Overcoming health inequalities by using the Bug Busting ‘whole‐school approach’ to eradicate head lice

Ibarra, Joanna; Fry, F. A.; Wickenden, Clarice; Olsen, Alice; Stichele, Robert Vander; Lapeere, Hilde; Jenner, Maryan; Franks, Andrea; Smith, Jane

doi:10.1111/j.1365-2702.2007.01795.x

Cited by 24 publications

(25 citation statements)

References 31 publications

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“…Much professional time spent previously with the large number of worried parents could now be saved, and adequate time given to the few families who were dependent on one-to-one guidance. 51,52 D DI IS SC CU US SS SI IO ON N The 1970-1973 Teesside experience 10,12,30 revealed that co-ordinated detection compensated for poorly performing treatments in an anti-head louse campaign. Families became aware that they could not rely on medication to kill louse eggs and intensified egg removal with a Derbac comb.…”

Section: -2008mentioning

confidence: 98%

The impact of well-developed preventative strategies on the eradication of head lice

Ibarra

Fry

Wickenden³

et al. 2009

Perspect Public Health

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In the 1970s Donaldson applied the principles of infectious disease surveillance to pediculosis capitis infestation with head lice. This provided a lasting insight into an effective strategy for prevention. Research in Teesside, UK, proved that the first step in breaking the chain of transmission is the engagement of parents in an intensive detection/treatment campaign. United action halved the infestation rate, even though failing lindane treatments were in use. Subsequently although effective malathion treatment was introduced, it became clear that the late detection of light cases of head lice still undermines eradication. This paper analyzes the development by the health charity, Community Hygiene Concern, of the Bug Busting programme based on this solid evidence. In the 1990s the charity solved the problem of detecting asymptomatic lice using a specially designed Bug Buster louse comb in wet, conditioned hair. It undertook the popularization of this method and the co-ordination of national detection days (Bug Busting Days) through primary schools. In 2004 this structured approach to prevention was adopted in Chester. It produced a 24% reduction in health authority spending on treatment products in the first year and appreciable savings in professional time. It is concluded that participation in the Bug Busting programme benefits community health providers and schools. Provision of dependable detection combs with the correct instructions to families at risk, empowers them to gain sustainable, cost-effective control of head lice.

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Section: -2008mentioning

confidence: 98%

The impact of well-developed preventative strategies on the eradication of head lice

Ibarra

Fry

Wickenden³

et al. 2009

Perspect Public Health

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“…Relying on products alone to contain head louse infestations at a reasonable level will not be sufficient. Public health programs at local community level involving parents, schools, and community services with accurate screening methods (Combescot 1990;Demaeseneer et al 2000;Mumcuoglu et al 2007;Jahnke 2009) and synchronized treatment campaigns with effective treatments will be needed (Meinking et al 1986;Combescot 1990;Ibarra et al 2007;Feldmeier 2012).…”

Section: Recommendations For Practicementioning

confidence: 99%

Ex vivo effectiveness of French over-the-counter products against head lice (Pediculus humanus capitis De Geer, 1778)

et al. 2015

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Head lice infestation is still a public health problem worldwide, with an intracountry and intercountry prevalence variation of 0.7 to 59%. There is a large variety of over-the-counter anti-louse products, but their efficacy is not always well assessed. Our objective was to test the pediculicidal and ovicidal efficacy of 21 over-the-counter head louse products, available in France during the period of 2008 to 2012. We tested children living in Tours City in central France and visiting preschools, primary schools, kindergarten, camps, and child care facilities, as well as children in their family houses, and were examined for the presence of lice. The products were collected from randomly selected pharmacies by covert investigators and then tested in the laboratory on an ex vivo sample of head lice and their eggs, collected from the hair of infested children. Living lice and unharmed eggs were collected from the scalps of 3-12 years old. The laboratory conditions for ex vivo testing mimicked the manufacturers' instructions for exposure time and application method. In 21 runs, 3919 living lice and 4321 undamaged living eggs were collected from the scalp of over 400 children. The 21 products were classified in three groups: 6 products in a group of potentially 100% pediculicidal activity and potentially 100% ovicidal activity, 8 products in a group of potentially 100% pediculicidal activity but insufficient ovicidal activity (including 2 products with claims of single application treatment), and 7 products in a group of insufficient pediculicidal activity and ovicidal activity. The pharmaceutical market for head lice products in France is swamped with poorly tested and ineffective products. Rigorous efficacy testing preregistration and periodic screening and testing of effectiveness in the post-registration period should be endorsed by the health authorities.

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“…At the time of the study the most widely promoted combing method was “Bug-Busting” (Community Hygiene Concern, London), which used a fine toothed plastic comb for wet combing with conditioner, repeated at 3–4 day intervals for 2 weeks. It suggested the first combing could remove all lice so only newly hatched nymphs would be found during subsequent combing sessions before they could mature and lay eggs 5 . Before our investigation only two studies of wet-combing had been conducted.…”

Section: Introductionmentioning

confidence: 99%

Comparison of phenothrin mousse, phenothrin lotion, and wet-combing for treatment of head louse infestation in the UK: a pragmatic randomised, controlled, assessor blind trial

Burgess¹,

Brown²,

Nair

2014

F1000Res

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In this investigation of effectiveness of an alternative pediculicide dosage form, we recruited 228 children and 50 adult participants from Bedfordshire, UK, to a randomised, controlled, assessor blind trial comparing two insecticide products with mechanical removal of lice as a control group. Participants using insecticide were treated with either the investigative 0.5% phenothrin mousse, for 30 minutes, or 0.2% phenothrin lotion, for 2 hours as the reference product. Both treatments were applied only once, followed by shampoo washing. Those treated by wet-combing with conditioner were combed 4 times over 12 days. Parents/carers carried out the treatments to mimic normal consumer use. The outcome measure was the absence of lice, 14 days after treatment for the insecticides, and up to 14 days after completion of combing. Intention to treat analysis of the outcomes for 275 participants showed success for phenothrin mousse in 21/105 (20.0%), in 23/107 (21.5%) for phenothrin lotion, and in 12/63 (19.1%) for wet-combing. People receiving mousse were 1.07 (95% CI, 0.63 to 1.81) times more likely to still have lice after treatment compared with those treated with lotion. The group of participants who received the wet combing treatment were 1.13 (95% CI, 0.61 to 2.11) times more likely to still have lice after the treatment. None of the treatments was significantly (p < 0.05) more effective than any other. This study was carried out in an area where moderate resistance to phenothrin was demonstrated after the study by using a bioassay. Analysis of post treatment assessments found that failure of insecticides to kill louse eggs had influenced the outcome.

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Overcoming health inequalities by using the Bug Busting ‘whole‐school approach’ to eradicate head lice

Abstract: Incorporation of the Bug Busting approach to head lice into clinical practice in school communities contributes to sustainable control whilst overcoming health inequalities in participating families.

Cited by 24 publications

References 31 publications

The impact of well-developed preventative strategies on the eradication of head lice

The impact of well-developed preventative strategies on the eradication of head lice

Ex vivo effectiveness of French over-the-counter products against head lice (Pediculus humanus capitis De Geer, 1778)

Comparison of phenothrin mousse, phenothrin lotion, and wet-combing for treatment of head louse infestation in the UK: a pragmatic randomised, controlled, assessor blind trial

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