Anthropometric Measurements as Predictors of Low Birth Weight Among Tanzanian Neonates: A Hospital-Based Study
November 7, 2025
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Background
Pediculosis that influences further millions of people each year is reported in all countries for all groups of population, including people with high income. Lice are insects that are parasitic in nature and do not possess any stage in their life cycle that is not parasitic. They are usually transmitted either by direct contact between the skin or through objects that are already infected. The symptoms are often delaying to appear and manifest within 3 to 4 weeks of infection. There are three types of lice that infest humans: There are three different types of lice specifically, Pediculus humanus capitis (head louse), Pthirus pubis (pubic or crab louse), and Pediculus humanus (body louse). Head lice are present in any class, socio-economic, and ethnic groups, while body lice are present in unsanitary conditions, like homeless people and refugees.
Epidemiology
Global Prevalence: Cutaneous pediculosis caused by Pediculus humanus is associated with millions of people around the globe. Head lice are most frequently seen in children while body lice are seen in situations of unhygienic environments and crowded living conditions. Approximately 6 to 12 million persons in the United States are infested with head lice each year, and other developed countries appear to have similar prevalence rates.
Demographics:
Head Lice: Most recorded in children between the age of 3 and 12 years mainly due to frequent contacts at school and childcare programs. For example, prevalence in school aged children in the U. S varies between 2% and 12% at a given time.
Body Lice: It is more frequent in the populations who can be referred to as vulnerable populations including the homeless people, refugees and people living in congested houses. Head lice infestations are associated with poor practices in the washing and availability of clean garments clothing and amenities.
Anatomy
Pathophysiology
The Pediculus humanus infestation, which includes head infestation by Pediculus humanus capitis and body infestation by Pediculus humanus corporis, is highly dependent on the interactions between the lice and their human host. These are the obligatory blood feeders with mouth structures used to penetrate the skin and feed on the blood. Their saliva has anticoagulant and other proteins that work to prevent the clotting of blood and some of which cause an allergic response in the host as manifested by rashes, itching, redness, and swelling. Itching will cause persistent scratching of the skin, and this will make the skin barrier to be easily breached leading to secondary infection from bacteria such as Staphylococcus aureus and Streptococcus species. Furthermore, body lice are associated with several lethal diseases, namely epidemic typhus transmitted through Rickettsia prowazekii, trench fever caused through Bartonella quintana, and relapsing fever through Borrelia recurrentis.
Etiology
Pediculus humanus capitis (Head Louse): Head lice move mostly by direct human to human contact that involves head, hair and scalp touching or coming close. This can happen in any settings that the child is engaged in for example when playing at school or even at home. Personal cleanliness of the mouth, and cleanliness of the surrounding environment does not contribute to transmission regularly, but occasionally combs, hats, and hairbrushes may be responsible for spreading the disease. Certain risk factors that predispose people to head lice include young age, living in close conditions, female sex, and temperature, particularly in warmer areas. Restricted hospital environments particularly do not have a high risk of transmission of the disease unless patients come in close contact with each other.
Pediculus humanus corporis (Body Louse): Public lice are strongly related with poor hygiene, cramped environment or probably from areas which are densely populated like shelters, prison or transport vehicles. They are also associated with such practices as wearing of clothes and other fabrics for long periods without washing or changing. Information was also obtained on the transmission mode of body lice through contaminated beddings, towels or clothes. Therefore, people most at risk of being infested with body lice are those in the states of homelessness, poverty, or living in refugee camps.
Genetics
Prognostic Factors
Morbidity:
Persistent Itching: The frequent use of pediculicides may sometimes result in persistent itching.
Disease Transmission: Although body lice are not directly known transmitters of several fatal diseases such as epidemic typhus, trench fever, and relapsing fever but they are considered its agents.
Secondary Infections: Possible complications of lice bites depend on the degree of the skin damage and can range from bacterial infections, including MRSA.
Social Impact: However, infestation with lice triggers more embarrassment and exclusion as compared to other forms of parasitic infestations though they are less related to severe medical complications.
Clinical History
Age Group:
Head Lice (Pediculus humanus capitis): Generally, it is more common in kids in their ages from 3 to 12 years. Nevertheless, it can affect all age groups and it is contracted by those people who have close contact with the infested human. Places that children spend most of their time are considered as potential carriers of head lice because while schools and daycare centers children tend to come in close contact with each other.
Body Lice (Pediculus humanus corporis): Affects mostly the teenagers and adults, and usually in conditions where individual hygiene is much of a problem like the homeless or those crowded in very cramped spaces. But it is less frequent where the environment is well cleaned and disinfected.
Physical Examination
Head Lice (Pediculus humanus capitis): Among these the parts suspected to be affected should be closely inspected using magnification with the help of a hand mirror, good light and preferably a fine tooth comb.
Signs: Search for pediculosis or live lice, dermatitic pruritic lesions on the scalp, neck, and ears and nits, plugs or small oval eggs glued to the hair shafts especially in the occipital areas and posterior cervical regions.
Body Lice (Pediculus humanus corporis): Check seams of manufactured clothes; the seams of under garments are particularly important.
Signs: They include the live lice which are small, grayish-white insects that infest clothing; nits which are the eggs and laid on the fibers of the clothes; bite marks such as the papular or maculopapular erythematous lesions; excoriations; dermatitis; and signs of secondary infection like impetigo.
Age group
Associated comorbidity
Head Lice: Related to touching; in schools or during games or other forms of physical contact. In this case, personal hygiene cannot be considered a major cause, though lice infections are more frequent in populations with closer personal contact.
