Frequency of pyrethroid resistance in human head louse treatment: systematic review and meta-analysis

Toxic effects of deltamethrin on oxidative stress, behavioural, organosomatic indices and histopathological changes in Digitonthophagus gazella (Coleoptera: Scarabaeinae)

Pyrethroids pose a great concern to the declining population of dung beetles and the sustainability of ecosystem services. This study aimed to investigate the toxic effects of deltamethrin on Digitonthophagus gazella. First, the LC50 value (0.275 ppm) was determined, and sub-lethal concentrations (LD; low dose-0.014ppm, MD; medium dose-0.028ppm, and HD; high dose-0.055ppm) were assessed for physiological effects. The findings showed a significant dose and time dependent increase in fluorescence intensity (DCF-DA staining) and a decrease in antioxidant activity, including superoxide dismutase (SOD), catalase (CAT), and glutathione (GSH). Furthermore, significant down regulation of cyp4g7, cyp6bq9, and cyp4q4 expression indicates enhanced oxidative stress. Additionally, a reduction in the organosomatic index, accompanied by histological changes in the brain, gut, and gonads, suggests potential functional disturbances. Overall, deltamethrin exposure had profound and irreversible pathological consequences on various vital organs and systems in D. gazella, affecting reproduction and nesting.

First Report of the Gene Mutations Associated with Permethrin Resistance in Head Lice (Pediculus humanus capitis De Geer, 1767) from Primary School Children in Istanbul (Türkiye) and Nagarkot (Nepal)

Head lice infestation (HLI), caused by Pediculus humanus capitis De Geer, 1767, has long been a common global problem of school children. Permethrin is an old pyrethroid derivative that has been used commonly for its treatment, and it exerts its activity over the voltage-sensitive calcium channels (VSCC) of the lice. There has been a growing list of persistent HLI cases lately in the world among patients using permethrin, and knockdown resistance (kdr)-related point mutations on VSCC have been identified and reported from those resistant lice samples. The aim of this study was to investigate the gene mutations associated with permethrin resistance in head lice collected from primary school children in Istanbul (Türkiye) and Nagarkot (Nepal) for the first time. A total of 192 P. h. capitis adults were collected from school children aged 6-12 years in two cities (96 lice each). Following DNA isolation, the fragment of the VSCC a-subunit gene, which contained the possible mutation sites ((kdr-like M815I (ATG > ATT), kdr T917I (ACA > ATA), and kdr-like L920F (CTT > TTT)), was amplified in each louse by PCR, and the PCR products were sequenced and aligned, followed by frequency calculations for alleles, genotypes, and haplotypes. Using nucleic acid sequence analysis, it was revealed that M815I, T917I, or L920F mutations were present on the VSCC genes in the lice samples from both Türkiye and Nepal. In addition, genotypic analyses indicated the presence of all three mutations in the lice samples from Türkiye, while the T917I mutation was detected in none of the lice collected in Nepal. This is the first report of gene mutations associated with permethrin resistance in head lice collected from a group of primary school children in the largest city of Türkiye (Istanbul) and Nagarkot. High mutation rates were identified in the lice, especially those from Istanbul, which is concordant with our previous unpublished study, in which almost 60% of the examined lice of the school children (in the same school selected in this study) remained alive despite long-term exposure to permethrin in the laboratory. These initial results show that gene mutations associated with permethrin resistance are common in lice samples in Istanbul and Nagarkot, which may suggest the current need for the selection of new pediculicidal agents in HLI treatment.

Epidemiological analysis of pediculosis and the distribution of kdr mutation frequency in head lice populations in Torbat Heydarieh city of Khorasan Razavi Province, Northeastern Iran

Head lice infestations are the most prominent ectoparasitic infection in the world, including Iran, particularly among school children. Recently, numerous cases of infestation have been reported in various provinces of the country. This study aimed to investigate the prevalence of head louse infestations and analyze kdr gene sequences in terms of resistance mutations in the Torbat-e Heydarieh, Mahvelat, and Zaveh cities of Khorasan Razavi Province, Northeast Iran. The data related to the epidemiological and demographic history of head lice populations were extracted from their medical records and analyzed in Excel software. After extracting the genomic DNA, the kdr fragment was amplified using specific primers. The sequences were also analyzed using bioinformatics software. The prevalence of head louse infestations was 1.59% and 1.7% during 2016 and 2017, respectively. Sequence analysis revealed the frequency distribution of two kdr haplotypes, I and V, in the study areas. The increase in head louse infestations in recent years and the simultaneous presence of kdr mutations indicate the need for new treatments and monitoring/controlling resistance to head louse insecticides.

