BMJ 1995;311:604-608 (2 September)
General practice
Systematic review of clinical efficacy of topical treatments for head lice
Robert H Vander Stichele, general
practitioner,a Els M Dezeure, school health
services physician,a Marc G Bogaert, clinical
pharmacologist a
a Heymans Institute of Pharmacology, University of
Ghent, De Pintelaan, 185, B-9000 Ghent, Belgium
Correspondence to: Dr Vander Stichele.
Abstract
Objectives: To collect and evaluate all trials
on clinical efficacy of topical treatments for head lice.
Design: Systematic review of randomised trials identified
from following data sources: Medline, International
Pharmaceutical Abstracts, Science Citation Index, letters to key
authors and companies, and hand search of journals.
Setting: Trials in schools or communities.
Subjects: Patients infested with lice.
Main
outcome measure: Cure rate (absence of live lice and viable nits)
on day 14 after treatment.
Results: Total of 28 trials
were identified and evaluated according to eight general and 18 lice
specific criteria. Of the 14 trials rated as having low to moderate
risk of bias, seven were selected as they used the main outcome
measure. These seven trials described 21 evaluations of eight
different compounds and placebo (all but two evaluations were of
single applications). Only permethrin 1% creme rinse showed efficacy
in more than two studies with the lower 95% confidence limit of cure
rate above 90%.
Conclusions: Only for permethrin has
sufficient evidence been published to show efficacy. Less expensive
treatments such as malathion and carbaryl need more evidence of
efficacy. Lindane and the natural pyrethrines are not sufficiently
effective to justify their use.
|
| Key messages
- Key messages
- In this systematic review we found only 28 randomised trials on
clinical efficacy of topical treatments for head lice
- Of these trials, only seven were of acceptable methodological
quality and measured outcome at 14 days after treatment (the optimum
time to assess clinical efficacy)
- Of the eight different compounds evaluated, only permethrin 1% creme
rinse showed efficacy in more than two studies with a lower 95%
confidence limit of cure rate above 90%
- Only for permethrin has sufficient evidence been published to show
efficacy: less expensive treatments such as malathion and carbaryl need
more evidence of efficacy, while lindane and the natural pyrethrines are
not sufficiently effective to justify their use
|
IntroductionHead lice are among the most common of human ectoparasites, though
they are not vectors of serious diseases
and in many cases do not
cause symptoms.1 2 3 Treatment
with natural pyrethrines has been known for more
than 100 years, and lindane has been used since the second world war. The synthetic
pyrethrines were
marketed in the 1950s, malathion and carbaryl in the
'60s, and permethrin in the '80s. Although products
abound, the
prevalence of head lice remains high and epidemics occur regularly
despite all efforts at
control.3 4 5 Problems such
as fear of insects (entomophobia), fear of stigmatisation, and denial
of infection by
patients and schools may cause under-treatment, overtreatment, and unnecessary prophylaxis, which can lead
to
development of resistance and insufficient control of
epidemics.6
Furthermore, many of the commercially
available treatments might be underdosed, incorrectly labelled, or ineffective.
Our aim was to collect and evaluate all trials of clinical efficacy
of topical treatments for head lice.7 8
Methods
We searched for trials of topical treatments for people infested
with head lice (Pediculus humanus capitis) in
which the outcome
was measured clinically by inspection of the scalp to determine
cure rate (absence of live
lice and viable nits).
SEARCH STRATEGY
We searched the medical literature in Medline (1966 to March 1995
using the MESH keywords "Pediculosis,"
"Lice," "Pediculus"), in
International Pharmaceutical Abstracts, and in the Science Citation
Index without
restriction for language of publication. We scanned the
references of all identified clinical trials. We sent letters
requesting information about unpublished studies to seven key authors
in the subject, to the pharmaceutical
companies active in this
subject, and to the World Health Organisation centre Vector Biology
Control. We
hand searched journals in which key references were
published for comments, letters, or corrections in the year
after
publication of the key reference.