Body Lice: And associated with poor hygiene, increased population density, and living standards. Prevalent in areas such as shelters, camps, and other transient populations, homeless population included.
Associated activity
Acuity of presentation
Head Lice: Pest infections do not manifest their effects right from the time of infection though they are infectious. Usually, itching and irritation appears 3-4 weeks after the first contact due to the allergy to the saliva of lice. In this case, manifestations such as severe pruritus and the presence of macroscopic ectoparasites (lice or their ova, nits) on the head can be noted.
Body Lice: Signs may manifest in a shorter time, which can be even several days after the pests have invaded a home. There are cases where people modify their skin’s feeling and feel itchy and irritable in regions where garments make connection with their skin. If the skin is scratched this cross can lead to secondary bacterial infections.
Differential Diagnoses
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
The non-pharmacological management of lice and nits involves wet combing, environmental control, and prohibiting sharing of items. The non-pharmacological treatments are such as pyrethrins/piperonyl butoxide, permethrin, malation, vinegar, vermectin, benzyl alcohol spinosad, isopropyl myristate, mineral oil, dimethicone, and abametapir.
Pharmacological interventions are applying pyrethrins/piperonyl butoxide, permethrin, malathion, vermectin, benzyl alcohol, spinosad, isopropyl myristate, mineral oil, dimethicone, and abametapir. Such measures include wet combing, cleaning the environment, vacuuming the living spaces, and treating contacts.
Management phases comprise the diagnostic and evaluation phase, inducting phase; the subsequent phase comprises re-evaluation and regular check-up phase; and the final phase includes the teaching phase concerning prevention and hygiene. The following are non-pharmacological procedures: washing and combing, cleanliness of the environment, and the practice of avoiding sharing of objects. Pharmacological control measures include pyrethrum/piperonyl butoxide, permetherin, malition, vermection, benzyl alcohol, spinosad, isopropyl myristate, mineral oily, dimeticone and abamentapir.
Conventional approaches include nit combing, cleaning of the environment, and contact treatment. Stages for management include the diagnostic and initial evaluation phase followed by stabilization and start of treatment, post treatment or follow up and evaluation, and finally the essential preventative education on hygiene.
by Stage
by Modality
Chemotherapy
Radiation Therapy
Surgical Interventions
Hormone Therapy
Immunotherapy
Hyperthermia
Photodynamic Therapy
Stem Cell Transplant
Targeted Therapy
Palliative Care
use-of-a-non-pharmacological-approach-for-treating-pediculus-humanus-infestation
Wet Combing: Combing the hair with nit comb preferably during the shower when hair is wet and conditioner is applied on hair every three to four days for several weeks without failure until a finding of lice is realized.
Environmental Measures: Wash bedding, clothing, and hats with hot water and iron them with high temperature. Enclose non- washables and place in a plastic bag for two weeks as a part of additional precaution.
Avoid Sharing Personal Items: Avoid the spread by not sharing combs, brushes, hats, gloves, hand bands, socks, shoes, scarfs, handkerchief etc.
Role of Antiparasitic Agents
Permethrins/Piperonyl Butoxide: The first-line treatment for head, pubic, and severe body lice contains pyrethrins, which comes in mousse or shampoo forms. They work through excessive stimulation of the parasites’ nervous system leading to seizure and death. They are rather old over the counter remedies but the treatments work, nonetheless. But they provide a non-enduring amount of the pest control of permethrin and such controls usually need to be reapplied. Pyrethrin products should not be used by persons with ragweed, turpentine or chrysanthemums allergy. These organophosphate acaricides which include abamectin, bifenthrin, clofentezine, fenbutatin, and spirodiclofen are combined with piperonyl butoxide to improve on their efficacy and to check on resistance.
Application: To use: Massage into dry hair, let it sit for 10 minutes, before rinsing it out. If one treatment is not effective and there is proof that live lice are still in the hair after 9 days then a second treatment is advised.
Permethrin (such as Nix and Elimite)
Some people have recommended the use of permethin as the first choice for head lice treatment as well as pubic and severe body lice treatment to children who are over the ages of two months. This neurotoxin immobilizes and kills lice, is superior to crotamiton as decreased symptoms and secondary bacterial infections were observed. Permethrin also leaves the hair after several hair washes since it has a residual effect.
Application: Massage to the scalp then wash it to the roots, suitable for use on the hair just after shampooing and towel drying. A second application is advised 7 days after the first application has been made on the problem area. Because of this, there may be reasons to switch to other types of pediculicides in some geographic locations.
Malathion(Ovide): Malathion, an FDA-approved head lice treatment, is an organophosphorus insecticide that inhibits cholinesterase reactions irreversibly; it is rapidly metabolized in mammals except for insects and their eggs. Some of it can stick to hair and provide a rather limited amount of protection.
Application: Use the 0. 5% lotion on the skin of patients who are 6 years old or older. Since Malathion is flammable, you should not expose it to heat sources such as open flames or heat styling tools.
Ivermectin Topical (for example Sklice, Soolantra): Topical ivermectin eliminates head lice through selective binding to glutamate-gated chloride channels on the parasite that may lead to paralysis and death. It is a safe treatment which can be carried out with one application of 10 minutes and does not involve nit combing.
