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.

CIBER of Epidemiology and Public Health Carlos 3 Health Institute Madrid Spain

CIBER of Infectious Diseases Carlos 3 Health Institute Madrid Spain

Department of Parasitology Faculty of Pharmacy University of Valencia Burjassot Spain

Faculty of Chemistry Biological Sciences Autonomous University of Guerrero Chilpancingo Guerrero Mexico

Research Group in Social and Nutritional Epidemiology Pharmacoepidemiology and Public Health Department of Preventive Medicine and Public Health Food Sciences Toxicology and Forensic Medicine Faculty of Pharmacy University of Valencia Burjassot Spain

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Feldmeier H, Heukelbach J. Epidermal parasitic skin diseases: a neglected category of poverty-associated plagues. Bull World Health Organ. 2009;87(2):152-9.

Gutiérrez MM, González JW, Stefanazzi N, Serralunga G, Yañez L, Ferrero AA. Prevalence of Pediculus humanus capitis infestation among kindergarten children in Bahía Blanca city, Argentina. Parasitol Res. 2012;111(3):1309-13.

Dursun N, Cengiz ZT. [Distribution of head lice in the Erciş district of Van]. Turkiye Parazitol Derg. 2010;34(1):45-9. Turkish.

ALBashtawy M. Head lice infestation in schoolchildren and related factors in Mafraq governorate, Jordan. Int J Dermatol. 2012;51(2):168-72.

Rupeš V, Moravec J, Chmela J, Ledvinka J, Zelenková J. A resistance of head lice (Pediculus capitis) to permethrin in Czech Republic. Cent Eur J Public Health. 1995 Feb;3(1):30-2.

Frankowski BL, Bocchini JA, Jr; Council on School Health and Committee on Infectious Diseases. Head lice. Pediatrics. 2010 Aug;126(2):392-403.

Mumcuoglu KY. Prevention and treatment of head lice in children. Pediatric Drugs. 1999;1(3):211-8.

Smith CH, Goldman RD. An incurable itch: head lice. Can Fam Physician. 2012 Aug;58(8):839-41.

De Maeseneer J, Blokland I, Willems S, Vander Stichele R, Meersschaut F. Wet combing versus traditional scalp inspection to detect head lice in schoolchildren: observational study. BMJ. 2000 Nov 11;321(7270):1187-8.

Balcioglu C, Burgess IF, Limoncu ME, Şahin MT, Ozbel Y, Bilaç C, et al. Plastic detection comb better than visual screening for diagnosis of head louse infestation. Epidemiol Infect. 2008;136(10):1425-31.

Jahnke C, Bauer E, Hengge UR, Feldmeier H. Accuracy of diagnosis of pediculosis capitis: visual inspection vs wet combing. Arch Dermatol. 2009;145(3):309-13.

Nolt D, Moore S, Yan AC, Melnick L; Committee on Infectious Diseases, Committee on Practice and Ambulatory Medicine, Section on Dermatology. Head Lice. Pediatrics 2022;150(4):e2022059282. doi: 10.1542/peds.2022-059282. DOI

Amanzougaghene N, Fenollar F, Raoult D, Mediannikov O. Where are we with human lice? A review of the current state of knowledge. Front Cell Infect Microbiol. 2020;9:474. doi: 10.3389/fcimb.2019.00474. DOI

Downs AM, Stafford KA, Hunt LP, Ravenscroft JC, Coles GC. Widespread insecticide resistance in head lice to the over-the-counter pediculocides in England, and the emergence of carbaryl resistance. Br J Dermatol. 2002;146(1):88-93.

Tebruegge M, Pantazidou A, Curtis N. What's bugging you? An update on the treatment of head lice infestation. Arch Dis Child Educ Pract Ed. 2011 Feb;96(1):2-8.

Clark JM. New chemistries for the control of human head lice, Pediculus humanus capitis: A mini-review. Pestic Biochem Physiol. 2022;181:105013. doi: 10.1016/j.pestbp.2021.105013. DOI

Abbasi E, Nasiri Z, Mohammadi J, Yazdani Z, Mohseni S. Knockdown resistance (kdr) associated organochlorine resistance in human head lice: systematic review and meta-analysis. MedRxiv. 2022. doi: 10.1101/2022.10.02.22280631. DOI

Abbasi E, Daliri S, Yazdani Z, Mohseni S, Mohammadyan G, Hosseini SNS, et al. Evaluation of resistance of human head lice to pyrethroid insecticides: a meta-analysis study. MedRxiv. 2022. doi: 10.1101/2022.08.04.22278398. DOI

Clark JM. Permethrin resistance due to knockdown gene mutations is prevalent in human head louse populations. Open Dermatol J. 2010;4:63-8.

Durand R, Bouvresse S, Berdjane Z, Izri A, Chosidow O, Clark JM. Insecticide resistance in head lice: clinical, parasitological and genetic aspects. Clin Microbiol Infect. 2012;18(4):338-44.

Hatam-Nahavandi K, Ahmadpour E, Pashazadeh F, Dezhkam A, Zarean M, Rafiei-Sefiddashti R, et al. Pediculosis capitis among school-age students worldwide as an emerging public health concern: a systematic review and meta-analysis of past five decades. Parasitol Res. 2020;119(10):3125-43.

Falagas ME, Matthaiou DK, Rafailidis PI, Panos G, Pappas G. Worldwide prevalence of head lice. Emerg Infect Dis. 2008 Sep;14(9):1493-4.

Feldmeier H. Pediculosis capitis: new insights into epidemiology, diagnosis and treatment. Eur J Clin Microbiol Infect Dis. 2012;31(9):2105-10.