The association between knockdown resistance and treatment outcome of 1% permethrin lotion in head lice infestations in Nonthaburi province, Thailand

Head lice infestations significantly impact schoolchildren, with permethrin being the primary treatment. The escalation in the prevalence of the knockdown resistance (kdr) mutation, potentially affecting treatment efficacy, is highly concerning. This study examined head lice infestation prevalence, the efficacy of 1% permethrin lotion, kdr mutation frequency, and the association between kdr genotype and permethrin treatment outcomes in schoolchildren in Nonthaburi province, Thailand. Participants and lice samples were collected from six primary schools using cluster sampling. Clinical outcomes and adverse events were assessed on days 7 and 14 post-treatment. Kdr mutations (T917I) in head lice samples were analyzed using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Head lice infestation prevalence was 6.1%, with a kdr mutation frequency of 63.2% and a permethrin cure rate of approximately 50%. Multivariate regression analysis revealed the association between kdr genotype and clinical response to permethrin treatment (Odds Ratio (OR) = 13.15, p = 0.005). The presence of resistance genes hinders the cure rate (presence 35.9% versus absence 85.7%). These findings highlight the importance of the kdr genotype in predicting permethrin treatment responses in head lice infestations. Furthermore, in regions with documented reduced permethrin efficacy and a high prevalence of kdr mutations, alternative non-pyrethroid-based pediculicides should be considered. This research could help improve the control of head lice infestations, especially in problematic areas of Thailand.

Treatment Modalities of Pediculosis Capitis: A Narrative Review

The review has been done to find out the best-suited treatment modality for pediculosis capitis. Pediatric patients frequently experience pediculosis capitis, a head louse infestation brought on by the Pediculus humanus var. capitis. The primary sign of head lice infestation is a scratchy scalp, and the presence of living nits confirms this diagnosis. When a doctor diagnoses pediculosis as a primary bacterial infection, a bacterial impetignization and secondary infection, and cervical and occipital lymphadenopathy might make the clinical diagnosis more difficult. A proper therapy of pediculosis requires screening and treatment of all close contacts. The careful use of topical pediculicidal treatments, especially permethrin lotion and wet combing with a fine tooth comb, is required for the medical treatment of a head louse infestation. We've tried to outline the key points of treating head lice infestations. There are several treatment alternatives suggested, including over-the-counter permethrin and pyrethrin as well as prescription medications including malathion, lindane, benzyl alcohol, and spinosad.

Organochlorine knockdown-resistance (kdr) association in housefly (Musca domestica): A systematic review and meta-analysis

Introduction

Although house flies (Musca domestica) do not directly cause disease in humans, they transmit pathogens to them, which provide the basis for many diseases. The main way to deal with this insect is to use insecticides. Due to the resistance from insecticides, the fight against house flies has been hampered. This study aimed to determine the prevalence of knockdown resistance against organochlorine insecticides in house flies worldwide.

Methods

This study was conducted via a systematic review and meta-analysis to investigate the prevalence of knockdown resistance against organochlorine insecticides in house flies. Accordingly, by searching the databases of Web of Science, PubMed, Scopus, Proquest, Bioone, and Embase, all published articles were extracted, and reviewed until the end of May 2022. Statistical data analysis was performed using the random-effects model in the meta-analysis, meta-regression, and I2 index.

Results

Nine studies entered the meta-analysis process. Based on this, the prevalence of knockdown resistance against organochlorine insecticide in house flies was estimated to be 49.1%. Meta-regression showed that the prevalence of knockdown resistance increased with increasing years of study but decreased with increasing sample size.

Conclusion

According to the findings, about 50% of house flies have knockdown resistance against organochlorine insecticide. As a result, it is necessary to adopt effective and combined methods to combat this insect to control it and prevent the transmission of diseases caused by it.

Evaluation of resistance of human head lice to pyrethroid insecticides: A meta-analysis study

Introduction

Pediculosis is one of the most common annoying infections caused by parasitic lice in humans. Pyrethroids are one of the main insecticides used to treat this infection. But recently, due to the Resistance of lice to this group of insecticides, its insecticidal effects have been affected. The present study was conducted through a meta-analysis to investigate the prevalence of pyrethroid resistance against these insecticides worldwide.

Methods

This study was conducted as a meta-analysis of the prevalence of treatment resistance in human head lice against pyrethroid insecticides worldwide. Based on this, all articles published without a time limit until the end of June 2022 in PubMed/MEDLINE, Web of Science (ISI), Scopus, and Google Scholar databases were extracted and using random-effects meta-analysis model statistical methods in the meta-analysis, Cochrane, Index I2, and funnel plot were analyzed by STATA software.

