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ORIGINAL CONTRIBUTIONS |
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| Year : 2002 | Volume
: 56
| Issue : 9 | Page : 449-452 |
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A study of pediculosis capitis among primary school children in Delhi
A Khokhar
Department of Community Medicine, Maulana Azad Medical College, Delhi-110002,
Correspondence Address:
A Khokhar
Department of Community Medicine, Maulana Azad Medical College, Delhi-110002
PMID: 12710343
How to cite this article:
Khokhar A. A study of pediculosis capitis among primary school children in Delhi. Indian J Med Sci 2002;56:449-52 |
Pediculosis capitis or head louse infestation has been known to be a world wide public health problem specially among school age children for a long time[1]. Although age group most at risk is generally 6-12 years, adults and older children who have familial contact with a child or primary school children are also susceptible to infection.[2] is widely accepted that the school environment helps in the spread of the infestation simply because it affords opportunity for continual close contact of children. However prevalence of infestation and pattern of transmission is also largely influenced by the family size and number of school age children in the family.[3],[4],[5]
Pediculosis is a blood ectoparasite of man that lives on scalp and hair. Both larvae and adults take two blood meals daily, with repeated exposure the host develops an inflammatory hypersensitivity reaction manifesting as a small red papule at each new feeding site. Pruritus results in scratching, a weeping dermatitis and secondary infection.[6]
Although lice have been described as the commonest ectoparasite of man in the tropics but most of what is known about the infestation has been drawn from studies conducted in Europe and America[7]. The current study was undertaken with the objective to determine the prevalence and distribution of Pediculosis humanus capitis among primary school children and to identify factors involved in the spread. Such studies would help to provide relevant information and impetus for planning of measures for the commonest infestation among school children and health education messages.
| € Material and methods | |  |
Primary school children of four of the government run schools located in the vicinity of Maulana Azad Medical College, Delhi were studied. These schools were chosen for convenience of the study. There were a total of 995 children enrolled from 1st to 5th standard. Out of which 940 could be contacted for the purpose of the study. The study was conducted between July and October 2001.
Infestation was determined by inspection of each child's head with. the aid of magnifying hand lens, if necessary, which was considered infested if at least one adult, nymph or an egg of the louse was present.
After the inspection the children were interviewed using interview schedule forms which contained questions pertaining to age, sex, family history of louse infestation, knowledge about prevention of transmission and history of sharing bedding and comb. All the children were educated about prevention and control of this infestation. All those found to be infested were treated.
Socio-economic classification was done according to Gupta et al classification.[8] The data was analyzed on the computer using the Epiinfo version 6.0.
| € Results | | |
A total of 940 primary school students from four of the Government run schools of Delhi were interviewed and examined. 548 (58.29%) of them were males and 392(41.70%) females. Hindus constituted 818(87.02%), Muslims 94(10%) and others 28(2.2\97%). Majority, 592(62.97%) belonged to lower income group and 300 (31.91 %) to lower middle and 48(5.10%) to upper middle. A total of 156/940(16.59%) were found to be infested with head louse. A significantly higher proportion of girls (20.42%) were found to be infested as compared to boys (13.86%)p<0.05.
From history, out of a total of 156 infested, 102(65.38%) were aware of the infestation. 54/156(34.61 %) did not give a history of infestation but on examination were found to be otherwise. Age-wise no difference was found in the infestation of boys, girls and both groups combined (p>0.05). Those who shared both bedding and the comb showed a higher infestation rate (p<0.05) [Table 1]. As many as 71/102(69.60%) of the subjects who were aware of the infestation had practiced manual removal of the lice, 58(56.86%) of the subjects had used a comb, 17(16.66%) had tried shaving of the hair from the head, 6(5.88%) had used a medicated shampoo to kill the lice and 4(3.92%) had used the medicated oil.9(8.8%) subjects had tried using lime and kerosene oil and 16(15.68%) did not use any remedy.
Only 16(1.70%) had no knowledge about modes transmission of head louse. 584(62.21%) had knowledge about transmission of head louse by comb and brush, 319(33.93%) of person to person contact, 12(1.27%) clothing, 9(0.95%) bedding. 16(1.70%) were not aware of any means of spread. As many as 640(68.08%) had knowledge about manual removal as means of control of spread followed by comb, 596(63.40%), oil 54(5.74%) and shampoo 49 (5.21 %). 69(7.34%) mentioned about other methods like use of kerosene oil and lime powder.
| € Discussion | | |
Head louse infestation was observed to be a common condition among primary school children as has also been documented by others[1],[2],[9] Sarkar et al in their study reported the maximum infestation in the age group of 3 to 10 years[10] In the current study higher proportions of girls were infested as compared to boys. Negi et al who conducted their study in Garwal region of UP found the prevalence among girls to be 35.8% as compared to 11.2% among boys.[11] Bhatia in his study conducted in semi-urban community of Delhi, Bhansali et al among school children of Udaipur[12] Koley et al in their research in children from district Bankura[13] and Sharma et al[14] ad in their work conducted among urban school children also found the prevalence of infestation to be higher among girls. Girls generally have longer hair as compared to boys and longer hair require better grooming and combing. Sharing of bedding and combs by children is strongly associated with pediculosis among them. Overcrowding and poor standard of hygiene of the children are basically responsible for the high degree of infestation found among children.
