of 0.12 and 0.25 ml/cm(2) of each herbal shampoo were applied to filter paper, and ten head lice were place on the filter paper. The mortalities of head lice on the filter paper were recorded at 1, 5, 10, 30 and 60 min by sterio-microscope. All herbal shampoos at 0.25 ml/cm(2) were more effective pediculicide than carbaryl shampoo with 100 % mortality at 5 min. The median lethal time (LT(50)) of all herbal shampoos at 0.25 ml/cm(2) showed no significant differences over at 0.12 ml/cm(2) (P < 0.01). The most effective pediculicide was T. indica extract shampoo, followed by Av. bilimbi extract shampoo and Ac. concinna extract shampoo, with LT(50) values <1.0 min. Our data showed that all herbal shampoos have high potential of pediculicide to head lice treatments for schoolchildren.

Concepts: Head louse, Pediculosis, Body louse, Louse, Lice, Crab louse, Treatment of human head lice, Averrhoa bilimbi

26

Pediculosis is a frequent public health problem. The pattern and prevalence of Pediculosis is dependent on many socio-demographic and economic factors. It is common in schoolchildren especially primary level; it may affect their learning performance. This study aimed to determine the prevalence of head louse among primary students, in Fayoum and Bagor districts, and explore the predisposing factors of head louse infestation in both public and private schools. The study was a cross-sectional descriptive study, conducted in two governorates: Fayoum and Minofiya governorates which represent upper and lower Egypt respectively during the academic year of 2012-2013. The students were selected from different grades with a total of 10,935 students. The prevalence of head lice in the study group was 16.7 %. The incidence was higher in public schools 20.7 % than private schools 9.04 % and in girls 25.8 % more than boys, especially covered hair girls 6.2 %. There was a socio-demographic influence of louse infestation on residence, presence of water supply, number of house rooms, and number of family member. It is concluded that head lice are a common childhood problem related to poor hygiene and socioeconomic status. There is a need for collaboration effort between family, school, community, and media, to create an environment that establishes healthy behaviors and health promotion.

Concepts: Epidemiology, Primary education, Head louse, Pediculosis, Body louse, Louse, Crab louse, Head-louse infestation

26

Head lice infestation (or pediculosis) is an important public health problem in Thailand, especially in children between the ages 5 and 11 years. Head lice resistance is increasing, chemical pediculicides have lost their efficacy, and, therefore, alternative pediculicides such as herbal shampoos have been proposed to treat head lice infestation. Thus, the present study investigated the efficacy of three herbal shampoos based on native plants in Thailand (Acorus calamus Linn., Phyllanthus emblica Linn., and Zanthoxylum limonella Alston) against head lice and compared them with carbaryl shampoo (Hafif shampoo®, 0.6 % w/v carbaryl), malathion shampoo (A-Lice shampoo®, 1.0 % w/v malathion), and commercial shampoos (Babi Mild Natural' N Mild® and Johnson’s baby shampoo®) in order to assess their in vitro and in vivo efficacy. For in vitro study, doses of 0.12 and 0.25 ml/cm(2) of each herbal shampoo were applied to filter paper, then 10 head lice were place on the filter paper. The mortalities of head lice were recorded at 5, 15, 30, and 60 min. The results revealed that all herbal shampoo were more effective on pediculicidal activity than chemical and commercial shampoos with 100 % mortality at 15 min; LT50 values ranged from 0.25 to 1.90 min. Meanwhile, chemical shampoos caused 20-80 % mortality, and LT50 values ranged from 6.50 to 85.43 min. On the other side, commercial shampoos showed 4.0 % mortality. The most effective pediculicide was Z. limonella shampoo, followed by A. calamus shampoo, P. emblica shampoo, carbaryl shampoo, malathion shampoo, and commercial shampoo, respectively. In vivo results showed that all herbal shampoos were also more effective for head lice treatment than chemical and commercial shampoos with 94.67-97.68 % of cure rate after the first treatment; the second treatment, 7 days later, revealed that the cure rate was 100 %. Meanwhile, chemical shampoo showed 71.67-93.0 % of cure rate and, unfortunately, commercial shampoos were nontoxic to head lice and showed 0 % of cure rate after the first and the second treatments. Our data showed that three herbal shampoos of native plants in Thailand in this study are suitable to be used as pediculicides for Thai children since it is safe for children and there is no side-effect after application.

Concepts: In vitro, Head louse, Pediculosis, Body louse, Louse, Crab louse, Treatment of human head lice, Sweet Flag

25

Head lice infestation is still a public health problem worldwide, with an intracountry and intercountry prevalence variation of 0.7 to 59 %. There is a large variety of over-the-counter anti-louse products, but their efficacy is not always well assessed. Our objective was to test the pediculicidal and ovicidal efficacy of 21 over-the-counter head louse products, available in France during the period of 2008 to 2012. We tested children living in Tours City in central France and visiting preschools, primary schools, kindergarten, camps, and child care facilities, as well as children in their family houses, and were examined for the presence of lice. The products were collected from randomly selected pharmacies by covert investigators and then tested in the laboratory on an ex vivo sample of head lice and their eggs, collected from the hair of infested children. Living lice and unharmed eggs were collected from the scalps of 3-12 years old. The laboratory conditions for ex vivo testing mimicked the manufacturers' instructions for exposure time and application method. In 21 runs, 3919 living lice and 4321 undamaged living eggs were collected from the scalp of over 400 children. The 21 products were classified in three groups: 6 products in a group of potentially 100 % pediculicidal activity and potentially 100 % ovicidal activity, 8 products in a group of potentially 100 % pediculicidal activity but insufficient ovicidal activity (including 2 products with claims of single application treatment), and 7 products in a group of insufficient pediculicidal activity and ovicidal activity. The pharmaceutical market for head lice products in France is swamped with poorly tested and ineffective products. Rigorous efficacy testing preregistration and periodic screening and testing of effectiveness in the post-registration period should be endorsed by the health authorities.

Concepts: Head louse, Pediculosis, Body louse, Louse, Lice, Crab louse, Treatment of human head lice, Head lice

25

An 11-year-old child presented with poor school attendance, and signs and symptoms of severe anaemia. He was heavily covered in lice. He was investigated for other causes of anaemia. Following treatment for head lice and also iron supplementation, he was back in full-time education. This case highlights the link between head lice (pediculosis capitis) infestation and iron-deficiency anaemia.

Concepts: Bleeding, Iron deficiency anemia, The Link REIT, Teacher, Head louse, Pediculosis, Body louse, Louse