Assessment of topical versus oral ivermectin as a treatment for head lice

Ahmad, Hesham M.; Abdel-Azim, Eman S.; Abdel-Aziz, Rasha T A

doi:10.1111/dth.12144

Cited by 24 publications

(7 citation statements)

References 12 publications

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“…Ivermectin was considered an alternative treatment in this study. Its efficacy has been supported by many studies [7,17,18,22,28]. The present study revealed that the cure rates of oral IVM were 93.4%, 95.0%, and 99.4% on days 7, 14, and 28, respectively.…”

Section: Discussionsupporting

confidence: 77%

“…Typically, the infested person will apply approximately 30 ml of topical 25% benzyl benzoate lotion thoroughly onto a dry scalp until wet and leave the lotion on the affected area for 12 to 24 hr before rinsing off with shampoo and water; application is usually repeated on Day 7. This treatment has been reported to cause irritation and burning sensations, especially in the scratched or infected scalp [17,18]. Several oral-ivermectin treatments have been studied, particularly in hard-to-treat head-lice infestations [17–23].…”

Section: Introductionmentioning

confidence: 99%

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Prevalence and Alternative Treatment of Head-Lice Infestation in Rural Thailand: A Community-Based Study

et al. 2019

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Head-lice infestation, pediculosis capitis, remains a public-health burden in many countries. The widely used first-line pediculicides and alternative treatments are often too costly for use in poor socio-economic settings. Ivermectin has been considered an alternate treatment for field practice. This study was composed of 2 parts, a cross-sectional survey and an intervention study. The main objectives were to determine the prevalence and potential factors associated with head-lice infestation, and to evaluate the effectiveness and safety of oral ivermectin administration. A community-based cross-sectional survey was conducted among 890 villagers in rural areas along Thai-Myanmar border. Females with infestations were eligible for the intervention study, and 181 participated in the intervention study. A post-treatment survey was conducted to assess acceptance of ivermectin as a treatment choice. Data analysis used descriptive statistics and a generalized-estimation-equation model adjusted for cluster effect. The study revealed the prevalence of head-lice infestation was 50% among females and only 3% among males. Age stratification showed a high prevalence among females aged <20 years, and among 50% of female school-children. The prevalence was persistent among those with a history of infestation. The major risk factors were residing in a setting with other infected cases, and sharing a hair comb. The study also confirmed that ivermectin was safe and effective for field-based practice. It was considered a preferable treatment option. In conclusion, behavior-change communication should be implemented to reduce the observed high prevalence of head-lice infestation. Ivermectin may be an alternative choice for head-lice treatment, especially in remote areas.

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Section: Discussionsupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Prevalence and Alternative Treatment of Head-Lice Infestation in Rural Thailand: A Community-Based Study

et al. 2019

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“…It should be noted that these municipalities have a zero prevalence of PC infestation. Furthermore, ivermectin has shown its effectiveness in the treatment of PC after oral or local administration ( Ahmad et al, 2014 ; Chosidow et al, 2010 ; Nofal, 2010 ). Coscione et al (2018) demonstrated that ivermectin used for scabies control, had a collateral benefit on head lice infestation, as well.…”

Section: Discussionmentioning

confidence: 99%

Pediculosis capitis in Abidjan, Côte d'Ivoire: Epidemiological profile and associated risk factors

Denis

Angora

Miezan

et al. 2020

Parasite Epidemiology and Control

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Pediculosis capitis (PC) is a parasitic infestation, common in children's communities caused by Pediculus humanus capitis . Various factors including infestation-related stigma, treatment cost and health risks make this infestation deserves special attention. This study aims to determine epidemiological profile of pediculosis capitis twenty years after the last study in Abidjan, Côte d’Ivoire. An epidemiological cross-sectional survey was carried out from April to June 2018 across 40 public primary schools in the ten districts of Abidjan. Data from schoolchildren and parents and/or guardians were collected using a pretested questionnaire after agreement and signature of the informed consent form. Head lice were identified visually with a magnifying glass, and then collected using fine combs and hairbrushes. The positive diagnosis was made by the detection of living lice in the hair. Of the 4, 805 included participants, 28 (0.58%) were hosting living lice in hair. Analysis of associated factors showed that gender related-status was associated with PC. In this case, girls were more affected than boys (p=0.018). Plateau, Treichville and Port Bouët municipalities were the most affected (p=0.018). The length hair was associated with the occurrence of PC (p<0,001). Schoolchildren from families with low monthly income was most infected by PC (p=0.023). Some parameters such as promiscuity and collective use of washing facilities and bedding, were not found to be associated to head lice infestation. This study shows a drastic decrease of PC prevalence in Abidjan corresponding to 97%. This could be due to the improvement in the quality of life and education of the population of Abidjan. The establishment of hygiene committees and the teaching of basic hygiene practices from the first school years have contributed to these achievements. Maintaining these measures will contribute to the sustainable elimination of CP among children in Abidjan.

