JRSM > Volume 95, Number 7 > Pp. 348-352

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Wet combing for head lice: feasibility in mass screening, treatment preference and outcome

R H Vander Stichele MD   L Gyssels BA  ¹ C Bracke BA  ¹ F Meersschaut BA  ¹ I Blokland MD  ¹ E Wittouck MD  ² S Willems MA  ³   J De Maeseneer MD PhD  ³

Heymans Institute of Pharmacology, Ghent University, Belgium
¹ Community Health Centres Brugse Poort, De Sleep and Botermarkt, Ghent, Belgium
² Department of Dermatology, Ghent University, Belgium
³ Department of General Practice and Primary Health Care, Ghent University, Belgium

Correspondence to: Dr R Vander Stichele, Heymans Institute of Pharmacology, Ghent University, De Pintelaan 185, B-9000 Ghent, Belgium E-mail: Robert.VanderStichele{at}rug.ac.be

There is no scientific consensus on the best way to control head louse infestation in schoolchildren. A study was conducted to test the feasibility and acceptability of a screening campaign by wet combing and a community approach to head-louse control with home visits, and to explore parents' treatment preferences and treatment outcomes. A non-controlled intervention (advice on treatment options offered to all positive children) was nested within an epidemiological prevalence study. All children in three primary schools in Ghent, Belgium, were invited to take part in screening by wet combing (n=677, 3-11 years). Positive children were offered structural treatment advice, a home visit on day 7, and a check by wet combing on day 14.

83% of the children were screened. The prevalence of active infestation (living moving lice) was 13.0% in school 1 and 19.5% in school 3. In school 2, prevalence of signs of active and past infestation was 40.7%. A home visit was made to 58% of the positive children. 85% of the positive children were screened again on day 14. Wet combing was the most widely used treatment, followed by chemical treatment and a combination of the two. In school 1 and 3 51% were cured, and in school 2 24% became nit-free. A wet combing screening campaign and a community-oriented approach to head-louse control is feasible though resource-intensive. The prevalence of head lice was high and the cure rate was low, with either topical treatments or wet combing.

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