Korean J Parasitol.  2019 Oct;57(5):499-504. 10.3347/kjp.2019.57.5.499.

Prevalence and Alternative Treatment of Head-Lice Infestation in Rural Thailand: A Community-Based Study

Affiliations
  • 1Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. singha.onuma@gmail.com
  • 2Department of Pharmacology, Phramongkutklao College of Medicine, Bangkok, Thailand.

Abstract

Head-lice infestation, pediculosis capitis, remains a public-health burden in many countries. The widely used first-line pediculicides and alternative treatments are often too costly for use in poor socio-economic settings. Ivermectin has been considered an alternate treatment for field practice. This study was composed of 2 parts, a cross-sectional survey and an intervention study. The main objectives were to determine the prevalence and potential factors associated with head-lice infestation, and to evaluate the effectiveness and safety of oral ivermectin administration. A community-based cross-sectional survey was conducted among 890 villagers in rural areas along Thai-Myanmar border. Females with infestations were eligible for the intervention study, and 181 participated in the intervention study. A post-treatment survey was conducted to assess acceptance of ivermectin as a treatment choice. Data analysis used descriptive statistics and a generalized-estimation-equation model adjusted for cluster effect. The study revealed the prevalence of head-lice infestation was 50% among females and only 3% among males. Age stratification showed a high prevalence among females aged <20 years, and among 50% of female school-children. The prevalence was persistent among those with a history of infestation. The major risk factors were residing in a setting with other infected cases, and sharing a hair comb. The study also confirmed that ivermectin was safe and effective for field-based practice. It was considered a preferable treatment option. In conclusion, behavior-change communication should be implemented to reduce the observed high prevalence of head-lice infestation. Ivermectin may be an alternative choice for head-lice treatment, especially in remote areas.

Keyword

Head louse; ivermectin; rural health; community-based study

MeSH Terms

Animals
Comb and Wattles
Cross-Sectional Studies
Female
Hair
Humans
Ivermectin
Lice Infestations
Male
Pediculus
Prevalence*
Risk Factors
Rural Health
Statistics as Topic
Thailand*
Ivermectin
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