Ivermectin Oral (e. g., Stromectol): Ivermectin is available in the oral form and is administered in a dosage of 6mg through a pill which inhibits the binding of chloride ion channels in certain invertebrate nerve and muscle cells to cause cell death. It has been used in mass hatching epidemics and for those circumstances or cases when the active pharmacological preparations do not help. Limited data exist for the fetotoxicity outcomes of the compound when used during pregnancy and they do not show that it is toxic to the fetus.
Lindane: It is the second line, being available as 1% lotion, cream, or shampoo which affects the nervous system of the parasite by causing seizure which leads to the death of the parasite. Because of higher risk for side effects including those potentially fatal it is recommended for use only if other medications have failed.
Benzyl Alcohol: This substance was found to be effective in paralyzing the lice since their respiratory spiracles are closed hence leading to suffocation. It is not ovicidal. It has been approved for patients who are six months and older; it is administered two times, first at the time of consultation and the second time a week later, each time for 10 minutes.
Spinosad: The compound paralyzes and kills lice by causing hyperexcitation of the neurons in the insect’s nervous system. It is used for the local treatment of head lice infestation in patients 4 years and older.
Isopropyl Myristate (Resultz): This treatment softens the wax coat round the scalp and body of lice, which results in formation of Daft skin, hence, they die due to dehydration. The physical character of action makes it improbable to develop resistance with its help.
Mineral oil topical: Mineral oil also seems to be a suitable substitute to insecticide and its effectiveness is substantiated by its ability to proffer physical control hence minimizing on insecticide resistance.
Dimethicone Topical: Even though, dimethicone is equally effective in treating head lice with minimal side effects; this makes the lotion more safe than those containing pesticides.
Abametapir (example, Xeglyze): Abametapir 0. 74% lotion is used as a one- time treatment for head lice using a 10-minute application and is recommended for patients of 6 months old and above. It impedes the metalloproteinase that is useful for the growth of eggs and sustenance of lice.
use-of-intervention-with-a-procedure-in-treating-pediculus-humanus-infestation
Pharmacological Interventions:
Pyrethrins/Piperonyl Butoxide: Rinse it off after leaving it on dry hair for about 10 minutes; it improves hair health and reduces dandruff. It is expected that after 9 days, if necessary, the patient should repeat the procedure.
Permethrin: Wash to be used on damp hair and leave on the hair for 10 minutes then wash off. Repeat after 7 days.
Malathion: Apply 0. 5% lotion applied to dry hair left for 8-12 hours and rinsed out. If not resolved, repeat the examination after 7-9 days of treatment.
Ivermectin Topical: Massage it gently into the scalp and spread onto the hair before leaving it on for 10 minutes and then wash off.
Benzyl Alcohol: Massage gently with fingers into the hair & leave on for 10 minutes and then wash out as usual. Repeat after one week.
Spinosad: It should be applied to the dry hair for about 10 minutes before washing the hair again.
Procedural Interventions:
Wet Combing: Comb the hair with a nit comb made from steel when the hair is wet and conditioned for about three to four days continuously for several weeks.
Environmental Cleaning: Take bathtubs and doing clothes in hot water, cover other items that cannot be washed with plastics for two weeks, and vacuum the rooms.
Treating Contacts: The entire household members and close contact should be inspected and treated at the same time.
use-of-phases-in-managing-pediculus-humanus-infestation
Specifically, the eradication of Pediculus humanus requires a step-by-step process with distinct phases to optimize the chance of elimination as well as minimize the possibility of reinfestation. They have categorized the process starting from the diagnosis and first evaluation which involve checking on active live lice and nits through physical assessment and history of contact and manifestation of symptoms.
In the diagnosed treatment initiation phase, appropriate pharmacological treatments as pyrethrins/piperonyl butoxide or permethrin should be provided as described in product labeling. In the persistent ones, some other possibilities which can be recommended include malathion or even ivermectin. In this phase, medical management consists of procedural interventions such as wet combing to be repeated every 3 to 4 days and environmental measures where the lice-infested items and living spaces are cleaned.
The ‘follow-up and monitoring’ phase is an essential stage that affirms the effectiveness of the treatment. This involves treatment and auscultation after one and two weeks to ensure that there are no remaining lice and continued treatment where necessary.
Medication
Begin by applying the product to dry hair and/or the affected area
Leave it in place for a duration of ten minutes
after which you should thoroughly wash and rinse the area
For best results, it is recommended to repeat this treatment once every seven-ten days
For Adolescents and children aged two years and older
Intended for topical use
Begin by applying the product to dry hair and/or the affected area Leave it in place for a duration of ten minutes
after which you should thoroughly wash and rinse the area
For best results, it is recommended to repeat this treatment once every seven-ten days
Future Trends
Pediculosis that influences further millions of people each year is reported in all countries for all groups of population, including people with high income. Lice are insects that are parasitic in nature and do not possess any stage in their life cycle that is not parasitic. They are usually transmitted either by direct contact between the skin or through objects that are already infected. The symptoms are often delaying to appear and manifest within 3 to 4 weeks of infection. There are three types of lice that infest humans: There are three different types of lice specifically, Pediculus humanus capitis (head louse), Pthirus pubis (pubic or crab louse), and Pediculus humanus (body louse). Head lice are present in any class, socio-economic, and ethnic groups, while body lice are present in unsanitary conditions, like homeless people and refugees.
Global Prevalence: Cutaneous pediculosis caused by Pediculus humanus is associated with millions of people around the globe. Head lice are most frequently seen in children while body lice are seen in situations of unhygienic environments and crowded living conditions. Approximately 6 to 12 million persons in the United States are infested with head lice each year, and other developed countries appear to have similar prevalence rates.
