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Aisha Jabeen
Mirza Tasawer Baig
Sadaf Ibrahim
Nayel syed
Samina Sheikh
Aiman syed
Quratulain Pirzada
Noorulain Pirzada


School-based screening, Hygiene practices, Pediculus humanus capitis, Prevention


Background: Head lice (Pediculosis humanus capitis) are a significant public health concern globally. This study aimed to assess the prevalence of head lice infestation among elementary school children in Karachi, Pakistan, and identify associated risk factors.

Methods: A descriptive cross-sectional study was conducted from January to May 2023 in randomly selected elementary schools (government and private) in Karachi. A total of 1501 students aged 5-13 years were examined for head lice and nits. Data on demographics, hygiene practices, and family history were collected using a pretested questionnaire with informed consent.

Results: Head lice infestation was identified in 351 (23.4%) participants. Females had a significantly higher prevalence (59.5%) compared to males (40.45%). The highest infestation rate (44%) was observed among children aged 3-4 years, followed by 5-10 years (34.7%) and 10-13 years (20%). Students with parents of lower educational attainment, unemployed fathers, and a history of infestation were more likely to be infested (p<0.001). Infrequent combing (less than daily) and infrequent bathing (once or less per week) were associated with a higher prevalence (p<0.05). Head covering among girls significantly reduced transmission risk (p=0.004). Having lice in other family members were significant risk factors (p<0.05). Itching was the most prevalent symptom (p=0.004). Family size did not significantly influence infestation rates.

Conclusion: Head lice infestation remains a common public health problem among elementary school children in Karachi. The study identified several risk factors, including age, gender, socioeconomic status, hygiene practices, and family history. School-based screening programs, coupled with education on hygiene and transmission prevention, are crucial for controlling head lice infestation in this population.

