Head lice infestations in rural Honduras: the need for an integrated approach to control neglected tropical diseases

Abstract

Background Pediculosis capitis is a neglected tropical disease (NTD) that receives little attention in countries where it continues to be endemic. This study aimed to understand the impact of Pediculus humanus capitis infestations in the lives of Honduran children living in extreme poverty. Methods A qualitative study on head lice infestation was conducted in June 2016 in a rural community in Honduras. Parents were invited to bring their children for head lice inspection using a dry‐combing technique with a stainless steel‐toothed comb with suction power. A semistructured questionnaire was administered to participants. Questions were broadly grouped into knowledge about transmission, control practices, barriers to treatment, and the overall impact of these infestations in children's wellbeing. Responses were coded, categorized, and organized through a theme‐based approach. Results In total, 52 children aged 2–14 years (42 girls) and their mothers were enrolled in the study. The overall proportion of children with an infestation was 83%. Response analysis revealed a lack of understanding regarding lice transmission and stigmatization of infested children and the widespread belief that head lice were acquired during bathing in the slow‐flowing river running through the village. An agricultural plaguicide was commonly used to rid children of head lice. Conclusions The study underscores the dire situation of the rural poor, their physical and mental health affected by pediculosis capitis as well as other NTDs. These results highlight the need to reassess approaches and action towards combating NTDS under an integrated framework.

First evidence of the mutations associated with pyrethroid resistance in head lice (Phthiraptera: Pediculidae) from Honduras

“…In Honduras, research on head lice infestation is scarce, with only three studies available in the literature [22][23][24]. In these investigations, reported prevalence of head lice varied from 10 to 83%, which is well above the overall 5% epidemiological value considered to be of epidemic importance [30].…”

“…As in many countries, pediculosis is a neglected infestation in Honduras which is not prioritized in national or regional public health programmes. In fact, ectoparasitic diseases are included in the strategic plan for the prevention, attention, control, and elimination of neglected infectious diseases in Honduras [24]. Currently, permethrin and cypermethrin are the most commonly used OTC pediculicides in the country, with permethrin being the most available compound with 83% of the market share (CAR, personal communication).…”

“…1). Lice were collected from heads of infested children using a dry-combing technique with the aid of an electric V-comb (ToLife Technologies, Welshpool, Australia), a stainless-steel metal comb that utilizes suction power to trap head lice and nits into single-use filters [24]. An adjustable headset with magnifying lenses (MG81001-G-2 led Headband illuminating Magnifier 2; ToLife Technologies) to inspect the head in order to identify the different insect stages was used.…”

“…In Honduras, a few authors have reported that pediculosis is a neglected and serious health problem affecting 10-83% of school-aged children from several regions [22][23][24]. Chemical lice control in Honduras is ubiquitous, with an abundance of pyrethrin and pyrethroid-based products in the market (e.g.…”

“…Notwithstanding, there is a paucity of research on head lice, and no data about head lice insecticide resistance are available for Honduras. With the exception of anecdotal reports about the inefficacy of OTC pediculicides [24], whether insecticide resistance is emerging among head lice populations in the country remains unknown. The present study aimed to investigate the presence and distribution of the nonsynonymous mutation responsible of the T917I kdr substitution in head lice from two localities of Honduras.…”