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Resumen Introducción. La infestación por piojos de la cabeza en humanos (Pediculus humanus capitis) se conoce como pediculosis capitis. Estos parásitos pueden ser vectores de enfermedades infecciosas con potencial reemergente. Objetivos. Revisar la literatura actual sobre las enfermedades infecciosas transmitidas por piojos de la cabeza y realizar una breve descripción de sus manifestaciones clínicas. Materiales y métodos. Se realizó una revisión de la literatura en Medline, ScienceDirect, Google Scholar y SciELO mediante la siguiente estrategia de búsqueda: años de publicación: 1938 a 2019; idioma: inglés y español; términos de búsqueda: "Pediculus", "lice infestations", "bacteria", "emerging communicable diseases", "Rickettsia", "Bartonella", "Borrelia", "Acinetobacter", "Yersinia", and "Colombia", y sus equivalentes en español. Resultados. De los 110 artículos incluidos, la mayoría correspondió a investigaciones originales (48.2%). A nivel mundial, numerosos estudios han reportado la transmisión de Rickettsia prowazekii, Bartonella quintana, Borrelia recurrentis, Staphylococcus aureus, Acinetobacter bau-manniiy Yersiniapestis, entre otras bacterias, por los piojos de la cabeza y del cuerpo en humanos. Conclusiones. Aunque las enfermedades infecciosas transmitidas por piojos de la cabeza son raras, guardan potencial reemergente en poblaciones afectadas por migraciones humanas, crisis sociopolíticas, indigencia e inmunosupresión. En Colombia no se han realizado investigaciones sobre la transmisión de estas enfermedades por Pediculus spp., por lo que se sugiere que en estudios futuros se determine la prevalencia y los aspectos epidemiológicos de las enfermedades transmitidas por piojos de la cabeza.

Abstract Introduction: Head lice (Pediculus humanus capitis) infestation in humans is known as pediculosis capitis. These parasites can be vectors of potentially re-emerging infectious diseases. Objective: To review the current literature on infectious diseases transmitted by head lice and provide a brief description of their clinical manifestations. Materials and methods: A literature review was conducted in the Medline, ScienceDirect, Google Scholar and SciELO databases using the following search strategy: Publication time: 1938 to 2019; Publication language: English and Spanish; Search terms: "Pediculus", "lice infestations", "bacteria", "emerging communicable diseases", "Rickettsia", "Bartonella", "Borrelia", "Acinetobacter", "Yersinia", and "Colombia", and their Spanish equivalents. Results: Of the 110 studies included in the review, most of them were original research articles (48.2%). Worldwide, many studies have reported the transmission of Rickettsia prowazekii, Bartonella quintana, Borrelia recurrentis, Staphylococcus aureus, Acinetobacter baumannii and Yersinia pestis, among other bacteria, by head and body lice in humans. Conclusions. Although infectious diseases transmitted by head lice are rare, they have the potential to become re-emerging infectious diseases in population groups affected by human migration processes, socio-political crises, homelessness, and immunosuppression conditions. In Colombia, so far, there are no studies on the transmission of these bacterial diseases by Pediculus spp., so in future studies the prevalence and epidemiological characteristics of human head louse-borne diseases should be determined.

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A study of head lice infestations among young people, adults and elderly individuals was conducted from August 2010 to July 2013 in Manaus, AM, Northern Brazil. Hair samples collected from 1,860 individuals in 18 barber shops and beauty parlors were examined for the ectoparasite. The occurrence of pediculosis and its association with factors, such as sex, age, ethnicity, hair characteristics and the socioeconomic profile of salon customers, salon location and seasonal variation were determined. The overall occurrence rate was 2.84%. Occurrence was higher in hair samples from non-blacks and the elderly. Higher occurrence was also observed during kindergarten, elementary and junior education school holidays. The results indicate that the occurrence of head lice among young people, adults and the elderly in Manaus is relatively low compared to that determined in children and in other regions of the country. After children, the elderly were the most affected. The study also indicated the need to adopt additional procedures to improve surveys among the population with low or no purchasing power, which is usually the most affected by this ectoparasitic disease.