REVIEW
We focused on clinical efficacy--the result of pediculicidity,
ovicidity, and residual activity--and so we chose
cure rate as
the main outcome measure for clinical evaluation. The cure rate is
the percentage of patients cured
after application of the treatment
(the 95% confidence interval=p +/- 1.96 (square root p (100-p)/n),
where p is
the sample percentage and n the number of subjects in the
study). Determination of the cure rate by experienced
evaluators--on
the basis of visual inspection for viable nymphs in nits, hatching
nymphs, and adult lice (with a
x 10 magnifying lens)--has an
acceptable specificity and sensitivity.9 We
considered an interval of 14 days
between treatment and evaluation to
be optimal as this would allow evaluation of the combined effect of
pediculicidity (on living lice), ovicidity (on ripening eggs), and
residual activity (on hatching nymphs and
reinfesting lice).
We evaluated all identified clinical trials with regard to eight
general criteria of quality in clinical trials (adapted
from
Chalmers et al10) and 18
criteria specific for head lice treatment (see table I). We developed
these specific
criteria after studying the literature to
systematically screen the trials for flaws in design, execution, or
reporting.
Firstly, we made a structured abstract of each clinical
trial according to recommended guidelines.11 Each of us
then independently assessed the trials. Trials were
rejected if four or more flaws in general criteria or 12 or
more
flaws in treatment specific criteria were found. The remaining
trials were rated as having a low risk of bias if less
than
eight specific criteria were flagged, or a moderate risk of
bias if otherwise. Again, we set these cut off
points for rating
of quality after studying the literature. The structured abstracts,
assessment scores, and overall
ratings were submitted to an
advisory panel (four physicians and a community pharmacist) and
discussed until
consensus was reached. Of the trials of acceptable
methodological quality, we selected those in which the main
outcome
measure was the cure rate at 14 days after treatment.
|
TABLE I--Criteria of quality in evaluation of design, execution, and
reporting of trials on clinical efficacy of topical treatment for head lice
------------------------------------------------------------------------------
Item No Criterion
------------------------------------------------------------------------------
General
1 Randomisation procedure
2 Concealment of allocation to patients
3 Concealment of allocation to investigators
4 Precision of definition of exclusion criteria
5 Handling and reporting of drop outs
6 Ethical procedures*
7 Statistical procedures
8 Appropriateness of conclusions
Treatment specific
1 Documentation of prior exposure of screened population to
pesticides (therapeutic or agricultural)
2 Documentation of history of previous lice treatment and
comorbidity of index patients
3 Quality of informed consent procedure (involvement of parents)
4 Inclusion criteria (definition of "current" head lice infection)
5 Specification of the formulation of active ingredients
6 Storage and manipulation of pharmaceutical compound
7 Time and season of study
8 Prevalence of lice in study area
9 Standardisation of cotreatment and swimming
10 Identity of applicants and evaluators
11 Application procedure
12 Intensity of tracing contacts
13 Use of nit combs
14 Documentation of pediculicidity
15 Documentation of ovicidity
16 Documentation of residual activity
17 Documentation of cure rate
18 Adverse events reported
------------------------------------------------------------------------------
*More relevant to good clinical practice than evaluation of bias. |
ResultsSELECTION OF TRIALS
We identified 28 trials of clinical efficacy, 27 from the computer
databases12 13 14 15 16 17 18 19 20 21 22 23 24 25
26 27 28 29 30 31 32 33 34 35 36 37 38 and one supplied by an author in reply to
our request.39 We also identified
an internal document of the Wellcome company describing a series of
11 small (11<n<74) unpublished
comparative trials of permethrin and malathion performed between 1983
and 1986 and apparently yielding
high cure rates for permethrin and malathion.40 As we decided not to accept the company's
demands for
confidentiality, the full texts of these studies were not made
available to us and these trials were not included in
the analysis. Hand searching did not reveal additional relevant
reports of trials. The search in the Science
Citation Index showed only limited citing activity in this field. An
official of WHO confirmed that the debate on
the choice of head lice treatment for the list of essential drugs had
been
based on expert opinion without a
formal literature review.
