A COMPREHENSIVE REVIEW OF EPIDEMIOLOGY, RESISTANCE AND TREATMENT OF PEDICULUS CAPITIS IN THAILAND
DOI:
https://doi.org/10.55374/jseamed.v9.248Keywords:
Pediculosis capitis, Thailand, Drug resistance, Alternative treatment, Health educationAbstract
Background: Pediculosis capitis, or head lice infestation, is a significant public health issue in Thailand, particularly among school-aged children. Prevalences are high, ranging from 23% to over 80% in various communities. A significant challenge to control efforts is the widespread resistance to common chemical treatments, such as permethrin, caused by knockdown resistance (kdr) mutations. This situation calls for a review to address these challenges to guide public health policies.
Objective: This review aims to consolidate the current literature on the epidemiology, resistance, and treatment strategies for pediculosis capitis in Thailand, highlighting key findings and ongoing challenges.
Methods: A comprehensive search was conducted across five bibliographic databases: PubMed, Scopus, Web of Science, Thai Journals Online (ThaiJO), and Google Scholar, from which 15 relevant articles were selected for this review.
Results: Epidemiological studies confirm a high prevalence of head lice among Thai schoolchildren, reaching up to 83.9% in some areas, with girls being more frequently affected. Molecular studies detected a high frequency of kdr mutations (97.4%) in lice populations across Thailand, which are strongly linked to treatment failure for 1% permethrin lotion (failure rate of 47.5%). Alternative treatments have shown high effectiveness; oral ivermectin achieved a 94.8% cure rate, and 4% dimeticone demonstrated 100% mortality in ex vivo tests. A herbal shampoo demonstrated a 100% cure rate (compared to 3.3% for the placebo), and health education programs reduced the prevalence from 59.2% to 44.1%, while also improving knowledge and practices.
Conclusion: Pediculosis capitis remains a persistent challenge in Thailand, characterized by a high prevalence and significant resistance to permethrin. Alternative treatments, such as ivermectin and dimeticone, combined with health education, are effective ways to control the condition. Future efforts should focus on integrated strategies that combine molecular surveillance and community-based education to tackle drug resistance and the social factors that sustain infestations.
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