Estudo sobre a pediculose do couro cabeludo em jovens, adultos e idosos foi realizado de agosto de 2010 a julho de 2013 em Manaus - AM, região norte do Brasil. Amostras de cabelos obtidas de 1.860 indivíduos em 18 barbearias e salões de beleza foram examinadas à procura do parasito. Procurou-se verificar a ocorrência da pediculose e sua associação com fatores tais como: sexo, idade, etnia, características dos cabelos e perfil socioeconômico dos clientes dos salões, localização dos salões e variação sazonal. A taxa de ocorrência encontrada foi 2,84%. Ela foi maior em amostras de cabelos de não negros e dos idosos. Também se observou maior prevalência no período de férias escolares do ensino fundamental e médio. Os resultados indicam que a ocorrência da pediculose em jovens, adultos e idosos em Manaus é relativamente baixa em comparação com as encontradas em crianças e as encontradas em outras regiões do país. Depois das crianças, os idosos seriam os mais acometidos. O estudo também indica a necessidade de adotar procedimentos adicionais para melhor amostrar a faixa da população com menor ou com nenhum poder aquisitivo, a qual geralmente é a mais acometida por esta ectoparasitose.

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INTRODUCCIÓN: la automedicación y el uso de diversos productos como pediculicidas parece ser frecuente entre los convivientes para tratar de eliminar los piojos de la cabeza en los escolares. OBJETIVO: analizar el uso deliberado, por los convivientes con educandos de primaria, de diversos productos para controlar la pediculosis capitis en los niños. MÉTODOS: se realizó una encuesta por cuestionario e intercambio de opiniones con 896 convivientes con niños entre 5 y 10 años, que estudiaban en 19 escuelas urbanas y semiurbanas de primera enseñanza, de las provincias de las zonas occidental, central y oriental de Cuba, sobre los productos utilizados para controlar o eliminar los piojos de la cabeza. RESULTADOS: la población encuestada cita más de 40 productos. Entre las sustancias más reportadas se encuentra el alcohol, el DDT y el lindano, que fueron anteriormente rechazados por su toxicidad e ineficacia. Se reportan en uso productos empleados en la agricultura, la salud pública y la medicina veterinaria para el control de plagas; entre ellos, temephos, esteladón, malathion, parathión, baytex; también derivados del petróleo como el líquido de freno, keroseno y la gasolina. CONCLUSIÓN: en el trabajo se refieren numerosas sustancias tóxicas utilizadas en la terapóutica para el control de Pediculus capitis en niños, cuyo riesgo supera los beneficios esperados. Resulta bajo el porcentaje de personas que utilizan la extracción manual como único tratamiento, no obstante ser el método menos dañino y más eficaz (AU)

INTRODUCTION: self-medication and use of several products as peliculicides seem to be common procedures for those persons living with schoolchildren, in order to eliminate head lice. OBJECTIVE: to analyze the deliberate use of several products by the people living with elementary school children, so as to control their pediculosis capitis. METHODS: a questionnaire- and exchange of opinion-based survey on the products used to control or eliminate head lice was administered to 896 people who lived with children aged 5 to 10 years. These children studied in 19 elementary schools in urban and suburban areas located in the western, central and eastern provinces of Cuba. RESULTS: the surveyed population mentioned more than 40 products. Among the most reported substances were alcohol, DDT and lindano which were previously rejected owing to their toxicity and ineffectiveness. There were also reports on products from agricultural, public health and veterinary medicine, including those devoted to plague control such as temephos, steladon, malathion, parathion, baytex; also oil derivatives like brake fluid, kerosene and gasoline. CONCLUSIONS: the paper mentioned a number of toxic substances used in treating Pediculus capitis in children, the risks of which outweighted the expected benefits. The percentage of persons who manually remove lice from the head as the only treatment is low; however, this is the less harmful and more effective method (AU)