Narrative reports of studies and older reports of treatment
campaigns41 42 43 44 45
were not included in the analysis.
Four studies were not controlled,12 18 26 39 three studies (two of malathion and one of
permethrin) were
placebo controlled,15 21 23 and the remaining 21 studies were comparisons between
two or more active
substances. We rated the quality of the identified trials according
to the criteria in table I and rejected 14 of the
trials because of an excess of general or treatment specific flaws
(table II). Seven trials were excluded from the
analysis, although their methodological quality was acceptable,
because the cure rate was not determined on
day 14 after treatment (three measured cure rate on day 7,15 21 38 and four measured it on day 21 or later16 29
30 32). The characteristics of the excluded trials
are listed in table III.
|
TABLE II--Assessment of 28 trials according to eight general and 18 treatment specific criteria of quality
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------
General item No* Treatment specific item No*
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Study 1 2 3 4 5 6 7 8 Total 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Total Risk of bias
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Trials of acceptable quality with cure rate at day 14
Maunder14 F F F 3 F F f F F F F f f 9 Moderate
Brandenburg et al22 F F F 3 F F F F f 5 Low
Taplin et al23 F 1 f f f 3 Low
Bowerman et al24 F F 2 F f F F f f f 7 Low
Carson et al27 F F 2 f F f f f f f 7 Low
DiNapoli et al28 F F F 3 F f f F f f f 7 Low
Clore et al36 F F 2 F f F F f f f f f 9 Moderate
Trials of acceptable quality without cure rate at day 14
Taplin et al15 F 1 F F F F f f f 7 Low
Mathias et al16 F F F 3 F F F F f f f f 8 Moderate
Urcuyo et al21 F F 2 F F F F f f f f 8 Moderate
Miller et al29 F 1 F F F F f F f F f f 10 Moderate
Kyle30 F F 2 f f F F f f F f f f 10 Moderate
Sexton et al32 F F 2 f f F F F f f F f f f 11 Moderate
Chosidow et al38 F F 2 f F F f f F f 7 Low
Trials of unacceptable quality
Blommers et al12 F F F F 4 F F F F F F F F F F f F F F 14 High
Preston et al13 F F F F 4 F F f F F f f f F F F f 12 High
De Boer17 F F F F F 5 F f F F F F F f f f f f f 13 High
De Boer et al18 F F F F F 5 F F f F F f f f F f f f 12 High
Mazas et al19 F F F F 4 f F F F F F f F f F f f F 13 High
Donaldson et al20 F F 2 F f F f F f f F f f f f f 13 High
Armoni et al25 F F F F 4 F F f F F F f f f f 10 High
Mazas et al26 F F F F 4 F F F f F F f F f F f f f 13 High
Rousset et al39 F F F F F 5 F F F f F F F F F f f 11 High
Mathias et al31 F F F F 4 F F f F f F F f 8 High
Doss et al33 F F 2 f f F F F F f f F f f f 12 High
Jolley et al34 F 1 f f F F f f F f F f f f 12 High
Fan et al35 F F F F 4 F F F F F F f F f f f f 12 High
Burgess et al37 F F F F F 5 F F f F F f F F 8 High
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------
*See table 1 for details of items.