Results

Twenty studies were included in the meta-analysis process. According to this, the prevalence of pyrethroid resistance insecticides in human head lice was estimated at 59% (CI95%: 50%-68%). Among pyrethroid insecticides, the highest prevalence of pyrethroid resistance against permethrin insecticide was 65%. Regarding the prevalence of Resistance by year, the prevalence before 2004 was estimated at 33%, but after 2015, this rate reached 82%. Also, the majority of pyrethroid resistance was estimated at 68% using genetic diagnosis methods and 43% using clinical diagnosis methods.

Conclusion

More than half of human head lice pyrethroid resistance insecticides. Based on this, it is recommended that before using this treatment method to treat human head lice Infestation, it should investigate the prevalence of pyrethroid resistance in that area, and if the majority of Resistance is high, alternative or combined treatment methods should be used.

First report of classical knockdown resistance (kdr) mutation, L1014F, in human head louse Pediculus humanus capitis (Phthiraptera: Anoplura)

There are at least three known knockdown resistance (kdr) mutations reported globally in the human head louse Pediculus humanus capitis De Geer (Phthiraptera: Anoplura) that are associated with reduced sensitivity to pyrethroids. However, the prevalence of kdr mutation in head lice is not known in the Indian subcontinent. To identify kdr mutations in the Indian head lice population, the genomic region of the voltage-gated sodium channel gene encompassing IIS1-2 linker to IIS6 segments was PCR-amplified and sequenced from P. humanus capitis samples collected from different geographic localities of India. DNA sequencing revealed the presence of four kdr mutations: M827I, T929I, L932F and L1014F. The presence of a classical kdr mutation L1014F, the most widely reported mutation across insect-taxa associated with the kdr-trait, is being reported for the first time in P. humanus capitis.

A comprehensive survey of permethrin resistance in human head louse populations from northwest Iran: ex vivo and molecular monitoring of knockdown resistance alleles

BACKGROUND

Head louse infestation is an important public health problem, and expanding resistance to permethrin is a major challenge to its control. The mapping and detection of pyrethroid resistance are essential to the development of appropriate treatments and ensure the effectiveness of current measures. The aim of this study was to present the phenotypic and genotypic basis of permethrin resistance and identify knockdown resistance (kdr) mutations in head louse populations in northwestern Iran.

METHODS

Adult head lice were collected from 1059 infested girls in Ardebil, East Azerbaijan, West Azerbaijan and Zanjan Provinces, northwestern Iran. The toxicity of permethrin and the possible synergistic effect of piperonyl butoxide (PBO) on this toxicity were assessed using bioassays. Fragments of voltage-sensitive sodium channels (vssc) and cytochrome b (cytb) genes were amplified and analyzed for the detection of knockdown resistance (kdr) mutations and mitochondrial groups. Moreover, genotypes of the two hot spot regions of the vssc gene were determined by melting curve analysis of amplicons.

RESULTS

A total of 1450 adult head lice were collected during 2016-2021. Live lice were exposed to a dose of 1% permethrin for 12 h, and the median lethal time (LT₅₀) and time to achieve 90% mortality (LT₉₀) were determined to be 6 and 14.8 h, respectively. Topical application of 2 and 16 ng permethrin per louse resulted in 25% and 42.11% mortality, respectively. Pre-exposure of samples to 3% piperonyl butoxide had no synergistic effect on the effects of permethrin. Analysis of the 774-bp vssc gene fragment showed the presence of the M815I, T917I and L920F mutations, wild-type and T917I mutation, in 91.6%, 4.2% and 4.2% of samples, respectively. Investigation of the mitochondrial cytb gene demonstrated the predominance of clade B. The frequency of domain II segment 4 (S4)-S5 kdr genotypes in mitochondrial groups was identical, and heterozygotes were present in 93.5% of samples. A significant difference was detected in the frequency of domain IIS1-S3 kdr genotypes, and the frequency of resistant alleles and heterozygotes was higher in clade B than in clade A.

CONCLUSIONS

The presence of kdr mutations in the vssc gene and the non-synergist effect of PBO indicate that pyrethroid target site insensitivity is the main resistance mechanism. This phenomenon and the high frequency of resistant alleles necessitate that new pediculosis management programs be developed. Further studies need to be conducted to identify all factors contributing this resistance and to develop alternative pediculicides.