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INTRODUCCIÓN: la automedicación y el uso de diversos productos como pediculicidas parece ser frecuente entre los convivientes para tratar de eliminar los piojos de la cabeza en los escolares. OBJETIVO: analizar el uso deliberado, por los convivientes con educandos de primaria, de diversos productos para controlar la pediculosis capitis en los niños. MÉTODOS: se realizó una encuesta por cuestionario e intercambio de opiniones con 896 convivientes con niños entre 5 y 10 años, que estudiaban en 19 escuelas urbanas y semiurbanas de primera enseñanza, de las provincias de las zonas occidental, central y oriental de Cuba, sobre los productos utilizados para controlar o eliminar los piojos de la cabeza. RESULTADOS: la población encuestada cita más de 40 productos. Entre las sustancias más reportadas se encuentra el alcohol, el DDT y el lindano, que fueron anteriormente rechazados por su toxicidad e ineficacia. Se reportan en uso productos empleados en la agricultura, la salud pública y la medicina veterinaria para el control de plagas; entre ellos, temephos, esteladón, malathion, parathión, baytex; también derivados del petróleo como el líquido de freno, keroseno y la gasolina. CONCLUSIÓN: en el trabajo se refieren numerosas sustancias tóxicas utilizadas en la terapóutica para el control de Pediculus capitis en niños, cuyo riesgo supera los beneficios esperados. Resulta bajo el porcentaje de personas que utilizan la extracción manual como único tratamiento, no obstante ser el método menos dañino y más eficaz (AU)

INTRODUCTION: self-medication and use of several products as peliculicides seem to be common procedures for those persons living with schoolchildren, in order to eliminate head lice. OBJECTIVE: to analyze the deliberate use of several products by the people living with elementary school children, so as to control their pediculosis capitis. METHODS: a questionnaire- and exchange of opinion-based survey on the products used to control or eliminate head lice was administered to 896 people who lived with children aged 5 to 10 years. These children studied in 19 elementary schools in urban and suburban areas located in the western, central and eastern provinces of Cuba. RESULTS: the surveyed population mentioned more than 40 products. Among the most reported substances were alcohol, DDT and lindano which were previously rejected owing to their toxicity and ineffectiveness. There were also reports on products from agricultural, public health and veterinary medicine, including those devoted to plague control such as temephos, steladon, malathion, parathion, baytex; also oil derivatives like brake fluid, kerosene and gasoline. CONCLUSIONS: the paper mentioned a number of toxic substances used in treating Pediculus capitis in children, the risks of which outweighted the expected benefits. The percentage of persons who manually remove lice from the head as the only treatment is low; however, this is the less harmful and more effective method (AU)

RESUMO

INTRODUCCIÓN: la automedicación y el uso de diversos productos como pediculicidas parece ser frecuente entre los convivientes para tratar de eliminar los piojos de la cabeza en los escolares. OBJETIVO: analizar el uso deliberado, por los convivientes con educandos de primaria, de diversos productos para controlar la pediculosis capitis en los niños. MÉTODOS: se realizó una encuesta por cuestionario e intercambio de opiniones con 896 convivientes con niños entre 5 y 10 años, que estudiaban en 19 escuelas urbanas y semiurbanas de primera enseñanza, de las provincias de las zonas occidental, central y oriental de Cuba, sobre los productos utilizados para controlar o eliminar los piojos de la cabeza. RESULTADOS: la población encuestada cita más de 40 productos. Entre las sustancias más reportadas se encuentra el alcohol, el DDT y el lindano, que fueron anteriormente rechazados por su toxicidad e ineficacia. Se reportan en uso productos empleados en la agricultura, la salud pública y la medicina veterinaria para el control de plagas; entre ellos, temephos, esteladón, malathion, parathión, baytex; también derivados del petróleo como el líquido de freno, keroseno y la gasolina. CONCLUSIÓN: en el trabajo se refieren numerosas sustancias tóxicas utilizadas en la terapéutica para el control de Pediculus capitis en niños, cuyo riesgo supera los beneficios esperados. Resulta bajo el porcentaje de personas que utilizan la extracción manual como único tratamiento, no obstante ser el método menos dañino y más eficaz.

INTRODUCTION: self-medication and use of several products as peliculicides seem to be common procedures for those persons living with schoolchildren, in order to eliminate head lice. OBJECTIVE: to analyze the deliberate use of several products by the people living with elementary school children, so as to control their pediculosis capitis. METHODS: a questionnaire- and exchange of opinion-based survey on the products used to control or eliminate head lice was administered to 896 people who lived with children aged 5 to 10 years. These children studied in 19 elementary schools in urban and suburban areas located in the western, central and eastern provinces of Cuba. RESULTS: the surveyed population mentioned more than 40 products. Among the most reported substances were alcohol, DDT and lindano which were previously rejected owing to their toxicity and ineffectiveness. There were also reports on products from agricultural, public health and veterinary medicine, including those devoted to plague control such as temephos, steladon, malathion, parathion, baytex; also oil derivatives like brake fluid, kerosene and gasoline. CONCLUSIONS: the paper mentioned a number of toxic substances used in treating Pediculus capitis in children, the risks of which outweighted the expected benefits. The percentage of persons who manually remove lice from the head as the only treatment is low; however, this is the less harmful and more effective method.