F=major flaw; f=minor flaw. |
TABLE III-Overview of clinical trials excluded from analysis
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Percentage difference in
No of cure rate from highest
Treatment (single application index Cure outcome (95% confidence
Study unless stated otherwise) patients rate (%) interval)
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Trials of acceptable quality without cure rate at day. 14
Taplin et al (cure rate at day 7)15 Malathion 0.5% lotion 65 95
Control vehicle 47 45 50 (35 to 65)*
Matthias et al (cure rate at day 28-40)16 Malathion 0.5% lotion 29 76
Lindane 1% shampoo 33 78 2 (0 to 23)
Urcuyo et al (cure rate at day 7)21 Malathion 0.5% lotion 61 85
Control vehicle 58 7 78 (67 to 89)*
Miller et al (cure rate at day 21)29 (delta)-Phenothrin 0.2% lotion 32 100
(delta)-Phenothrin 0.2% lotion 24 100 0
Kyle (cure rate at day 21)30 (delta)-Phenothrin 0.2% shampoo 39 87
Malathion 0.5% lotion 38 82 5 (0 to 21)
Sexton et al (cure rate at day 21-28)32 (delta)-Phenothrin 0.2% shampoo 27 96
Carbaryl 0.5% lotion 23 87 9 (0 to 25)
Chosidow et al (cure rate at day 7)38 Malathion 0.5% lotion 94 95
(delta)-Phenothrin lotion 95 39 56 (45 to 67)*
Trials of unacceptable quality
Blommers et al12 Lindane 1% lotion+ 110
Uncontrolled
Preston et al13 Carbaryl 0.5% lotion 5
Carbaryl 1% gel shampoo 26
De Boer17 Malathion 0.5% lotion 51
Bioallethrin 1.8%+butoxide 76
De Boer et al18 Malathion 0.5% lotion 51
Uncontrolled
Mazas et al19 Permethrin 1% lotion 10
Permethrin 1% lotion 10
Donaldson et al20 (delta)-Phenothrin 0.2% shampoo 42
Carbaryl 1.5% gel shampoo 34
Armoni et al25 Pyrethrin 0.3%+butoxide shampoo 50
Pyrethroid 0.66%+butoxide spray 50
Malathion 0.4% lotion 50
Carbaryl 0.6% shampoo 50
Carbaryl 0.5% lotion 50
Mazas et al26 Malathion 0.5% lotion 37
Uncontrolled
Rousset et al39 Bioallethrin 0.66%+butoxide spray 100
Uncontrolled
Mathias et al31 Lindane 1% 25
Pyrethrin 0.3%+butoxide 28
Doss et al33 (delta)-Phenothrin 0.2% lotion 50
Malathion 0.5% lotion 23
Carbaryl 0.5% lotion 28
Jolley et al34 (delta)-Phenothrin 0.2% shampoo 25
Carbaryl 0.5% shampoo 25
Fan et al35 Permethrin 1% creme rinse 529
Bioallethrin 0.66% spray 314
Malathion 1% lotion 519
Lindane 1% powder 249
Burgess et al37 Synergised pyrethrin mousse 42
Permethrin 1% creme rinse 10
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------
*Significant difference (zero not included in 95% confidence interval of difference).
+Two applications. |
The remaining seven trials were of acceptable methodological
quality and had the cure rate on day 14 as main
outcome measure.14 22 23 24 27 28 36 Five of the trials had an overall quality
rating of low risk of bias, while two
had a moderate risk of bias
(table II). Three trials were conducted in an area with high
background prevalence
of head lice (>50% of screened population).14 23 24
RESULTS OF SELECTED TRIALS
In the seven selected trials 21 individual evaluations of topical
treatments were performed, comparing placebo
and eight compounds
(lindane, bioresmethrin, chlorphenamide, (delta)-phenothrin,
pyrethrin, malathion, carbaryl,
and permethrin), and all but
two evaluations27 36 were of single applications (table IV). We
juxtapositioned the
results obtained in different trials for the same
compounds, and the figure shows the cure rates for each
compound. The
cure rate with placebo was 6%,23 showing the lack of placebo effect and
spontaneous
remission with this condition. We found six evaluations
of lindane; in none of them did the lower confidence limit
of the
cure rate exceed 90%,
and in two trials even the upper confidence limit was below
90%. For the natural
pyrethrines (pyrethrin, bioresmethrin,
chlorphenamide, and (delta)-phenothrin), all the evaluations
resulted in
cure rates with lower confidence limits below 90%.