Investigating the Factors Related to Work-Family Conflicts Experienced by Working Women: A Systematic Review

Context: In recent decades, women’s participation in the labor market has increased dramatically. However, this has confronted working women with work-family conflicts. Objective: This systematic review aimed to find the factors related to work-family conflicts befallen women working. Methods: All scientific articles published on the subject from June 2000 until June 2021 were searched in five databases (Science Direct, Web of Science, PubMed, Embase, Scopus, and Google Scholar) using the Keywords of factor, female, working, work-life balance, life-work imbalance. Results: We found 3967 articles in the databases mentioned. After removing duplicate items, the titles and abstracts of 2573 articles were screened, 34 full-texts of which were reviewed, leading to the final selection of 31 articles (13 qualitative studies and 17 quantitative studies). Then we searched for the documents that cited any of the initially included studies, as well as the references of the primarily included studies; however, no additional articles were found in this step. We categorized the factors related to work-life conflicts into four categories and 22 sub-categories. The first category was individual factors (e.g., individual capacities and skills); the second category was interpersonal factors (e.g., spousal support and lack of family support); the third category was organizational factors (e.g., organizational policies and working hours), and the fourth category was cultural factors (e.g., patriarchal hegemony in society and family-friendly culture). Conclusions: First, individual skills are needed to be paid more attention to, such as planning, which may be simply modifiable and has the potential to inform therapeutic interventions and preventative strategies. Second, foremen and directors should be informed about the importance of work-life conflicts experienced by women and their decisive role in creating a work-life balance to help improve their working conditions.

Nanoparticles: A Potential and Effective Method to Control Insect-Borne Diseases

Insects act as vectors to carry a wide range of bacteria and viruses that can cause multiple vector-borne diseases in humans. Diseases such as dengue fever, epidemic encephalitis B, and epidemic typhus, which pose serious risks to humans, can be transmitted by insects. Due to the absence of effective vaccines for most arbovirus, insect control was the main strategy for vector-borne diseases control. However, the rise of drug resistance in the vectors brings a great challenge to the prevention and control of vector-borne diseases. Therefore, finding an eco-friendly method for vector control is essential to combat vector-borne diseases. Nanomaterials with the ability to resist insects and deliver drugs offer new opportunities to increase agent efficacy compared with traditional agents, and the application of nanoagents has expanded the field of vector-borne disease control. Up to now, the reviews of nanomaterials mainly focus on biomedicines, and the control of insect-borne diseases has always been a neglected field. In this study, we analyzed 425 works of the literature about different nanoparticles applied on vectors in PubMed around keywords, such as"nanoparticles against insect," "NPs against insect," and "metal nanoparticles against insect." Through these articles, we focus on the application and development of nanoparticles (NPs) for vector control, discussing the lethal mechanism of NPs to vectors, which can explore the prospect of applying nanotechnology in the prevention and control of vectors.

Over-the-counter Pediculus humanus capitis treatment: The nit comb is not appropriate for all hair types!

Biological diversity of hair affects what stress the hair can withstand. This proves to create a gap in care when evaluating over-the-counter (OTC) products available to treat Pediculus humanus capitis (head lice) in the United States. The nit comb would not be conducive for use in an individual with African hair, yet all OTC product instructions list the requirement of the nit comb. Lice treatment products provide instructions that are applicable for only specific hair types and do not address treatment recommendations for African hair. The OTC product instructions are outdated and exclusionary. A clear discrepancy and gap in care exist for many Americans seeking self-care treatment of pediculosis capitis. Pharmacists should remain aware of this discrepancy and counsel on alternative practices such as applying the active formulations in the hair but refrain from using the nit comb following the application of the topical medication.

Physically Acting Treatments for Head Lice—Can We Still Claim They Are ‘Resistance Proof’?

Head lice worldwide have developed resistance to insecticides, prompting the introduction of a range of alternative treatments including plant extracts and natural and synthetic oils. Clinical studies of physically acting treatments showed them to be highly effective when first introduced, and a widely held, but unsubstantiated, belief is that lice are unlikely to develop resistance to them. However, this ignores possibilities for natural selection of traits enabling lice to survive exposure. More recent investigations of some physically acting products have shown reduced efficacy, suggesting either changes of behavior, physical structure, or physiology of some louse populations. In addition, the activity of surfactants and similar compounds, acting as solubilizing agents of insect cuticular lipids, can be compromised by the widespread use of toiletry products containing similar substances. Hitherto, most clinical investigations have provided “best case” data resulting from investigator application of treatments. In the few studies involving participant application, the effectiveness was reduced, suggesting that consumer use allows some insects to survive, which could then be selected for tolerance. Unlike neurotoxic insecticides, there is no straightforward method to test for the activity of physically acting chemicals other than by clinical investigations, which need to be rigorous to eliminate poorly effective products as a way of ensuring the continued effectiveness of those treatments that are successful in eliminating infestation.