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“…Second, ivermectin is currently the only molecule used as an oral treatment against lice. For head lice, oral route avoids suboptimal shampoo application, thus reducing the emergence and transmission of resistant lice [28,[68][69][70]. For body lice, oral dosing is of particular interest to treat people having a limited access to basic hygiene services.…”

Section: New Insights Into the Mode Of Action Of Ivermectin On Licementioning

confidence: 99%

Distinct molecular targets for macrocyclic lactone and isoxazoline insecticides in the human louse: new prospects for the treatment of pediculosis

Lamassiaude

Toubaté

Neveu

et al. 2020

Preprint

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BackgroundControl of infestation by cosmopolitan lice (Pediculus humanus) is increasingly difficult due to the transmission of resistant parasites to pediculicides. However, since the targets for pediculicides have no been identified in human lice so far, their mechanism of action remain largely unknown. The macrocyclic lactone, ivermectin is active against a broad range of insects including human lice. Isoxazolines are a recent new chemical class targeting the γ-aminobutyric acid (GABA) receptor made of the resistant to dieldrin (RDL) subunit and exhibiting a strong insecticidal potential. Here, we addressed the pediculicidal potential of isoxazolines and deciphered the molecular targets of ivermectin and the novel ectoparasiticide lotilaner in the human body louse species Pediculus humanus humanus.Methods and findingsUsing toxicity bioassays, we showed that fipronil, ivermectin and lotilaner are efficient pediculicides on adult lice. The RDL (Phh-RDL) and glutamate-gated chloride channel subunits (Phh-GluCl) were cloned and characterized by two-electrode voltage clamp electrophysiology in Xenopus laevis oocytes. Phh-RDL and Phh-GluCl formed functional homomeric receptors respectively gated by GABA and L-glutamate with EC50 values of 6.4 µM and 9.3 µM. Importantly, ivermectin displayed a super agonist action on Phh-Glucl whereas Phh-RDL receptors were weakly affected. Reversally, lotilaner strongly inhibited the GABA-evoked currents in Phh-RDL with an IC50 value 0.5 µM, whereas it had no effect on Phh-GluCl.ConclusionsWe report here for the first time the pediculicidal potential of isoxazolines and reveal the distinct mode of action of ivermectin and lotilaner on GluCl and RDL channels from human lice. These results emphasize the clear repurposing future of the isoxazoline drug class to provide new pediculicidal agents to tackle resistant-louse infestations in humans.Autorship summaryWhy was this study done?Human cosmopolitan lice are responsible for pediculosis, which represent a significant public health concern. Resistant lice against insecticides and lack of safety of the treatments for human and environment is a growing issue worldwide. Here we investigated the efficacy on lice of the classical macrocyclic lactone drug, ivermectin, and the novel isoxazoline drug, lotilaner. This study was done to decipher their mode of action at the molecular and funtional levels in order to propose new strategies to control lice infestation.What did the researchers do and find?Our bioassay results indicate that ivermectin and lotilaner were potent at killing human adult lice, with lotilaner showing a higher efficacy than ivermectin. Furthermore, we identified and pharmacologically characterized the first glutamate- and GABA-gated chloride channels ever described in human lice yet. Mechanistically, our molecular biology and electrophysiology findings demonstrate that ivermectin acted preferentially at glutamate channels while lotilaner specifically targeted GABA channels.What do these findings mean?These results provide new insights in the understanding of the insecticide mode of action and highlight the isoxazolines as a new drug-repurposing opportunity for pest control strategies.

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Assessment of topical versus oral ivermectin as a treatment for head lice

Cited by 24 publications

References 12 publications

Prevalence and Alternative Treatment of Head-Lice Infestation in Rural Thailand: A Community-Based Study

Prevalence and Alternative Treatment of Head-Lice Infestation in Rural Thailand: A Community-Based Study

Pediculosis capitis in Abidjan, Côte d'Ivoire: Epidemiological profile and associated risk factors

Distinct molecular targets for macrocyclic lactone and isoxazoline insecticides in the human louse: new prospects for the treatment of pediculosis

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