Moradi A, Zahirnia A, Alipour A, Eskandari Z. The prevalence of Pediculosis capitis in primary school students in Bahar, Hamadan Province, Iran. J Res Health Sci. 2009;9(1):45-9.

Sim S, Lee IY, Lee KJ, Seo JH, Im KI, Shin MH, et al. A survey on head lice infestation in Korea (2001) and the therapeutic efficacy of oral trimethoprim/sulfamethoxazole adding to lindane shampoo. Korean J Parasitol. 2003 Mar;41(1):57-61.

Kokturk A, Baz K, Bugdayci R, Sasmaz T, Tursen U, Kaya TI, et al. The prevalence of pediculosis capitis in schoolchildren in Mersin, Turkey. Int J Dermatol. 2003;42(9):694-8.

Willems S, Lapeere H, Haedens N, Pasteels I, Naeyaert JM, De Maeseneer J. The importance of socio-economic status and individual characteristics on the prevalence of head lice in schoolchildren. Eur J Dermatol. 2005;15(5):387-92.

Counahan M, Andrews R, Büttner P, Byrnes G, Speare R. Head lice prevalence in primary schools in Victoria, Australia. J Paediatr Child Health. 2004;40(11):616-9.

Borges R, Mendes J. Epidemiological aspects of head lice in children attending day care centres, urban and rural schools in Uberlândia, central Brazil. Mem Inst Oswaldo Cruz. 2002;97(2):189-92.

Kurhanova I. Lice infestation and lice control remedies in the Ukraine. Ann N Y Acad Sci. 2006;1078(1):357-60.

Bharija SC, Kanwar AJ, Singh G, Belhaj MS. Pediculosis capitis in Benghazi, Libya: a school survey. Int J Dermatol. 1988;27(3):165-6.

Bush SE, Rock AN, Jones SL, Malenke JR, Clayton DH. Efficacy of the LouseBuster, a new medical device for treating head lice (Anoplura: Pediculidae). J Med Entomol. 2011;48(1):67-72.

Hodjati MH, Mousavi N, Mousavi M. Head lice infestation in school children of a low socioeconomy area of Tabriz city, Iran. Afr J Biotechnol. 2008;7(13):2292-4.

Birkemoe T, Lindstedt HH, Ottesen P, Soleng A, Naess Ø, Rukke BA. Head lice predictors and infestation dynamics among primary school children in Norway. Fam Pract. 2015;33(1):23-9.

AlBashtawy M, Hasna F. Pediculosis capitis among primary-school children in Mafraq Governorate, Jordan. East Mediterr Health J. 2012;18(1):43-8.

Chouela E, Abeldaño A, Cirigliano M, Ducard M, Neglia V, La Forgia M, et al. Head louse infestations: epidemiologic survey and treatment evaluation in Argentinian schoolchildren. Int J Dermatol. 1997;36(11):819-25.

Motovali-Emami M, Aflatoonian MR, Fekri A, Yazdi M. Epidemiological aspects of Pediculosis capitis and treatment evaluation in primary-school children in Iran. Pak J Biol Sci. 2008 Jan 15;11(2):260-4.

Rukke BA, Birkemoe T, Soleng A, Lindstedt HH, Ottesen P. Head lice prevalence among households in Norway: importance of spatial variables and individual and household characteristics. Parasitology. 2011;138(10):1296-304.

Speare R, Buettner PG. Head lice in pupils of a primary school in Australia and implications for control. Int J Dermatol. 1999;38(4):285-90.

Toloza A, Vassena C, Gallardo A, González-Audino P, Picollo MI. Epidemiology of Pediculosis capitis in elementary schools of Buenos Aires, Argentina. Parasitol Res. 2009;104(6):1295-8.

Chunge RN, Scott FE, Underwood JE, Zavarella KJ. A review of the epidemiology, public health importance, treatment and control of head lice. Can J Public Health. 1991;82(3):196-200.

Karakuş M, Arici A, Töz SÖ, Özbel Y. Prevalence of head lice in two socio-economically different schools in the center of Izmir city, Turkey. Turkiye Parazitol Derg. 2014;38(1):32-6.

Dehghanzadeh R, Asghari-Jafarabadi M, Salimian S, Asl Hashemi A, Khayatzadeh S. Impact of family ownerships, individual hygiene, and residential environments on the prevalence of pediculosis capitis among schoolchildren in urban and rural areas of northwest of Iran. Parasitol Res 2015;114(11):4295-303.

Rukke BA, Soleng A, Lindstedt HH, Ottesen P, Birkemoe T. Socioeconomic status, family background and other key factors influence the management of head lice in Norway. Parasitol Res. 2014;113(5):1847-61.

Mahmud S, Pappas G, Hadden WC. Prevalence of head lice and hygiene practices among women over twelve years of age in Sindh, Balochistan, and North West Frontier Province: National Health Survey of Pakistan, 1990-1994. Parasit Vectors. 2011 Feb2;4:11. doi: 10.1186/1756-3305-4-11. DOI

Badiaga S, Brouqui P. Human louse-transmitted infectious diseases. Clin Microbiol Infect. 2012 Apr;18(4):332-7.

Soultana V, Euthumia P, Antonios M, Angeliki RS. Prevalence of pediculosis capitis among schoolchildren in Greece and risk factors: a questionnaire survey. Pediatr Dermatol. 2009;26(6):701-5.

Fan CK, Liao CW, Wu MS, Hu NY, Su KE. Prevalence of Pediculus capitis infestation among school children of Chinese refugees residing in mountanous areas of northern Thailand. Kaohsiung J Med Sci. 2004 Apr;20(4):183-7.

Harris J, Crawshaw JG, Millership S. Incidence and prevalence of head lice in a district health authority area. Commun Dis Public Health. 2003 Sep;6(3):246-9.