Background: Intestinal parasitic infections affect child health and development and slow down growth, while reducing adults' productivity and work capacity. The aim of the present study was to determine and compare the incidences of intestinal parasitic infections and the socio-economic status of two near primary school children in Manisa, a western city of Turkey.

BackgroundDimeticone 4% lotion was shown to be an effective treatment for head louse infestation in two randomised controlled trials in England. It is not affected by insecticide resistance but efficacy obtained (70-75%) was lower than expected. This study was designed to evaluate efficacy of dimeticone 4% lotion in a geographically, socially, and culturally different setting, in rural Turkey and, in order to achieve blinding, it was compared with a potential alternative formulation.MethodsChildren from two village schools were screened for head lice by detection combing. All infested students and family members could participate, giving access to treatment for the whole community. Two investigator applied treatments were given 7 days apart. Outcome was assessed by detection combing three times between treatments and twice the week following second treatment.ResultsIn the intention to treat group 35/36 treated using dimeticone 4% had no lice after the second treatment but there were two protocol violators giving 91.7% treatment success. The alternative product gave 30/36 (83.3%) treatment success, a difference of 8.4% (95% CI -9.8% to 26.2%). The cure rates per-protocol were 33/34 (97.1%) and 30/35 (85.7%) respectively. We were unable to find any newly emerged louse nymphs on 77.8% of dimeticone 4% treated participants or on 66.7% of those treated with the alternative formulation. No adverse events were identified.ConclusionOur results confirm the efficacy of dimeticone 4% lotion against lice and eggs and we found no detectable difference between this product and dimeticone 4% lotion with nerolidol 2% added. We believe that the high cure rate was related to the lower intensity of infestation in Turkey, together with the level of community engagement, compared with previous studies in the UK.Trial RegistrationCurrent Controlled Trials ISRCTN10431107

Finding lice can be difficult in head louse infestation. We compared a new louse detection comb with visual inspection. All children in two rural Turkish schools were screened by the two methods. Those with lice were offered treatment and the results monitored by detection combing. Children with nits only were re-screened to identify latent infestations. Using visual inspection we found 214/461 children (46%) with nits but only 30 (6.5%) with live lice. In contrast detection combing found 96 (21%) with live lice, of whom 20 had no nits. Detection combing was 3.84 times more effective than visual inspection for finding live lice. Only 10/138 (7.2%) children with nits and no lice were found to have active infestation by day 16. We found that the detection comb is significantly (P<0.001) more effective than visual screening for diagnosis; that nits are not a good indicator of active infestation; and that treatment with 1% permethrin was 89.6% effective.

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Urinary tract infection is particularly common in young girls and Enterobius vermicularis (pinworm) is one of the most prevalent worms found in children worldwide. Young girls, with or without urinary tract infection, were examined for pinworms in order to explore a possible relationship between these two problems. Of the 55 young girls with urinary tract infection, 20 (36.4%) had pinworm eggs in the perianal and/or perineal region monitored using the cellophane tape method, while 9 (16.4%) of 55 young girls who had never previously had a urinary tract infection were found to have Enterobius eggs in at least one of the cellophane tape tests, and the difference was found to be significant (p<0.05). These results suggested that urinary tract infections may be related to pinworms. When a urinary tract infection is diagnosed in young girls, cellulose tape should be applied to both the perianal and the perineal regions on at least three consecutive occasions.

The efficacy of albendazole for the treatment of giardiasis has been indicated by previous in-vitro and in-vivo studies. In order to compare the therapeutic efficacy of albendazole and metronidazole, 107 Giardia-positive children (aged 3-15 years), diagnosed by three consecutive positive stool examinations, were enrolled in the study. Of these children, 52 were given a single daily dose of albendazole 10 mg/kg for 5 days, and 55 were given metronidazole 20 mg/kg daily in three doses for 7 days. Parasite eradication was achieved in 47 (90.4%) of 52 children treated with albendazole and 49 (89.1%) of 55 children treated with metronidazole (p > 0.05). These results suggest that albendazole is an effective treatment option for childhood giardiasis.

Head lice infestation (HLI) caused by Pediculus humanus capitis has been a public health problem worldwide. Specially designed combs are used to identify head lice, while anti-lice products are applied on the scalp for treatment. In the present study, we aimed to test whether combing only by precision detection comb (PDC) or metal pin comb (MPC) could be effective alternatives to the use of anti-lice products in children. A total of 560 children from two rural schools in Turkey were screened. In the PDC trial, children were combed every second day for 14 days, while in the MPC trial, combing was performed once in every four days for 15 days. Children were divided into two groups (dry combing and wet combing) for both trials and results were compared. The results showed no significant differences between dry and wet combing strategies for both combs for the removal of head lice (p > 0.05). The number of adult head lice declined significantly on each subsequent combing day in both approaches, except on day 15 in the MPC trial. In the end, no louse was found in 54.1 and 48.9% of children in the PDC and MPC trials, respectively. Since family members of infested children were not available, they were not checked for HLI. Four times combing within 2 weeks with MPC combs was found effective for both treatment of low HLI and prevention of heavy HLI. In conclusion, regular combing by special combs decreases HLI level in children and is safely applicable as long-term treatment.