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Fundamentos: Os métodos para diagnosticar Pediculus humanus var. capitis são controvertidos e a maioria dos estudos tem usado o exame visual direto. Objetivos: O objetivo deste estudo foi comparar a eficácia no diagnóstico do exame visual direto em contraposição ao uso do pente metálico de aço com dentes microcanaliculados. Métodos: Investigaram-se 946 crianças e adolescentes de quatro a 19 anos. O cabelo de cada criança foi examinado duas vezes, para detectar infestação pelos diferentes estádios, por meio da observação visual direta e com o pente metálico. Resultados: O diagnóstico visual apontou infestação em 30,7 por cento dos casos, enquanto que o pente metálico indicou um resultado de 51,5 por cento. O sexo feminino foi o mais acometido, de acordo com ambos os métodos. As formas parasitárias detectadas com o exame visual direto foram: somente piolhos (adultos e/ou ninfas); 1,4 por cento; somente lêndeas vivas, 64,8 por cento; e lêndeas vivas mais piolhos, 33,8 por cento; com o pente metálico, foram 6,4 por cento, 23,6 por cento e 70 por cento, respectivamente. A média de tempo para descobrir um piolho foi de 57 segundos com o pente metálico e de 116,4 segundos com a observação visual direta. Conclusões: O diagnóstico é duas vezes mais rápido e 3,6 vezes mais eficiente com o pente metálico microcanaliculado. O método visual leva a uma subestimação das infestações ativas e revela as passadas não ativas.

Background: Methods for the diagnosis of Pediculus humanus var. capitis are controversial and most studies are based on direct visual exam. Objective: The objective of this study was to compare the diagnosis efficacy of both direct visual exam and the use of a metal microchanelled fine-toothed comb. Methods: 946 children and teenagers 4 to 19 years of age were examined. Each individual’s hair was examined twice to determine whether there was infestation by lice or nits, through direct visual exam and the use of a metal microchanelled fine-toothed comb. Results: The visual diagnosis detected infestation in 30.7 percent of the cases, while the metal comb detected infestation in 51.5 percent. Females were the most affected. The forms of parasites detected through direct visual exam were: only lice (adults and/or nymphs) 1.4 percent, only live nits 64.8 percent and live nits and lice, 33.8 percent; with the metal comb the percentages were 6.4 percent, 23.6 percent and 70 percent, respectively. The average time to find a louse was 57 seconds with the fine-toothed comb and 116.4 seconds through the direct visual exam. Conclusions: Diagnosis with the microchanelled fine-toothed comb is twice as fast and 3.6 times more efficient than through direct visual exam.The direct visual exam detects non-active, past infestations, and underestimates active ones.

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Pediculosis seems to have afflicted humans since the most ancient times and lice have been found in several ancient human remains. Examination of the head hair and pubic hair of the artificial mummy of Ferdinand II of Aragon (1467-1496), King of Naples, revealed a double infestation with two different species of lice, Pediculus capitis, the head louse, and Pthirus pubis, the pubic louse. The hair samples were also positive for the presence of mercury, probably applied as an anti-pediculosis therapy. This is the first time that these parasites have been found in the hair of a king, demonstrating that even members of the wealthy classes in the Renaissance were subject to louse infestation.

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Introducción: entre los problemas que inciden en los fallos, de los tratamientos pediculicidas, están la forma de aplicación y la baja efectividad de los productos utilizados. Objetivos: conocer, por medio de encuestas de opiniones, la forma de aplicación y la efectividad de la Permetrina 1 por ciento fabricada en Cuba para el control de los piojos. Métodos: los cuestionarios se distribuyeron entre los convivientes con escolares de primaria, que con anterioridad habían utilizado el producto en los niños. El trabajo se realizó de mayo a julio de 2007 en escuelas urbanas y rural-urbanas de las provincias Ciudad de La Habana, Sancti Spíritus y Las Tunas, en Cuba. Resultados: de 786 convivientes encuestados, 637 (81,17 por ciento) no aplicaron el pediculicida según las indicaciones formuladas en el prospecto, que se adjunta al frasco, 579 (73,66 por ciento) la consideran ineficaz y solo 143 (16,32 por ciento) la han utilizado como único tratamiento. Conclusiones: no existe sincronización en los pasos seguidos durante el tratamiento. Se evidencia una alta heterogeneidad en las respuestas, porque más de 70 por ciento de los encuestados la consideran ineficaz para el tratamiento de la pediculosis capitis(AU)