Demographics:
Head Lice: Most recorded in children between the age of 3 and 12 years mainly due to frequent contacts at school and childcare programs. For example, prevalence in school aged children in the U. S varies between 2% and 12% at a given time.
Body Lice: It is more frequent in the populations who can be referred to as vulnerable populations including the homeless people, refugees and people living in congested houses. Head lice infestations are associated with poor practices in the washing and availability of clean garments clothing and amenities.
The Pediculus humanus infestation, which includes head infestation by Pediculus humanus capitis and body infestation by Pediculus humanus corporis, is highly dependent on the interactions between the lice and their human host. These are the obligatory blood feeders with mouth structures used to penetrate the skin and feed on the blood. Their saliva has anticoagulant and other proteins that work to prevent the clotting of blood and some of which cause an allergic response in the host as manifested by rashes, itching, redness, and swelling. Itching will cause persistent scratching of the skin, and this will make the skin barrier to be easily breached leading to secondary infection from bacteria such as Staphylococcus aureus and Streptococcus species. Furthermore, body lice are associated with several lethal diseases, namely epidemic typhus transmitted through Rickettsia prowazekii, trench fever caused through Bartonella quintana, and relapsing fever through Borrelia recurrentis.
Pediculus humanus capitis (Head Louse): Head lice move mostly by direct human to human contact that involves head, hair and scalp touching or coming close. This can happen in any settings that the child is engaged in for example when playing at school or even at home. Personal cleanliness of the mouth, and cleanliness of the surrounding environment does not contribute to transmission regularly, but occasionally combs, hats, and hairbrushes may be responsible for spreading the disease. Certain risk factors that predispose people to head lice include young age, living in close conditions, female sex, and temperature, particularly in warmer areas. Restricted hospital environments particularly do not have a high risk of transmission of the disease unless patients come in close contact with each other.
Pediculus humanus corporis (Body Louse): Public lice are strongly related with poor hygiene, cramped environment or probably from areas which are densely populated like shelters, prison or transport vehicles. They are also associated with such practices as wearing of clothes and other fabrics for long periods without washing or changing. Information was also obtained on the transmission mode of body lice through contaminated beddings, towels or clothes. Therefore, people most at risk of being infested with body lice are those in the states of homelessness, poverty, or living in refugee camps.
Morbidity:
Persistent Itching: The frequent use of pediculicides may sometimes result in persistent itching.
Disease Transmission: Although body lice are not directly known transmitters of several fatal diseases such as epidemic typhus, trench fever, and relapsing fever but they are considered its agents.
Secondary Infections: Possible complications of lice bites depend on the degree of the skin damage and can range from bacterial infections, including MRSA.
Social Impact: However, infestation with lice triggers more embarrassment and exclusion as compared to other forms of parasitic infestations though they are less related to severe medical complications.
Age Group:
Head Lice (Pediculus humanus capitis): Generally, it is more common in kids in their ages from 3 to 12 years. Nevertheless, it can affect all age groups and it is contracted by those people who have close contact with the infested human. Places that children spend most of their time are considered as potential carriers of head lice because while schools and daycare centers children tend to come in close contact with each other.
Body Lice (Pediculus humanus corporis): Affects mostly the teenagers and adults, and usually in conditions where individual hygiene is much of a problem like the homeless or those crowded in very cramped spaces. But it is less frequent where the environment is well cleaned and disinfected.
Head Lice (Pediculus humanus capitis): Among these the parts suspected to be affected should be closely inspected using magnification with the help of a hand mirror, good light and preferably a fine tooth comb.
Signs: Search for pediculosis or live lice, dermatitic pruritic lesions on the scalp, neck, and ears and nits, plugs or small oval eggs glued to the hair shafts especially in the occipital areas and posterior cervical regions.
Body Lice (Pediculus humanus corporis): Check seams of manufactured clothes; the seams of under garments are particularly important.
Signs: They include the live lice which are small, grayish-white insects that infest clothing; nits which are the eggs and laid on the fibers of the clothes; bite marks such as the papular or maculopapular erythematous lesions; excoriations; dermatitis; and signs of secondary infection like impetigo.
Head Lice: Related to touching; in schools or during games or other forms of physical contact. In this case, personal hygiene cannot be considered a major cause, though lice infections are more frequent in populations with closer personal contact.
Body Lice: And associated with poor hygiene, increased population density, and living standards. Prevalent in areas such as shelters, camps, and other transient populations, homeless population included.
Head Lice: Pest infections do not manifest their effects right from the time of infection though they are infectious. Usually, itching and irritation appears 3-4 weeks after the first contact due to the allergy to the saliva of lice. In this case, manifestations such as severe pruritus and the presence of macroscopic ectoparasites (lice or their ova, nits) on the head can be noted.
Body Lice: Signs may manifest in a shorter time, which can be even several days after the pests have invaded a home. There are cases where people modify their skin’s feeling and feel itchy and irritable in regions where garments make connection with their skin. If the skin is scratched this cross can lead to secondary bacterial infections.
The non-pharmacological management of lice and nits involves wet combing, environmental control, and prohibiting sharing of items. The non-pharmacological treatments are such as pyrethrins/piperonyl butoxide, permethrin, malation, vinegar, vermectin, benzyl alcohol spinosad, isopropyl myristate, mineral oil, dimethicone, and abametapir.