Pyrethroid-linked resistance allelic mutations by molecular analysis in wild human head louse (Phthiraptera: Pediculidae) populations from schoolgirls of South Iran

Background

Human head louse, Pediculus humanus capitis De Geer, 1767 (Anoplura: Pediculidae), is one of the most frequent ectoparasites infesting Homo sapiens worldwide. Reduced sensitivity to treatment due to genetic mutations, in particular knockdown resistance (kdr) (or target site insensitivity) allele, has led to this infestation prevalence. Molecular characterization of this resistance has a crucial impact on selecting appropriate treatment protocol. The aim of this study was to investigate kdr gene mutations on voltage-sensitive sodium channel (VSSC) among wild head lice samples from Fars province, southern Iran.

Methods

Head lice were collected using plastic detection combs on girls enrolled in public schools from 10 counties in Fars province. The specimens were screened in 10 pools (each pool per county containing 35 specimens), with three pools (30%) being positive. Following species identification with valid entomological keys, 350 (68%) out of 514 randomly collected adult head lice were analyzed after their somatic genomic DNA extraction using Sinaclon kit. Samples were investigated by polymerase chain reactions (PCR), and the amplicon was subsequently sequenced.

Results

Sequence analysis showed that the sodium channel genes in the pooled ectoparasites had two intron and three exon regions. Single (L840F), double (I836L, E837K), and triple novel point mutations (V875L, Q876P, S879V); the last involving two concomitant allelic substitutions; were discovered in the second and third exon regions of head louse DNA on chromosome II from three (30%) counties. Other exon or intron regions remained non-mutated from the remaining seven counties.

Conclusions

The detection of six amino acid substitutions from 30% of examined head lice among infested schoolgirls reveal that mutants are minutely developing. These findings provide further incentive to recapitulate the legitimacy of current control measures and resolve dynamics of resistance in human head louse populations.

Molecular and Functional Characterization of GABA Receptor Subunits GRD and LCCH3 from Human Louse Pediculus Humanus Humanus

Human louse Pediculus humanus is a cosmopolitan obligatory blood-feeding ectoparasite causing pediculosis and transmitting many bacterial pathogens. Control of infestation is difficult due to the developed resistance to insecticides that mainly target GABA (γ-aminobutyric acid) receptors. Previous work showed that Pediculus humanus humanus (Phh) GABA receptor subunit resistance to dieldrin (RDL) is the target of lotilaner, a synthetic molecule of the isoxazoline chemical class. To enhance our understanding of how insecticides act on GABA receptors, two other GABA receptor subunits were cloned and characterized: three variants of Phh-grd (glycine-like receptor of Drosophila) and one variant of Phh-lcch3 (ligand-gated chloride channel homolog 3). Relative mRNA expression levels of Phh-rdl, Phh-grd, and Phh-lcch3 revealed that they were expressed throughout the developmental stages (eggs, larvae, adults) and in the different parts of adult lice (head, thorax, and abdomen). When expressed individually in the Xenopus oocyte heterologous expression system, Phh-GRD1, Phh-GRD2, Phh-GRD3, and Phh-LCCH3 were unable to reconstitute functional channels, whereas the subunit combinations Phh-GRD1/Phh-LCCH3, Phh-GRD1/Phh-RDL, and Phh-LCCH3/Phh-RDL responded to GABA in a concentration-dependent manner. The three heteromeric receptors were similarly sensitive to the antagonistic effect of picrotoxin and fipronil, whereas Phh-GRD1/Phh-RDL and Phh-LCCH3/Phh-RDL were respectively about 2.5-fold and 5-fold more sensitive to ivermectin than Phh-GRD1/Phh-LCCH3. Moreover, the heteropentameric receptor constituted by Phh-GRD1/Phh-LCCH3 was found to be permeable and highly sensitive to the extracellular sodium concentration. These findings provided valuable additions to our knowledge of the complex nature of GABA receptors in human louse that could help in understanding the resistance pattern to commonly used pediculicides. SIGNIFICANCE STATEMENT: Human louse is an ectoparasite that causes pediculosis and transmits several bacterial pathogens. Emerging strains developed resistance to the commonly used insecticides, especially those targeting GABA receptors. To understand the molecular mechanisms underlying this resistance, two subunits of GABA receptors were cloned and described: Phh-grd and Phh-lcch3. The heteromeric receptor reconstituted with the two subunits was functional in Xenopus oocytes and sensitive to commercially available insecticides. Moreover, both subunits were transcribed throughout the parasite lifecycle.