Background: Among the problems that influence on failure of pediculosis treatment is the way of application and low effectiveness of used products. Objectives: to find out, through surveys, the ways of application and the effectiveness of 1 percent permethrin manufactured in Cuba for the control of pediculosis capitis. Methods: the questionnaires were distributed among people living with elementary schoolchildren, who had previously applied the products to children. The study was performed from May to July 2007 in urban and rural-urban schools located in City of Havana, Sancti Spiritus and Las Tunas provinces in Cuba. Results: Seven hundred and eighty six people were surveyed, 637 of them (81,17 percent) did not follow the instructions given in the flask in applying the anti-pediculosis products, 579 (73,66 percent) considered it as ineffective and only 143 (16,32 percent) had used it as unique treatment. Conclusions: there is not any agreement in steps followed by these people during treatment. Responses were very heterogeneous because over 70 % of surveyed persons stated that permethrin was ineffective for treatment of pediculosis capitis(AU)

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Introducción: entre los problemas que inciden en los fallos, de los tratamientos pediculicidas, están la forma de aplicación y la baja efectividad de los productos utilizados. Objetivos: conocer, por medio de encuestas de opiniones, la forma de aplicación y la efectividad de la Permetrina 1 por ciento fabricada en Cuba para el control de los piojos. Métodos: los cuestionarios se distribuyeron entre los convivientes con escolares de primaria, que con anterioridad habían utilizado el producto en los niños. El trabajo se realizó de mayo a julio de 2007 en escuelas urbanas y rural-urbanas de las provincias Ciudad de La Habana, Sancti Spíritus y Las Tunas, en Cuba. Resultados: de 786 convivientes encuestados, 637 (81,17 por ciento) no aplicaron el pediculicida según las indicaciones formuladas en el prospecto, que se adjunta al frasco, 579 (73,66 por ciento) la consideran ineficaz y solo 143 (16,32 por ciento) la han utilizado como único tratamiento. Conclusiones: no existe sincronización en los pasos seguidos durante el tratamiento. Se evidencia una alta heterogeneidad en las respuestas, porque más de 70 por ciento de los encuestados la consideran ineficaz para el tratamiento de la pediculosis capitis.

Background: Among the problems that influence on failure of pediculosis treatment is the way of application and low effectiveness of used products. Objectives: to find out, through surveys, the ways of application and the effectiveness of 1 percent permethrin manufactured in Cuba for the control of pediculosis capitis. Methods: the questionnaires were distributed among people living with elementary schoolchildren, who had previously applied the products to children. The study was performed from May to July 2007 in urban and rural-urban schools located in City of Havana, Sancti Spiritus and Las Tunas provinces in Cuba. Results: Seven hundred and eighty six people were surveyed, 637 of them (81,17 percent) did not follow the instructions given in the flask in applying the anti-pediculosis products, 579 (73,66 percent) considered it as ineffective and only 143 (16,32 percent) had used it as unique treatment. Conclusions: there is not any agreement in steps followed by these people during treatment. Responses were very heterogeneous because over 70 of surveyed persons stated that permethrin was ineffective for treatment of pediculosis capitis.

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During 1985, 50,356 children and adolecents from 105 public schools of Belo Horizonte, Minas Gerais State were questioned about or examined for head lice (Pediculus capitis). The mean prevalence of pediculosis, obtainde from the questionnaires and sometimes confirmed by head inspections, was 7.7% or else 10.2% when adjusted to 38,311 respondents. Current and past infestations combined - within a period of three months before survey - revealed a total prevalence of 57.4%. Significant differences were observed among socioeconomic levels, and grades of school age. The more prevalent categories among the factors studied were: sex - femal: 9.2% (P<0.001); ethnic group - white: 10.0% (P<0.001); hair length - long: 9.5% (P<0.05); year age-group - 1-5 years: 19.2% (P<0.001), with a peak in the 5th year (21.3%).

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