Only one evaluation was available for carbaryl 0.5% lotion
and
malathion 0.5% lotion, both giving cure rates with lower confidence
limits above 90%. We found five
evaluations of permethrin 1%
creme rinse (in a single application of 10 minutes) with cure
rates of nearly 100%
and lower 95% confidence limits above 90%.
Two of these studies were high quality studies in populations
with
a high background prevalence of head lice (>50% of screened
population infested).23 24
|
TABLE IV--Overview of included trials
----------------------------------------------------------------------------------------------------------------------------------
Percentage difference in
No of Cure rate (%) cure rate at day 14 from
Ttreatment (single applications index ------------------- highest outcome (95%
Study unless stated otherwise) patients Day 7 Day 14 confidence interval)
----------------------------------------------------------------------------------------------------------------------------------
Maunder14 Carbaryl 0.5% lotion 81 100
Carbaryl 0.5% shampoo 64 97 3 (0 to 7)
Bioresmethrin 0.2% lotion 49 92 8 (0 to 7)
Chlorphenamide 0.2% lotion 93 86 14 (7 to 21)*
Lindane 0.5% lotion 97 91 9 (3 to 15)*
Lindane 1% shampoo 57 86 14 (5 to 23)*
Malathion 0.5% lotion 108 98 2 (0 to 5)
Brandenburg et al22 Permethrin 1% creme rinse 257 99 99
Lindane 1% shampoo 251 92 85 14 (9 to 19)*
Taplin et al23 Permethrin 1% creme rinse 29 100 97
Control vehicle 34 9 6 91 (81 to 100)*
Lindane 1% (non-random) 30 67 43
Bowerman et al24 Permethrin 1% creme rinse 195 99 98
Lindane 1% shampoo 99 90 76 22 (13 to 31)*
Carson et al27 Permethrin 1% creme rinse 27 96 100
Pyrethrin 0.3% lotion+ 31 45 94 6 (0 to 14)
Di Napoli et al28 Permethrin 1% creme rinse 107 98 96
Permethrin 0.3% lotion 106 85 62 34 (24 to 44)*
Clore et al36 Lindane 1% shampoo+ 30 80 93
Permethrin 1% creme rinse 32 91 87 6 (0 to 21)
Pyrethrin 0.3% five brands 31 79 86 7 (0 to 18)
----------------------------------------------------------------------------------------------------------------------------------
*Significant difference (zero not included in 95% confidence interval of difference).
+Two applications. |
We also made an intrastudy comparison of the two largest trials.22 24 Both trials were of high quality and
compared single
applications of permethrin 1% creme rinse with lindane 1% shampoo.
The odds ratio of
treatment failure for lindane versus permethrin was
15.11 (95% confidence interval 4.60 to 49.62) in one
study22 and was 15.28 (5.13 to 45.52) in the second study.24 After performing a Breslow-Day test for
homogeneity of odds ratios (P=0.99), we obtained the Mantel-Haenszel
summary odds ratio of 15.18 (7.99
to 28.84). Hence, the risk of
treatment failure was likely to be at least eight times higher with
lindane than with
permethrin.
Discussion
Our aim was to collect details of all trials on the clinical
efficacy of treatment for head lice and to describe the
results
of the trials that were not invalidated by too many flaws. To
our surprise, we found only 28 published
studies.
METHODS OF REVIEW
We cannot exclude the possibility that important research findings
were missed by our method of retrieval. We
did not engage in a
hand search of core journals, as recommended for structured
reviews,46 because there did
not seem to be a core group of
journals, where research publications are concentrated,47 for
this subject. Our
failure to obtain the full text of unpublished
trials comparing permethrin with malathion excluded evidence
for the
efficacy of malathion.
