[The prevalence of head louse infestation among urban and rural children in Korea]

Pediculosis capitis among school-age students worldwide as an emerging public health concern: a systematic review and meta-analysis of past five decades

Pediculosis by Pediculus humanus capitis is still an important health issue in school-age students worldwide. Although pediculicidal agents effectively kill head lice, the re-infestation rate is still high. This study was conducted to provide a summary of evidence about the prevalence of pediculosis capitis among school-age students worldwide. Different databases including MEDLINE/PubMed, Scopus, and Web of Science were searched for publications related to pediculosis capitis in school-age students from 1977 to 2020. All peer-reviewed original research articles describing pediculosis capitis among school-age students were included. Statistical heterogeneity of the different years among studies was assessed using the standard chi squared and I² tests. Due to the significant heterogeneity, a random effect model was adopted to estimate the pooled, continent, and gender-specific prevalence of pediculosis. Two hundred and one papers met the inclusion criteria of this review and entered into the meta-analysis including 1,218,351 individuals. Through a random effect model, the prevalence of pediculosis capitis among school students was estimated as 19% (CI 95% = 0.18-0.20%, I² = 99.89%). The prevalence of pediculosis capitis among boys was 7% (CI 95% = 0.05-0.10) compared to 19% (CI 95% = 0.15-0.24) in girls. The highest prevalence was in Central and South America (33%, CI 95% = 0.22-0.44, I² = 99.81%) and the lowest was in Europe (5%, CI 95% = 4-6, I² = 99.28%). Relatively high pediculosis capitis prevalence among school-age students observed in this study emphasizes the need for implementing screening and prophylaxis tailored to the local context.

Parasitic infections and medical expenses according to Health Insurance Review Assessment claims data in South Korea, 2011-2018

Introduction

In South Korea, Health Insurance Review and Assessment claims data contain comprehensive information on healthcare services for almost the entire population. The present study used claims data on parasitic diseases from 2011 to 2018, and associated medical expenses to investigate infection trends associated with endemic parasitic diseases in South Korea, including those not monitored by Korea Centers for Disease Control and Prevention.

Methods

Basic data regarding each parasitic disease were curated from the Healthcare Bigdata Hub (http://opendata.hira.or.kr). Ten endemic parasitic diseases, three pandemic protozoan diseases, and three ectoparasitic diseases were evaluated between 2011 and 2018. Data on each parasitic disease included the number of patients of each sex, age range within 5 years, province, and total medical expenses. Heatmap and principal component analysis were performed to visualize the incidence pattern of parasitic diseases by provinces.

Results

Clonorchiasis and pinworm infections decreased remarkably from 6,097 and 4,018 infections in 2011 to 3,008 and 1,988 infections in 2018, respectively. Other endemic parasitic diseases mostly declined or remained steady over the 8-year period, except for anisakiasis, which doubled from 409 in 2011 to 818 in 2018. Provinces close to North Korea had a higher frequency of claims for Plasmodium vivax infection. The highest rate of clonorchiasis was in Gyeongsangnam-do, while that of anisakiasis was in southern Korea. Jeju province had the highest number of claims for cysticercosis, anisakiasis, pinworm infection, and soil-transmitted helminth infections. The total medical expense for anisakiasis was 65 million Korean won (57,000 US$) in 2011, rising to 237 million Korean won (206,000 US$) in 2018. The medical expense for trichomoniasis was 6,063 million won and for scabies was 1,669 million won in 2018. Since the claims data include only data reported by healthcare providers, some discrepancies might have occurred.

Conclusion

Our findings provide the basis for a health policy to reduce further infections and medical expense.