Pharmacological interventions are applying pyrethrins/piperonyl butoxide, permethrin, malathion, vermectin, benzyl alcohol, spinosad, isopropyl myristate, mineral oil, dimethicone, and abametapir. Such measures include wet combing, cleaning the environment, vacuuming the living spaces, and treating contacts.
Management phases comprise the diagnostic and evaluation phase, inducting phase; the subsequent phase comprises re-evaluation and regular check-up phase; and the final phase includes the teaching phase concerning prevention and hygiene. The following are non-pharmacological procedures: washing and combing, cleanliness of the environment, and the practice of avoiding sharing of objects. Pharmacological control measures include pyrethrum/piperonyl butoxide, permetherin, malition, vermection, benzyl alcohol, spinosad, isopropyl myristate, mineral oily, dimeticone and abamentapir.
Conventional approaches include nit combing, cleaning of the environment, and contact treatment. Stages for management include the diagnostic and initial evaluation phase followed by stabilization and start of treatment, post treatment or follow up and evaluation, and finally the essential preventative education on hygiene.
Infectious Disease
Wet Combing: Combing the hair with nit comb preferably during the shower when hair is wet and conditioner is applied on hair every three to four days for several weeks without failure until a finding of lice is realized.
Environmental Measures: Wash bedding, clothing, and hats with hot water and iron them with high temperature. Enclose non- washables and place in a plastic bag for two weeks as a part of additional precaution.
Avoid Sharing Personal Items: Avoid the spread by not sharing combs, brushes, hats, gloves, hand bands, socks, shoes, scarfs, handkerchief etc.
Infectious Disease
Permethrins/Piperonyl Butoxide: The first-line treatment for head, pubic, and severe body lice contains pyrethrins, which comes in mousse or shampoo forms. They work through excessive stimulation of the parasites’ nervous system leading to seizure and death. They are rather old over the counter remedies but the treatments work, nonetheless. But they provide a non-enduring amount of the pest control of permethrin and such controls usually need to be reapplied. Pyrethrin products should not be used by persons with ragweed, turpentine or chrysanthemums allergy. These organophosphate acaricides which include abamectin, bifenthrin, clofentezine, fenbutatin, and spirodiclofen are combined with piperonyl butoxide to improve on their efficacy and to check on resistance.
Application: To use: Massage into dry hair, let it sit for 10 minutes, before rinsing it out. If one treatment is not effective and there is proof that live lice are still in the hair after 9 days then a second treatment is advised.
Permethrin (such as Nix and Elimite)
Some people have recommended the use of permethin as the first choice for head lice treatment as well as pubic and severe body lice treatment to children who are over the ages of two months. This neurotoxin immobilizes and kills lice, is superior to crotamiton as decreased symptoms and secondary bacterial infections were observed. Permethrin also leaves the hair after several hair washes since it has a residual effect.
Application: Massage to the scalp then wash it to the roots, suitable for use on the hair just after shampooing and towel drying. A second application is advised 7 days after the first application has been made on the problem area. Because of this, there may be reasons to switch to other types of pediculicides in some geographic locations.
Malathion(Ovide): Malathion, an FDA-approved head lice treatment, is an organophosphorus insecticide that inhibits cholinesterase reactions irreversibly; it is rapidly metabolized in mammals except for insects and their eggs. Some of it can stick to hair and provide a rather limited amount of protection.
Application: Use the 0. 5% lotion on the skin of patients who are 6 years old or older. Since Malathion is flammable, you should not expose it to heat sources such as open flames or heat styling tools.
Ivermectin Topical (for example Sklice, Soolantra): Topical ivermectin eliminates head lice through selective binding to glutamate-gated chloride channels on the parasite that may lead to paralysis and death. It is a safe treatment which can be carried out with one application of 10 minutes and does not involve nit combing.
Ivermectin Oral (e. g., Stromectol): Ivermectin is available in the oral form and is administered in a dosage of 6mg through a pill which inhibits the binding of chloride ion channels in certain invertebrate nerve and muscle cells to cause cell death. It has been used in mass hatching epidemics and for those circumstances or cases when the active pharmacological preparations do not help. Limited data exist for the fetotoxicity outcomes of the compound when used during pregnancy and they do not show that it is toxic to the fetus.
Lindane: It is the second line, being available as 1% lotion, cream, or shampoo which affects the nervous system of the parasite by causing seizure which leads to the death of the parasite. Because of higher risk for side effects including those potentially fatal it is recommended for use only if other medications have failed.
Benzyl Alcohol: This substance was found to be effective in paralyzing the lice since their respiratory spiracles are closed hence leading to suffocation. It is not ovicidal. It has been approved for patients who are six months and older; it is administered two times, first at the time of consultation and the second time a week later, each time for 10 minutes.
Spinosad: The compound paralyzes and kills lice by causing hyperexcitation of the neurons in the insect’s nervous system. It is used for the local treatment of head lice infestation in patients 4 years and older.
Isopropyl Myristate (Resultz): This treatment softens the wax coat round the scalp and body of lice, which results in formation of Daft skin, hence, they die due to dehydration. The physical character of action makes it improbable to develop resistance with its help.
Mineral oil topical: Mineral oil also seems to be a suitable substitute to insecticide and its effectiveness is substantiated by its ability to proffer physical control hence minimizing on insecticide resistance.
Dimethicone Topical: Even though, dimethicone is equally effective in treating head lice with minimal side effects; this makes the lotion more safe than those containing pesticides.
Abametapir (example, Xeglyze): Abametapir 0. 74% lotion is used as a one- time treatment for head lice using a 10-minute application and is recommended for patients of 6 months old and above. It impedes the metalloproteinase that is useful for the growth of eggs and sustenance of lice.