In this first systematic approach to the treatment of head lice it
was not possible to determine the acceptance
criteria a priori. The
rating system was instead developed after study of the identified
trials. We chose cure rate
at 14 days as the main outcome measure
since it was the most commonly used criterion for efficacy and
is, in
our opinion, the most appropriate outcome measure. We
preferred not to consider the cure rate at seven days,
as hatching
of nymphs can take longer than this48 and as a week is too short to evaluate the
effect of residual
activity on reinfestation (which is important in
stopping transmission during epidemics).49 We have, however,
presented cure rates at day 7 and
beyond day
14 (tables III and IV), but these results do not challenge the
overall conclusions of our review.
DATA EXTRACTION
We presented the efficacy data of each active ingredient by
juxtaposition of treatment groups from the seven
selected trials.
This procedure is methodologically weak but has the advantage
of extracting at least some of the
limited knowledge from the
clinical studies. The representation of the confidence intervals
in the figure should be
interpreted with caution, as many of
the results fall in the extreme end of the range of cure rates,
where
confidence intervals based on the sample percentage tend
to shrink to zero.
|
No of
Control vehicle patients
(Taplin et al23) 34
-------------------------------------------------------------------------------------------------------------------
Lindane
1% Shampoo (Clore et al36)* 30
0.5% Shampoo (Maunder14) 97
1% Shampoo (Maunder14) 57
1% Shampoo (Brandenburg et al22) 251
1% Shampoo (Bowerman et al24) 99
1% Shampoo (Taplin et al23) 30
-------------------------------------------------------------------------------------------------------------------
Pyrethrines
Pyrethrin 0.3% lotion (Carson et al27)* 31
Bioresmethrin 0.2% lotion (Maunder14) 49
Chlorphenamide 0.2% lotion (Maunder14) 93
Pyrethrin 0.3% (five brands)(Clore et al36) 31
-------------------------------------------------------------------------------------------------------------------
Carbaryl
0.5% Lotion (Maunder14) 81
0.5% Shampoo (Maunder14) 64
-------------------------------------------------------------------------------------------------------------------
Malathion
0.5% Lotion (Maunder14) 108
-------------------------------------------------------------------------------------------------------------------
Permethrin
1% Creme rinse (Carson et al27) 27
1% Creme rinse (Brandenburg et al22) 257
1% Creme rinse (Bowerman et al24) 195
1% Creme rinse (Taplin et al23) 29
1% Creme rinse (DiNapoli et al28) 107
1% Creme rinse (Clore et al36) 32
0.3% Lotion (DiNapoli et al28) 106
-------------------------------------------------------------------------------------------------------------------
*Double application 0 10 20 30 40 50 60 70 80 90 100
Cure rate at day 14 (%)
Cure rates (95% confidence intervals) at day 14 after treatment for head lice. (Filled rectangles indicate high
background prevalence (>50% of screened population infested). Products were applied once unless
indicated otherwise) |
Within the seven selected trials it was difficult to make sensible
intrastudy comparisons. The sample size of two
of the trials27 36 was insufficient for testing relevant differences. Two
trials were selected despite flaws in
randomisation, one because of
the comparison with placebo23 and one because of the range of products
tested.14 The relevance of testing a product against
itself in an underdosed formulation in one study28 can be
questioned. Hence, we limited
ourselves to the comparison of the two bigger high quality trials,
which compared
permethrin with lindane.22 24
OTHER ASPECTS OF EVALUATING TREATMENT
We made no attempt to formally weigh criteria such as side effects,
toxicity, and cost. In the course of reviewing
the literature,
we found only one large scale postmarketing surveillance of
safety, which provided evidence for
the safety of permethrin.50
Theoretically, products with residual activity might facilitate
selection of resistant strains of head lice, and
proposals have
been made for a rotational or mosaic treatment strategy.49 51 There is no convincing evidence
for a need for such a
strategy,
but development of resistance should be monitored if the therapeutic
arsenal
diminishes to a few products of proved efficacy.
