Household-wide ivermectin treatment for head lice in an impoverished community: randomized observer-blinded controlled trial.
Objective To generate evidence on the effectiveness of household-wide treatment for preventing the transmission of pediculosis capitis (head lice) in resource-poor communities. Methods We studied 132 children without head lice who lived in a slum in north-eastern Brazil. We randomized the households...
| Publicado en: | Bulletin of the World Health Organization Vol. 88; no. 2; pp. 90 - 97 |
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| Autores principales: | , , , , , |
| Formato: | clinical trial research tables/charts Journal Article |
| Publicado: |
World Health Organization
Feb2010
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105125351&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105125351 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00429686 BUW jtl: Bulletin of the World Health Organization issn: 00429686 maglogo: N pubinfo: dt: Feb2010 vid: 88 iid: 2 pid: 437 pub: World Health Organization artinfo: ui: 105125351 2010572239 10.2471/BLT.08.051656 NLM20428365 PMC2814473 105125351 ppf: 90 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Household-wide ivermectin treatment for head lice in an impoverished community: randomized observer-blinded controlled trial. aug: au: Pilger D Heukelbach J Khakban A Oliveira FA Fengler G Feldmeier H affil: Institute of Microbiology and Hygiene, Universitütsmedizin Berlin, Hindenburgdamm 27, 12203 Berlin, Germany sug: subj: Lice Infestations Drug Therapy Adolescence Brazil Chi Square Test Child Child, Preschool Clinical Trials Cox Proportional Hazards Model Data Analysis Software Data Analysis, Statistical Descriptive Statistics Female Fisher's Exact Test Funding Source Human Kaplan-Meier Estimator Log-Rank Test Male Mann-Whitney U Test P-Value Sex Factors Structured Questionnaires Adolescent: 13-18 years Child: 6-12 years Child, Preschool: 2-5 years Female Male ab: Objective To generate evidence on the effectiveness of household-wide treatment for preventing the transmission of pediculosis capitis (head lice) in resource-poor communities. Methods We studied 132 children without head lice who lived in a slum in north-eastern Brazil. We randomized the households of the study participants into an intervention and a control group and prospectively calculated the incidence of infestation with head lice among the children in each group. In the intervention group, all of the children's family members who lived in the household were treated with ivermectin; in the control group, no family member was treated. We used the X2 test with continuity correction or Fisher's exact test to compare proportions. We performed survival analysis using Kaplan--Meier estimates with log rank testing and the Mann--Whitney U test to analyse the length of lice-free periods among sentinel children, and we used Cox regression to analyse survival data on a multivariate level. We also carried out a subgroup analysis based on gender. Findings Children in the intervention group remained free from infestation with head lice significantly longer than children in the control group. The median infestation-free period in the intervention group was 24 days (interquartile range, IQR: 11--45), as compared to 14 days (IQR: 11--25) in the control group (P = 0.01). Household-wide treatment with ivermectin proved significantly more effective among boys than among girls (P = 0.005). After treatment with ivermectin, the estimated number of annual episodes of head lice infestation was reduced from 19 to 14 in girls and from 15 to 5 in boys. Female sex and extreme poverty were independent risk factors associated with a shortened disease-free period. Conclusion In an impoverished community, girls and the poorest of the poor are the population groups that are most vulnerable for head lice infestation. To decrease the number of head lice episodes per unit of time, control measures should include the treatment of all household contacts. Mass treatment with ivermectin may reduce the incidence of head lice infestation and associated morbidity in resource-poor communities. © World Health Organization 2010. All rights reserved. pubtype: Academic Journal doctype: clinical trial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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