Vaccuuming method as a successful strategy in the diagnosis of active infestation by Pediculus humanus capitis

Most human epidemiological and clinical studies use visual inspection of the hair and scalp to diagnose Pediculus humanus capitis , however this method has low sensitivity to diagnose active infestations (presence of nymphs and adult lice). Vacuuming the hair and scalp has been used as a diagnostic...

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Published in:	Revista do Instituto de Medicina Tropical de São Paulo Vol. 62; pp. e7 - 7
Main Authors:	Lustosa, Bruno Paulo Rodrigues, Haidamak, Juciliane, Oishi, Camila Yumi, Souza, Ariela Both de, Lima, Bruna Jacomel Favoreto de Souza, Reifur, Larissa, Shimada, Márcia Kiyoe, Vicente, Vânia Aparecida, Aleixandre, Maria Adela Valero, Klisiowicz, Débora do Rocio
Format:	Journal Article
Language:	English
Published:	Brazil Instituto de Medicina Tropical de Sao Paulo 01-01-2020 Instituto de Medicina Tropical Instituto de Medicina Tropical de São Paulo Universidade de São Paulo (USP)
Subjects:	Animals Brazil - epidemiology Child Child, Preschool Detection Diagnosis Effectiveness Female Hair aspiration Head lice Humans Lice Infestations - diagnosis Lice Infestations - epidemiology Male Observer Variation Original Pediculosis Pediculus Pediculus humanus capitis Physical Examination - instrumentation Physical Examination - methods Prevalence TROPICAL MEDICINE Visual inspection Brazil Pediculosis Pediculus humanus capitis Effectiveness Head lice Prevalence Hair aspiration Diagnosis Detection Visual inspection
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Summary:	Most human epidemiological and clinical studies use visual inspection of the hair and scalp to diagnose Pediculus humanus capitis , however this method has low sensitivity to diagnose active infestations (presence of nymphs and adult lice). Vacuuming the hair and scalp has been used as a diagnostic method, but there are no previous data comparing its effectiveness with visual inspection. The aim of this study was to determine the prevalence of overall infestation (nits and trophic stages), of active infestation by Pediculus humanus capitis , and to evaluate the effectiveness of vacuuming in comparison with the visual inspection. Visual inspection was performed by three examiners and vacuuming of the scalp by one investigator, with an adapted vacuum cleaner. A total of 166 children aged 4 to 10 years old were randomly selected from public schools in Southern Brazil. Considering the positive results obtained by both methods, the prevalence of overall infestation was 63.3%, whereas active infestation was 18.7%. The visual inspection was more effective on diagnosing overall infestation, however, its effectiveness to detect active infestation was lower, ranging from 0.6% (RR=3%, p<0.001) to 6.6% (RR=35%, p=0.001), depending on the number of examiners. The effectiveness of vacuuming to diagnose active infestation was higher than the one of visual inspection, with a prevalence rate of 16.3% (RR=87%, p=0.332). As presented in our study, the vacuuming method was 2.74 to 7.87 times most likely to detect active infestation, thus it could be adopted as a more accurate method to diagnose active pediculosis.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 JH, CYO, VAV and DRK contributed to the study conception and design; JH, CYO, ABS and BJFSL attended the patients, applied the questionnaire and obtained the data and the informed consent from the patients and their legal guardians; JH, CYO and DRK performed the lab experiments; BPRL, LR, MKS, MAV and DRK analyzed the data and wrote the manuscript. All of the authors have read the paper and approved the final version. CONFLICT OF INTERESTS AUTHORS’ CONTRIBUTIONS The authors state that they have no conflict of interest to declare.
ISSN:	1678-9946 0036-4665 1678-9946
DOI:	10.1590/s1678-9946202062007