RECOMMENDATIONS FOR FUTURE TRIALS
The number of well conducted trials of clinical efficacy in this
subject of medical and economic importance is
limited, and
recommendations for treatment published in the medical literature are
not sufficiently sustained by
the results of research. Our list of
treatment specific criteria could be a starting point for evaluation
of new trials
in the subject. Moreover, inspection of the figure
leads us to recommend that only products with an expected
cure rate
of over 90% should be tested and that this should be done in trials
with sufficient power to establish
cure rates with a lower confidence
limit above 90%. We propose the use of equivalence testing (testing
for
non-null hypothesis) and of the odds ratio of treatment failure
with its 95% confidence interval, as the
 2 test
might not be
valid for testing differences in cure rates near 100%. Future
research on head lice treatments should
preferably test single
applications of compounds, as was the case in almost all the
acceptable clinical trials in this
study. Any treatment for lice
might be effective if it is applied repeatedly over a short interval.52 We found many
examples of instructions on
labels encouraging multiple application, especially with products
that lacked well
documented efficacy. In some cases these
instructions clearly played on people's entomophobia to stimulate
consumption, as has been stated by others.6
We are indebted to the members of the advisory panel: C Carton,
army pest control physician; J M Kaufman,
endocrinologist; G
Laekeman, professor of pharmacy; K Seynaeve, school health services
physician; and
E Van Hecke, dermatologist. We thank D De Bacquer
for statistical advice and A Herxheimer for critical
comments
on the manuscript.
Funding: This study was supported by a grant from the Belgium
Ministry of Health.
Conflict of interest: None.
- Chunge RN, Scott FE,
Underwood JE, Zavarella KJ. A review of the epidemiology, public health
importance, treatment and control
of head lice. Can J Public Health
1991;82:196-200.
-
Maunder JW. The appreciation of lice.
Proceedings of the Royal Institute 1983;55:1-31.
- Mumcuoglu KY, Miller J,
Gofin R, Adler B, Ben-Ishai F, Almog R, et al. Epidemiological studies on head
lice infestation in Israel:
parasitological examination of children. Int J
Dermatol 1990;29:502-6.
-
Lindsay SW, Peock S. Insecticides against head
lice in Glasgow. J R Soc Health 1993;113:181-3.
-
Oust the louse. BMJ 1975;ii:1043-4.
- Maunder B. Attitude to
head lice--a more powerful force than insecticides. J R Soc Health
1985;105:61-4.
-
Dickersin K, Herxheimer A, Silagy C. Preparing
and maintaining systematic reviews. In: Oxman A, Chalmers I, Clarke M, Enkin
M,
Schulz K, Starr M, eds. The Cochrane Collaboration tool kit. Oxford:
Cochrane Centre, 1994:1-87.
- Mulrow CD. Rationale for
systematic reviews. BMJ 1994;309:597-9.
-
Mathias RG, Wallace JF. Control of head lice:
using parent volunteers. Can J Public Health 1989;80:461-3.
-
Chalmers IC, Smith H, Blackburn B, Silverman B,
Schroeder B, Reitman D, et al. A method for assessing the quality of a
randomized control trial. Control Clin Trials 1981;2:31-49.
-
Haynes RB, Mulrow CD, Huth EJ, Altman DG, Gardner
MJ. More informative abstracts revisited.
Ann Intern Med
1990;113:69-76.
-
Blommers L, van Lennep M. Head lice in the
Netherlands: susceptibility for insecticides in field samples.
Entomologia
Experimentalis et Applicata
1978;23:243-51.
- Preston S, Fry L. An
assessment of two carbaryl preparations. J R Soc Health 1979;99:173.
- Maunder JW. Clinical and
laboratory trials employing carbaryl against the human head-louse,
Pediculus
humanus capitis (de Geer).
Clin Exp Dermatol 1981;6:605-12.