Some of the subjects mentioned use of lime powder and kerosene oil. Unsafe practices in the treatment of pediculosis capitis like alcohol, kerosene oil and insecticides has also been observed by Magee[15].
As manual removal of head louse was found to be the most popular remedy adopted by those infested but one is likely to incompletely remove the head louse by this method one needs to educate them about complete removal of head louse by more effective means.
Parents should be advised if one member of the family had head lice other close members should be checked for lice. Also parents should be advised to tell the school or playgroup or parents of their children's friend so that all the close contacts can be checked and treated. School teachers should be taught how to recognize louse infestation and school health inspection made compulsory. The school health team should be responsible for treating and preventing the lice infestation besides carrying out other school health services functions.
If however, all families with young children were to routinely check of live lice on weekly basis using a plastic comb, they would have a good chance of finding an infection before it had time to establish. Also families should not suspect lice for inappropriate reasons such as itching of the scalp which occurs only in a minority of head louse infestation and finding old, empty egg shells attached to the hairs.
| € Summary | | |
A cross-sectional study was conducted among primary school children of four of the government run schools of Delhi during July-October 2001. Out of a total of 940 study subjects studied 156 (16.59%) were found to be infested with head louse. Significantly higher proportions of girls (20.42%) were found to be infested as compared to boys (13.86%). 65.38% of those infested were aware of the infestation. Those who shared both bedding and comb showed a statistically higher significance as compare to others. Manual removal of head louse and nits was practiced by 69.60% of those aware of the infestation. Majority had knowledge of transmission of head louse by comb/brush. 66.08% had knowledge about control of head louse infestation spread by manual removal 7.34% mentioned other means like kerosene oil and lime powder.
Since head louse infestation is a common problem of school going children both parents and teachers along with the students should be taught how to recognize the infestation. Also school health teams should be responsible for treatment and prevention of louse infestation besides carrying our other school health service functions.
| € References | | |
| 1. | Jinadu MK, Pediculosis Humanus Capitis among Primary school children in Ile-Ife, Nigeria. J Roy Soc HIth 1985;1:25-27.  |
| 2. | Burgress FI. Head Lice-developing a practical approach. The Practitioner 1998;242:126-129. |
| 3. | Maunder JW. Pediculosis Capitis in a zoological context. J Roy Soc Hlth 1982; 102:255-57. |
| 4. | Donaldson RJ. The head louse in England, prevalence among school children. J Roy Soc Hlth 1976;96:55-57. |
| 5. | Petrelli G, Majors L, Maggini M, Maroli M. The head louse in Italy: An epidemiological study among school children. J Roy Soc Hlth 1980; 100:64-66. |
| 6. | Wilson Braunwald, Isselbachen et al. Harrison's Principles of Internal Medicine. Pediculosis, 1991, 10th edition; 1:832-833. |
| 7. | Iwuala MOE Onyeka JOA. The incidence and distribution of head lice infestation among elementary and primary school pupils. Nig Med J 1977; 2:274. |
| 8. | Gupta MC Modified BK.Text book of Preventive and Social Medicine ppl 35, Publishers-Jaypee brothers, 2nd edition, 199 7. |
| 9. | Hong HK, Kim CM, Lee WJYangYC Infestation rate of head lice in primary school children in Inchon, Korea. KorJ Parasitiology 1995;33:243- 244. |
| 10. | Sarkar R, Kanwar AJ. Three common Dermatological Disorders in children (Scabies, Pediculosis and Dermatophytoses) in children. Indian Paed 2001; 38; 995-1008. |
| 11. | Negi KS, Kandpal SD, Prasad, D. Pattern of skin diseases in children in Gatwahal Region in U.P. Indian Paed 2001;38:77-80. |
| 12. | Bhatia KK. Pattern of skin diseases in a semiurban community in Delhi. Indian J Dermatol Venerol Leprol 1984; 50:213-214. |
| 13. | Bhansali KM, Mathur G.M. Sharma, RA Study of morbidity pattern in pre-school children (Udaipur). Indian J Dermatol Venerol Leprol 1979;46:13-17. |
| 14. | Sharma NK,Garg N. Pattern of skin diseases in urban school children. Indian J Dermatol Venerol Leprol 1986;6:330-331. |
| 15. | Magee J Unsafe practices in the treatment of pediculosis capitis. J Sch.Nurs, 1996,,12:17-20. |
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