Infectious Disease
Pharmacological Interventions:
Pyrethrins/Piperonyl Butoxide: Rinse it off after leaving it on dry hair for about 10 minutes; it improves hair health and reduces dandruff. It is expected that after 9 days, if necessary, the patient should repeat the procedure.
Permethrin: Wash to be used on damp hair and leave on the hair for 10 minutes then wash off. Repeat after 7 days.
Malathion: Apply 0. 5% lotion applied to dry hair left for 8-12 hours and rinsed out. If not resolved, repeat the examination after 7-9 days of treatment.
Ivermectin Topical: Massage it gently into the scalp and spread onto the hair before leaving it on for 10 minutes and then wash off.
Benzyl Alcohol: Massage gently with fingers into the hair & leave on for 10 minutes and then wash out as usual. Repeat after one week.
Spinosad: It should be applied to the dry hair for about 10 minutes before washing the hair again.
Procedural Interventions:
Wet Combing: Comb the hair with a nit comb made from steel when the hair is wet and conditioned for about three to four days continuously for several weeks.
Environmental Cleaning: Take bathtubs and doing clothes in hot water, cover other items that cannot be washed with plastics for two weeks, and vacuum the rooms.
Treating Contacts: The entire household members and close contact should be inspected and treated at the same time.
Infectious Disease
Specifically, the eradication of Pediculus humanus requires a step-by-step process with distinct phases to optimize the chance of elimination as well as minimize the possibility of reinfestation. They have categorized the process starting from the diagnosis and first evaluation which involve checking on active live lice and nits through physical assessment and history of contact and manifestation of symptoms.
In the diagnosed treatment initiation phase, appropriate pharmacological treatments as pyrethrins/piperonyl butoxide or permethrin should be provided as described in product labeling. In the persistent ones, some other possibilities which can be recommended include malathion or even ivermectin. In this phase, medical management consists of procedural interventions such as wet combing to be repeated every 3 to 4 days and environmental measures where the lice-infested items and living spaces are cleaned.
The ‘follow-up and monitoring’ phase is an essential stage that affirms the effectiveness of the treatment. This involves treatment and auscultation after one and two weeks to ensure that there are no remaining lice and continued treatment where necessary.
Pediculosis that influences further millions of people each year is reported in all countries for all groups of population, including people with high income. Lice are insects that are parasitic in nature and do not possess any stage in their life cycle that is not parasitic. They are usually transmitted either by direct contact between the skin or through objects that are already infected. The symptoms are often delaying to appear and manifest within 3 to 4 weeks of infection. There are three types of lice that infest humans: There are three different types of lice specifically, Pediculus humanus capitis (head louse), Pthirus pubis (pubic or crab louse), and Pediculus humanus (body louse). Head lice are present in any class, socio-economic, and ethnic groups, while body lice are present in unsanitary conditions, like homeless people and refugees.
Global Prevalence: Cutaneous pediculosis caused by Pediculus humanus is associated with millions of people around the globe. Head lice are most frequently seen in children while body lice are seen in situations of unhygienic environments and crowded living conditions. Approximately 6 to 12 million persons in the United States are infested with head lice each year, and other developed countries appear to have similar prevalence rates.
Demographics:
Head Lice: Most recorded in children between the age of 3 and 12 years mainly due to frequent contacts at school and childcare programs. For example, prevalence in school aged children in the U. S varies between 2% and 12% at a given time.
Body Lice: It is more frequent in the populations who can be referred to as vulnerable populations including the homeless people, refugees and people living in congested houses. Head lice infestations are associated with poor practices in the washing and availability of clean garments clothing and amenities.
The Pediculus humanus infestation, which includes head infestation by Pediculus humanus capitis and body infestation by Pediculus humanus corporis, is highly dependent on the interactions between the lice and their human host. These are the obligatory blood feeders with mouth structures used to penetrate the skin and feed on the blood. Their saliva has anticoagulant and other proteins that work to prevent the clotting of blood and some of which cause an allergic response in the host as manifested by rashes, itching, redness, and swelling. Itching will cause persistent scratching of the skin, and this will make the skin barrier to be easily breached leading to secondary infection from bacteria such as Staphylococcus aureus and Streptococcus species. Furthermore, body lice are associated with several lethal diseases, namely epidemic typhus transmitted through Rickettsia prowazekii, trench fever caused through Bartonella quintana, and relapsing fever through Borrelia recurrentis.
Pediculus humanus capitis (Head Louse): Head lice move mostly by direct human to human contact that involves head, hair and scalp touching or coming close. This can happen in any settings that the child is engaged in for example when playing at school or even at home. Personal cleanliness of the mouth, and cleanliness of the surrounding environment does not contribute to transmission regularly, but occasionally combs, hats, and hairbrushes may be responsible for spreading the disease. Certain risk factors that predispose people to head lice include young age, living in close conditions, female sex, and temperature, particularly in warmer areas. Restricted hospital environments particularly do not have a high risk of transmission of the disease unless patients come in close contact with each other.
Pediculus humanus corporis (Body Louse): Public lice are strongly related with poor hygiene, cramped environment or probably from areas which are densely populated like shelters, prison or transport vehicles. They are also associated with such practices as wearing of clothes and other fabrics for long periods without washing or changing. Information was also obtained on the transmission mode of body lice through contaminated beddings, towels or clothes. Therefore, people most at risk of being infested with body lice are those in the states of homelessness, poverty, or living in refugee camps.