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

In the appraisal of head lice outbreak, in addition to socioeconomic factors and availability of health care services, environmental conditions of the households must be taken into account. However, interviewing with children or mailing questionnaires to families may not reflect the actualities. Therefore, in this study, all the inclusive factors which may be associated with head lice outbreak were thoroughly and closely investigated. The data were collected by examining students at schools and surveying patients' households. A questionnaire concerning children's personal hygienic practices, family features, and environmental conditions of the households was filled out during the close assessment of the residential area. The overall prevalence of head lice was obtained as 5.9%, and the difference was not significant within the urban (5.1%) and rural (6.1%) communities. Overall, the number of infested students was more frequent in girls (6.6%) than boys (2.8%), but the difference was not significant. The highest infestation rate was obtained in the examined students whose fathers were unemployed, farmer, and herdsman. Family income showed greater correlation with the prevalence of pediculosis capitis. A high frequency of pediculosis capitis was identified among the students who were sharing individual items with siblings. Assessment of households showed that room flooring material and keeping animals at home were highly correlated with head lice prevalence. Households should be informed that infestations happen, irrespective of socioeconomic status. However, the physical and environmental conditions of living areas and households play an important role in head lice prevention.

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

BACKGROUND

Head lice infestation is an infection of the scalp and skin which causes blood loss, discomfort, and social and psychological distress with the possibility of secondary bacterial infections occurring at scratch sites. In Pakistan, although some small scale studies have been conducted to investigate prevalence of head lice in school children and the general population, no population based estimates have been reported. The National Health Survey of Pakistan (NHSP 1990 - 94) was a nationally representative health examination survey of the Pakistani population. The NHSP is the first population based household survey to collect data on the prevalence of head lice in adult women in Pakistan. In this paper we use data from the NHSP to present an epidemiological profile of personal hygiene practices and head lice infestation among women aged 12 years or older in three provinces of Pakistan; Balochistan, Sindh and North West Frontier Province (NWFP).

RESULTS

Overall about 7% women aged 12 years and older suffered from head lice infestation. Multivariable logistic regression analysis identified factors independently associated with presence of head lice. Age less than 16 years and crowding at home were associated with higher infestation-rates. The impact of household socio-economic status on infestation rates among women was different in urban and rural settings; urban women with low socio-economic status were more vulnerable than similar women in rural settings. Bathing infrequently in summer was associated with higher prevalence rates only in Sindh, possibly due to the fact that among the three provinces Sindh has a hotter and more humid summer.

CONCLUSIONS

The results of our analysis of NHSP indicate high levels of head lice infestation among girls and women in the three Provinces. The epidemiological profile of hygienic practices of women indicated that NWFP and Balochistan as compared to Sindh, and rural as compared to urban areas were less developed with respect to access to water supply and soap for maintaining personal hygiene. Simple and cost-effective measures such as provision of water and soap, and improving awareness regarding maintaining personal hygiene can contribute significantly towards improving public health status of the women in Pakistan.

Infestation status of head louse and treatment with lindane shampoo in children of primary school and kindergarten in Chinju-shi, Kyongsangnam-do, Korea

The infestation status of head louse among children attending primary schools and kindergartens in Chinju-shi, Kyongsangnam-do, Korea, was investigated between June and July 1999. Out of 2,288 children examined, 3.9% of boys (48/1,242) and 23.5% of girls (246/1,046) were infested with nits or adult/nymphs of lice. The effectiveness of lindane shampoo (1% gamma benzene hexachloride solution) was evaluated after one or two time applications to all the children infested. The negative conversion rate of pediculosis was 93.5%. Effective control measures are needed to control and prevent such ectoparasite infestation amongst children.

Infestation rate of head lice in primary school children in Inchon, Korea

The survey of the head louse infestation of primary school children in Inchon city was carried out in May 26-27, 1995. Total number of the children surveyed were 1,530. Four (0.5%) out of 768 boys were infested with nits or adults/nymphs of lice and 72 (9.4%) out of 762 girls were positive with those of lice. The infestation rate of lice for girls was 19 times higher than that of boys.