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1. Abah, A. E., Owens, P., & Maduike, E. (2023). Reemergence of head lice (Pediculus humanus capitis) among a university community in Southern Nigeria. Egyptian Journal of Dermatology and Venerology, 43(1), 32-35.
2. Ahmad Nasrollahi, S., Daneshmand, B., & Kashani, N. (2018). Review of common head lice treatments. Journal of Dermatology and Cosmetic, 9(3), 219-225.
3. Alberfkani, M., Mero, W.M.S., 2020. The incidence of Scabies and Head lice and their associated risk factors among displaced people in Cham Mishko Camp, Zakho City, Duhok Province. Iraq. Pol. J. Microbiol. 69, 463–469.
4. Amanzougaghene, N., Fenollar, F., Raoult, D., & Mediannikov, O. (2020). Where are we with human lice? A review of the current state of knowledge. Frontiers in Cellular and Infection Microbiology, 9, 474.
5. Baghdadi, H. B., Omer, E. O., Metwally, D. M., & Abdel-Gaber, R. (2021). Prevalence of head lice (Pediculus humanus capitis) infestation among schools workers in the Eastern Region, Saudi Arabia. Saudi Journal of Biological Sciences, 28(10), 5662-5666.
6. Batool, N., Song, D., Reyes, J. V. M., Ahmad, S., Skulkidis, A., Almas, T., ... & Brown, M. (2021). Ectoparasitosis, a rare cause of severe iron deficiency anemia: a case report. Annals of Medicine and Surgery, 69.
7. Durden LA. Lice (Phthiraptera). In: Mullen GR, Durden LA, editors. Medical and d veterinary entomology. 3rd ed. London: Academic Press; 2019. p. 79–106.
8. El-Sayed, M. M., Toama, M. A., Abdelshafy, A. S., Esawy, A. M., & El-Naggar, S. A. (2017). Prevalence of pediculosis capitis among primary school students at Sharkia Governorate by using dermoscopy. Egyptian Journal of Dermatology and Venerology, 37(2), 33-42.
9. Ghavami, M. B., Panahi, S., Nabati, S. M., Ghanbari, M., & Taghiloo, B. (2023). A comprehensive survey of permethrin resistance in human head louse populations from northwest Iran: ex vivo and molecular monitoring of knockdown resistance alleles. Parasites & Vectors, 16(1), 57.
10. Greive K A, Barnes T M. The efficacy of Australian essential oils for the treatment of head lice infestation in children: A randomised controlled trial, Australasian Journal of Dermatology (2018) 59, e99-e105. doi: 10.1111/ajd.12626. [DOI:10.1111/ajd.12626]
11. Husni, L., & Al-Waiz, M. (2021). Topical ivermectin in the treatment of pediculosis capitis. Our Dermatology Online/Nasza Dermatologia Online, 12(1).
12. Kitvatanachai, S., Kritsiriwutthinan, K., Taylor, A., & Rhongbutsri, P. (2023). Head Lice Infestation in Pre-High School Girls, Lak Hok Suburban Area, Pathum Thani Province, in Central Thailand. Journal of Parasitology Research, 2023.
13. Liao, C. W., Cheng, P. C., Chuang, T. W., Chiu, K. C., Chiang, I. C., Kuo, J. H., ... & Fan, C. K. (2019). Prevalence of Pediculus capitis in schoolchildren in Battambang, Cambodia. Journal of Microbiology, Immunology and Infection, 52(4), 585-591.
14. Maramazi, H. G., Sharififard, M., Jahanifard, E., Maraghi, E., Sourestani, M. M., Malehi, A. S.& Rasaei, S. (2019). Pediculosis humanus capitis prevalence as a health problem in girl’s elementary schools, Southwest of Iran (2017-2018). Journal of Research in Health Sciences, 19(2), e00446.
15. Mumcuoglu, K. Y., Pollack, R. J., Reed, D. L., Barker, S. C., Gordon, S., Toloza, A. C., ... & Vander Stichele, R. H. (2021). International recommendations for an effective control of head louse infestations. International journal of dermatology, 60(3), 272-280.
16. Muršić, I., Kuric, I., Raguž, M., Kovačević, T., & Muršić, D. (2018). Treatment of scabies and pediculosis in health education publications and folk medicine of Eastern Croatia-Slavonija, Baranja and Western Srijem county. Acta dermatovenerologica Croatica, 26(1), 33-33.
17. Nategh, A., Eslam, M. A., Davoud, A., Roghayeh, S., Akbar, G., Hassan, B., & Mehdi, S. (2018). Prevalence of head lice infestation (pediculosis capitis) among primary school students in the Meshkin Shahr of Ardabil province. American Journal of Pediatrics, 4(4), 94-99.
18. Nejati, J., Keyhani, A., Kareshk, A. T., Mahmoudvand, H., Saghafipour, A., Khoraminasab, M., ... & Mousavi, S. M. (2018). Prevalence and risk factors of pediculosis in primary school children in South West of Iran. Iranian journal of public health, 47(12), 1923.
19. Sanei-Dehkordi, A., Soleimani-Ahmadi, M., Zare, M., Madani, A., & Jamshidzadeh, A. (2017). Head Lice Infestation (pediculosis) and associated factors among primary school girls in Sirik County, Southern Iran. International Journal of Pediatrics, 5(12), 6301-6309.
20. Shea, L. A., Freitas, E. L., Nguyen, T., Salawu, D. W., & Soquinase, N. (2023). Over-the-counter Pediculus humanus capitis treatment: The nit comb is not appropriate for all hair types!. Journal of the American Pharmacists Association, 63(1), 46-49.
21. Singhasivanon, O. U., Lawpoolsri, S., Mungthin, M., Yimsamran, S., Soonthornworasiri, N., & Krudsood, S. (2019). Prevalence and alternative treatment of head-lice infestation in rural Thailand: a community-based study. The Korean journal of parasitology, 57(5), 499.
22. WHO. Report of the tenth meeting of the WHO strategic and technical advisory group for neglected tropical diseases. 2017. https://www.who. int/publications/m/item/tenth-report-of-the-strategic-and-technical advisory-group-for-neglected-tropical-diseases-(stag-ntds).

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