Morbidity:
Persistent Itching: The frequent use of pediculicides may sometimes result in persistent itching.
Disease Transmission: Although body lice are not directly known transmitters of several fatal diseases such as epidemic typhus, trench fever, and relapsing fever but they are considered its agents.
Secondary Infections: Possible complications of lice bites depend on the degree of the skin damage and can range from bacterial infections, including MRSA.
Social Impact: However, infestation with lice triggers more embarrassment and exclusion as compared to other forms of parasitic infestations though they are less related to severe medical complications.
Age Group:
Head Lice (Pediculus humanus capitis): Generally, it is more common in kids in their ages from 3 to 12 years. Nevertheless, it can affect all age groups and it is contracted by those people who have close contact with the infested human. Places that children spend most of their time are considered as potential carriers of head lice because while schools and daycare centers children tend to come in close contact with each other.
Body Lice (Pediculus humanus corporis): Affects mostly the teenagers and adults, and usually in conditions where individual hygiene is much of a problem like the homeless or those crowded in very cramped spaces. But it is less frequent where the environment is well cleaned and disinfected.
Head Lice (Pediculus humanus capitis): Among these the parts suspected to be affected should be closely inspected using magnification with the help of a hand mirror, good light and preferably a fine tooth comb.
Signs: Search for pediculosis or live lice, dermatitic pruritic lesions on the scalp, neck, and ears and nits, plugs or small oval eggs glued to the hair shafts especially in the occipital areas and posterior cervical regions.
Body Lice (Pediculus humanus corporis): Check seams of manufactured clothes; the seams of under garments are particularly important.
Signs: They include the live lice which are small, grayish-white insects that infest clothing; nits which are the eggs and laid on the fibers of the clothes; bite marks such as the papular or maculopapular erythematous lesions; excoriations; dermatitis; and signs of secondary infection like impetigo.
Head Lice: Related to touching; in schools or during games or other forms of physical contact. In this case, personal hygiene cannot be considered a major cause, though lice infections are more frequent in populations with closer personal contact.
Body Lice: And associated with poor hygiene, increased population density, and living standards. Prevalent in areas such as shelters, camps, and other transient populations, homeless population included.
Head Lice: Pest infections do not manifest their effects right from the time of infection though they are infectious. Usually, itching and irritation appears 3-4 weeks after the first contact due to the allergy to the saliva of lice. In this case, manifestations such as severe pruritus and the presence of macroscopic ectoparasites (lice or their ova, nits) on the head can be noted.
Body Lice: Signs may manifest in a shorter time, which can be even several days after the pests have invaded a home. There are cases where people modify their skin’s feeling and feel itchy and irritable in regions where garments make connection with their skin. If the skin is scratched this cross can lead to secondary bacterial infections.
The non-pharmacological management of lice and nits involves wet combing, environmental control, and prohibiting sharing of items. The non-pharmacological treatments are such as pyrethrins/piperonyl butoxide, permethrin, malation, vinegar, vermectin, benzyl alcohol spinosad, isopropyl myristate, mineral oil, dimethicone, and abametapir.
Pharmacological interventions are applying pyrethrins/piperonyl butoxide, permethrin, malathion, vermectin, benzyl alcohol, spinosad, isopropyl myristate, mineral oil, dimethicone, and abametapir. Such measures include wet combing, cleaning the environment, vacuuming the living spaces, and treating contacts.
Management phases comprise the diagnostic and evaluation phase, inducting phase; the subsequent phase comprises re-evaluation and regular check-up phase; and the final phase includes the teaching phase concerning prevention and hygiene. The following are non-pharmacological procedures: washing and combing, cleanliness of the environment, and the practice of avoiding sharing of objects. Pharmacological control measures include pyrethrum/piperonyl butoxide, permetherin, malition, vermection, benzyl alcohol, spinosad, isopropyl myristate, mineral oily, dimeticone and abamentapir.
Conventional approaches include nit combing, cleaning of the environment, and contact treatment. Stages for management include the diagnostic and initial evaluation phase followed by stabilization and start of treatment, post treatment or follow up and evaluation, and finally the essential preventative education on hygiene.
Infectious Disease
Wet Combing: Combing the hair with nit comb preferably during the shower when hair is wet and conditioner is applied on hair every three to four days for several weeks without failure until a finding of lice is realized.
Environmental Measures: Wash bedding, clothing, and hats with hot water and iron them with high temperature. Enclose non- washables and place in a plastic bag for two weeks as a part of additional precaution.
Avoid Sharing Personal Items: Avoid the spread by not sharing combs, brushes, hats, gloves, hand bands, socks, shoes, scarfs, handkerchief etc.
Infectious Disease
Permethrins/Piperonyl Butoxide: The first-line treatment for head, pubic, and severe body lice contains pyrethrins, which comes in mousse or shampoo forms. They work through excessive stimulation of the parasites’ nervous system leading to seizure and death. They are rather old over the counter remedies but the treatments work, nonetheless. But they provide a non-enduring amount of the pest control of permethrin and such controls usually need to be reapplied. Pyrethrin products should not be used by persons with ragweed, turpentine or chrysanthemums allergy. These organophosphate acaricides which include abamectin, bifenthrin, clofentezine, fenbutatin, and spirodiclofen are combined with piperonyl butoxide to improve on their efficacy and to check on resistance.
Application: To use: Massage into dry hair, let it sit for 10 minutes, before rinsing it out. If one treatment is not effective and there is proof that live lice are still in the hair after 9 days then a second treatment is advised.