Head louse infestation in vagrants and children admitted to public welfare facilities, Republic of Korea

From December 1992 to February 1993, all vagrants and children admitted to public welfare facilities supported by the Government of Republic of Korea were examined for the presence of nit, nymph or adult of head louse. Of 36,055 persons examined, the number of positive was 7,393 (20.5%). Intensive control measures are needed to control this ectoparasitic infestation.

Infestation rate of lice in patients in a mental hospital, Seoul, Korea

We examined the infestation rate of head and/or body lice in patients in a mental hospital, Seoul, Korea on June 27-28, 1988. Of 438 women, 146 (33.3%) were positive with nits or worms of louse. Of 143 men, 22 (15.4%) were positive with those of louse. Regular control programs were necessary to this hospital.

Prevalence of head louse infestation in primary school children in Kangwon-do, Korea

We tried to reveal the prevalence rates of the head louse infestation in school children in Kangwon-do, Korea in December 1990. A total of 912 children in four primary schools was examined. The positive rate for adults and/or nits of Pediculus humanus capitis was 37.2%. One school was followed-up without specific intervention. There was no significant change of the prevalence rate 6 months after the first examination from 66.0% to 57.3%. We could see the persistent infestation rate if there was no intervention. We are emphasizing the significance of worm positive rate because it represents the potentiality of active transmission.

Mass treatment of head louse infestation with Sumithrin powder in primary schools in Korea

A mass treatment of head louse infestation with Sumithrin powder (0.4% phenothrin) in primary school children was implemented during the period of September 1991-May 1992. The infestation rate of total 2,515 children was 38.6% in average (21.2% in boys and 57.2% in girls). The reduction rate of head louse infestation was 93.4% with a single treatment and 94.8% with double consecutive treatments with about 10 days interval, which indicated that a single treatment would be recommended for the mass treatment in the community. Long term follow-up after Sumithrin powder application for head louse control in a primary school showed that the infestation rate dropped from 33.1% before treatment to 5.4% by seven months after treatment, giving a 83.4% reduction rate.

[Head louse infestation among girls in an orphanage and women in a mental hospital and mass-delousing with bioallethrin (PARA aerosol)]

After evaluation of presence of nits and/or lice, PARA aerosol(bioallethrin with piperonyl butoxide) was applied to 97 women and 43 girls, regardless of the results of their infestation, living at 2 separate institutions. Twelve days after the first treatment the second treatment was carried out and the presence of head lice was examined for the evaluation of treatment effect. Among total 140 subjects, 98(70.0%) were nit positive and 85(60.7%) were louse positive. The infestation rates of girls by nit(86.0%) and louse(86.0%) were higher than those of women, nit 62.9% and louse 49.5% (p less than 0.01). Also the detection rate of lice among nit positive subjects was higher in girls(100%) than in women(78.7%). On the second evaluation 12 days after treatment, 36(97.3%) out of 37 girls and 46(95.8%) out of 48 women were found louse-free. There was no difference in the treatment efficacy between the women and girls.

A historical review and prospects of medical entomology research in Korea

Research activities of medical entomology in Korea can briefly be divided into three periods. During the first period (1910-1959), medical entomology research was initiated by Japanese workers, and then by U.S. Army Medical Unit personnels and a few Korean pioneers, who greatly contributed to establishing a foundation for medical entomology in Korea. During the second period (1960-1979), research activities were intensively carried out by the entomology team of the Central Malaria Eradication Service and staffs of the Division of Medical Entomology, National Institute of Health, who collaborated with WHO-Vector Ecology and Control Research Unit. During the third period (1980-present), studies were expanded to different research laboratories, such as Departments of Biology in College of Natural Sciences and Departments of Parasitology or others in Medical Schools, and study topics also became diverse. Out of 313 papers on Korean arthropods of medical importance, the majority were on mosquitoes (142 papers, 45.4%) and, next, on flies (53 papers, 16.9%). It is hard to see the future prospect of medical entomology research in Korea, since it looks pessimistic in some respects but optimistic in others. Korean medical entomologists may be quantitatively lacking, but not qualitatively behind.