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Open Access 01-12-2009 | Research article

Treatment of head lice with dimeticone 4% lotion: comparison of two formulations in a randomised controlled trial in rural Turkey

Authors: Özgür Kurt, I Cüneyt Balcıoğlu, Ian F Burgess, M Emin Limoncu, Nogay Girginkardeşler, Tuba Tabak, Hasan Muslu, Özge Ermiş, M Turhan Sahin, Cemal Bilac, Hakan Kavur, Yusuf Özbel

Published in: BMC Public Health | Issue 1/2009

Abstract

Background

Dimeticone 4% lotion was shown to be an effective treatment for head louse infestation in two randomised controlled trials in England. It is not affected by insecticide resistance but efficacy obtained (70-75%) was lower than expected. This study was designed to evaluate efficacy of dimeticone 4% lotion in a geographically, socially, and culturally different setting, in rural Turkey and, in order to achieve blinding, it was compared with a potential alternative formulation.

Methods

Children from two village schools were screened for head lice by detection combing. All infested students and family members could participate, giving access to treatment for the whole community. Two investigator applied treatments were given 7 days apart. Outcome was assessed by detection combing three times between treatments and twice the week following second treatment.

Results

In the intention to treat group 35/36 treated using dimeticone 4% had no lice after the second treatment but there were two protocol violators giving 91.7% treatment success. The alternative product gave 30/36 (83.3%) treatment success, a difference of 8.4% (95% CI -9.8% to 26.2%). The cure rates per-protocol were 33/34 (97.1%) and 30/35 (85.7%) respectively. We were unable to find any newly emerged louse nymphs on 77.8% of dimeticone 4% treated participants or on 66.7% of those treated with the alternative formulation. No adverse events were identified.

Conclusion

Our results confirm the efficacy of dimeticone 4% lotion against lice and eggs and we found no detectable difference between this product and dimeticone 4% lotion with nerolidol 2% added. We believe that the high cure rate was related to the lower intensity of infestation in Turkey, together with the level of community engagement, compared with previous studies in the UK.

Trial Registration

Current Controlled Trials ISRCTN10431107

Available only for authorised users

Burgess IF, Brown CM, Lee PN: Treatment of head louse infestation with 4% dimeticone lotion: randomised controlled equivalence trial. Br Med J. 2005, 330: 1423-5. 10.1136/bmj.38497.506481.8F.CrossRef

Burgess IF, Lee PN, Brown CM: Randomised, controlled, parallel group clinical trials to evaluate the efficacy of isopropyl myristate/cyclomethicone solution against head lice. Pharm J. 2008, 280: 371-5. [http://www.pjonline.com/content/randomised_controlled_parallel_group_clinical_trials_to_evaluate_the_efficacy_of_isopropyl_m]

Burgess IF, Lee PN, Matlock G: Randomised, controlled, assessor blind trial comparing 4% dimeticone lotion with 0.5% malathion liquid for head louse infestation. PLoS ONE. 2007, 2 (11): e1127-10.1371/journal.pone.0001127.CrossRefPubMedPubMedCentral

Pilger D, Schwalfenberg S, Heukelbach J, Witt L, Mencke N, Khakban A, Feldmeier H: Controlling tungiasis in an impoverished community: an intervention study. PLoS Negl Trop Dis. 2008, 2 (10): e324-10.1371/journal.pntd.0000324.CrossRefPubMedPubMedCentral

Sim S, Lee I-Y, Lee K-J, Seo J-H, Im K-I, Shin MH, Yong T-S: A survey on head lice infestation in Korea (2001) and the therapeutic efficacy of oral trimethoprim/sulfamethoxazole adding to lindane shampoo. Korean J Parasitol. 2003, 41: 57-61. 10.3347/kjp.2003.41.1.57.CrossRefPubMedPubMedCentral

Balcioglu C, Burgess IF, Limoncu ME, Sahin M, Ozbel Y, Bilac C, Kurt O, Larsen KS: Plastic detection comb better than visual screening for diagnosis of head louse infestation. Epidemiol Infect. 2008, 136: 1425-31. 10.1017/S0950268807000118.CrossRefPubMedPubMedCentral

Balcioğlu IC, Kürt O, Limoncu ME, Dinç G, Gümüş M, Kilimcioglu AA, Kayran E, Özbilgin A: Rural life, lower socioeconomic status and parasitic infections. Parasitol Int. 2007, 56: 129-33. 10.1016/j.parint.2007.01.005.CrossRefPubMed

Ozkol M, Kilimcioğlu AA, Girginkardeşler N, Balcıoğlu IC, Şakru N, Korkmaz M, Ok ÜZ: A discrepancy between cystic echinococcosis confirmed by ultrasound and seropositivity in Turkish children. Acta Trop. 2005, 93: 213-6. 10.1016/j.actatropica.2004.11.002.CrossRefPubMed

Limoncu ME, Kürt O, Gümüş M, Kayran E, Balcioğlu IC, Dinç G, Ozbilgin A: Is there an association between clinical symptoms and intestinal parasitic infections?. Int J Clin Pharmacol Res. 2005, 25: 151-4.PubMed

10.

Ibarra J, Fry F, Wickenden C, Olsen A, Vander Stichele Vander RH, Lapeere H, Jenner M, Franks A, Smith JL: Overcoming health inequalities by using the Bug Busting 'whole-school approach' to eradicate head lice. J Clin Nurs. 2007, 16: 1955-65. 10.1111/j.1365-2702.2007.01795.x.CrossRefPubMed

11.

Department of Human Services: Parent-managed head lice program. A community-based option for head lice management in schools [Internet]. Melbourne, State Government of Victoria, [updated 27 March 2008, cited 16 January 2009], [http://www.health.vic.gov.au/headlice/downloads/pmp.pdf]

12.

Department of Health: Nitbusters: head lice in schools program [Internet]. North Sydney, New South Wales Government, [cited 16 January 2009], [http://www.health.nsw.gov.au/publichealth/environment/headlice/nitbusters.asp]

13.

Vermaak ZA: Model for the control of Pediculus humanus capitis. Public Health. 1996, 110: 283-8. 10.1016/S0033-3506(96)80090-4.CrossRefPubMed

14.

Maunder JW: Resistance to organochlorine insecticides in head lice, and trials using alternative compounds. Med Off. 1971, 125: 27-29.

15.

Maunder JW: Use of malathion in the treatment of lousy children. Community Med. 1971, 126: 145-147.

16.

Donaldson RJ: Prevalence amongst schoolchildren. J R Soc Health. 1976, 96: 55-57. 10.1177/146642407609600204.CrossRef

The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2458/9/441/prepub

Title: Treatment of head lice with dimeticone 4% lotion: comparison of two formulations in a randomised controlled trial in rural Turkey
Authors: Özgür Kurt
I Cüneyt Balcıoğlu
Ian F Burgess
M Emin Limoncu
Nogay Girginkardeşler
Tuba Tabak
Hasan Muslu
Özge Ermiş
M Turhan Sahin
Cemal Bilac
Hakan Kavur
Yusuf Özbel
Publication date: 01-12-2009
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2009
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/1471-2458-9-441

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Treatment of head lice with dimeticone 4% lotion: comparison of two formulations in a randomised controlled trial in rural Turkey

Abstract

Background

Methods

Results

Conclusion

Trial Registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Trial Registration

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