Permethrin (such as Nix and Elimite)
Some people have recommended the use of permethin as the first choice for head lice treatment as well as pubic and severe body lice treatment to children who are over the ages of two months. This neurotoxin immobilizes and kills lice, is superior to crotamiton as decreased symptoms and secondary bacterial infections were observed. Permethrin also leaves the hair after several hair washes since it has a residual effect.
Application: Massage to the scalp then wash it to the roots, suitable for use on the hair just after shampooing and towel drying. A second application is advised 7 days after the first application has been made on the problem area. Because of this, there may be reasons to switch to other types of pediculicides in some geographic locations.
Malathion(Ovide): Malathion, an FDA-approved head lice treatment, is an organophosphorus insecticide that inhibits cholinesterase reactions irreversibly; it is rapidly metabolized in mammals except for insects and their eggs. Some of it can stick to hair and provide a rather limited amount of protection.
Application: Use the 0. 5% lotion on the skin of patients who are 6 years old or older. Since Malathion is flammable, you should not expose it to heat sources such as open flames or heat styling tools.
Ivermectin Topical (for example Sklice, Soolantra): Topical ivermectin eliminates head lice through selective binding to glutamate-gated chloride channels on the parasite that may lead to paralysis and death. It is a safe treatment which can be carried out with one application of 10 minutes and does not involve nit combing.
Ivermectin Oral (e. g., Stromectol): Ivermectin is available in the oral form and is administered in a dosage of 6mg through a pill which inhibits the binding of chloride ion channels in certain invertebrate nerve and muscle cells to cause cell death. It has been used in mass hatching epidemics and for those circumstances or cases when the active pharmacological preparations do not help. Limited data exist for the fetotoxicity outcomes of the compound when used during pregnancy and they do not show that it is toxic to the fetus.
Lindane: It is the second line, being available as 1% lotion, cream, or shampoo which affects the nervous system of the parasite by causing seizure which leads to the death of the parasite. Because of higher risk for side effects including those potentially fatal it is recommended for use only if other medications have failed.
Benzyl Alcohol: This substance was found to be effective in paralyzing the lice since their respiratory spiracles are closed hence leading to suffocation. It is not ovicidal. It has been approved for patients who are six months and older; it is administered two times, first at the time of consultation and the second time a week later, each time for 10 minutes.
Spinosad: The compound paralyzes and kills lice by causing hyperexcitation of the neurons in the insect’s nervous system. It is used for the local treatment of head lice infestation in patients 4 years and older.
Isopropyl Myristate (Resultz): This treatment softens the wax coat round the scalp and body of lice, which results in formation of Daft skin, hence, they die due to dehydration. The physical character of action makes it improbable to develop resistance with its help.
Mineral oil topical: Mineral oil also seems to be a suitable substitute to insecticide and its effectiveness is substantiated by its ability to proffer physical control hence minimizing on insecticide resistance.
Dimethicone Topical: Even though, dimethicone is equally effective in treating head lice with minimal side effects; this makes the lotion more safe than those containing pesticides.
Abametapir (example, Xeglyze): Abametapir 0. 74% lotion is used as a one- time treatment for head lice using a 10-minute application and is recommended for patients of 6 months old and above. It impedes the metalloproteinase that is useful for the growth of eggs and sustenance of lice.
Infectious Disease
Pharmacological Interventions:
Pyrethrins/Piperonyl Butoxide: Rinse it off after leaving it on dry hair for about 10 minutes; it improves hair health and reduces dandruff. It is expected that after 9 days, if necessary, the patient should repeat the procedure.
Permethrin: Wash to be used on damp hair and leave on the hair for 10 minutes then wash off. Repeat after 7 days.
Malathion: Apply 0. 5% lotion applied to dry hair left for 8-12 hours and rinsed out. If not resolved, repeat the examination after 7-9 days of treatment.
Ivermectin Topical: Massage it gently into the scalp and spread onto the hair before leaving it on for 10 minutes and then wash off.
Benzyl Alcohol: Massage gently with fingers into the hair & leave on for 10 minutes and then wash out as usual. Repeat after one week.
Spinosad: It should be applied to the dry hair for about 10 minutes before washing the hair again.
Procedural Interventions:
Wet Combing: Comb the hair with a nit comb made from steel when the hair is wet and conditioned for about three to four days continuously for several weeks.
Environmental Cleaning: Take bathtubs and doing clothes in hot water, cover other items that cannot be washed with plastics for two weeks, and vacuum the rooms.
Treating Contacts: The entire household members and close contact should be inspected and treated at the same time.
Infectious Disease
Specifically, the eradication of Pediculus humanus requires a step-by-step process with distinct phases to optimize the chance of elimination as well as minimize the possibility of reinfestation. They have categorized the process starting from the diagnosis and first evaluation which involve checking on active live lice and nits through physical assessment and history of contact and manifestation of symptoms.
In the diagnosed treatment initiation phase, appropriate pharmacological treatments as pyrethrins/piperonyl butoxide or permethrin should be provided as described in product labeling. In the persistent ones, some other possibilities which can be recommended include malathion or even ivermectin. In this phase, medical management consists of procedural interventions such as wet combing to be repeated every 3 to 4 days and environmental measures where the lice-infested items and living spaces are cleaned.
The ‘follow-up and monitoring’ phase is an essential stage that affirms the effectiveness of the treatment. This involves treatment and auscultation after one and two weeks to ensure that there are no remaining lice and continued treatment where necessary.
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