-
Taplin D, Castillero PM, Spiegel J, Mercer S,
Rivera AA, Schachner L. Malathion for treatment of Pediculus humanus
var
capitis infestation. JAMA 1982;247:3103-5.
-
Mathias RG, Huggins DR, Leroux SJ, Proctor EM.
Comparative trial of treatment with Prioderm lotion and
Kwellada shampoo in
children with head lice. Can Med Assoc J 1984;130:407-9.
-
De Boer R. Efficacy of malathion and synergised
bioallethrine in the treatment of head louse, Pediculus humanus
spp capitis,
infestations. Acta Leidensia 1984;52:53-9.
-
De Boer R, van der Geest LPS. De werkzaamheid van
malathion tegen hoofdluis. Ned Tijdschr Geneeskd 1985;129:793-6.
-
Mazas EA, Porto MC, Perez MCS, Farquhar JA,
Hutchinson DBA. The efficacy of permethrin lotion in Pediculosis capitis.
Pharmacol Ther
1985;24:603-5.
- Donaldson RJ, Logie S.
Comparative trial of shampoos for treatment of head infestation. J R Soc
Health 1986;106:39-40.
-
Urcuyo FG, Zaias N. Malathion lotion as an
insecticide and ovicide in head louse infestation. Pharmacol Ther
1986;25:60-2.
- Brandenburg K, Deinard
AS, DiNapoli J, Englender SJ, Orthoefer J, Wagner D. 1% Permethrin cream rinse
vs
1% lindane shampoo in treating Pediculosis capitis. Am J Dis Child
1986;140:894-6.
-
Taplin D, Meinking TL, Castillero PM, Sanchez R.
Permethrin 1% creme rinse for the treatment of Pediculus humanus
var capitis
infestation. Pediatr Dermatol 1986;3:344-8.
-
Bowerman JG, Gomez MP, Austin RD, Wold DE.
Comparative study of permethrin 1% creme rinse and lindane shampoo
for the
treatment of head lice. Pediatr Infect Dis J 1987;6:252-5.
-
Armoni M, Bibi H, Schlesinger M, Pollak S,
Metzker A.
Pediculosis capitis: why prefer a solution to shampoo or spray?
Pediatr
Dermatol
1988;5:273-5.
- Mazas MEA, Salorio MLF,
Villar MJS, Duran JCG. Efficacy of a malathion lotion for the treatment of
Pediculosis capitis.
Int J Dermatol 1988;27:267-8.
-
Carson DS, Tribble PW, Weart CW. Pyrethrins
combined with piperonyl butoxide (RID) vs 1% permethrin (NIX) in the
treatment
of head lice. Am J Dis Child 1988;142:768-9.
-
DiNapoli JB, Austin RD, Englender SJ, Gomez MP,
Barrett JF. Eradication of head lice with a single treatment.
Am J Public
Health 1988;78:978-80.
-
Miller AJ, Miller RB, Simpson MB. Phenothrin
lotions in the treatment of head louse infestation. J R Soc Health
1988;108:11-4.
-
Kyle DR. Comparison of phenothrin shampoo and
malathion lotion in the treatment of head louse infection.
J R Soc Health
1990;110:62-3.
-
Mathias RG, Wallace JF. The hatching of nits as a
predictor of treatment failure with lindane and pyrethrin shampoos.
Can J
Public Health 1990;81:237-9.
-
Sexton C, Miller AJ. A comparison of a single
occasion treatment of head louse infestation with phenothrin liquid shampoo
or
a carbaryl lotion. Curr Med Res Opin 1991;12:466-70.
-
Doss S, Powell CA, Miller AJ. Phenothrin lotion,
the latest recruit in the battle against headlice: the result of two
controlled
comparative studies. J R Soc Health 1991;111:47-50.
-
Jolley JH, Kennedy JP, Miller AJ. A comparison of
two insecticidal shampoos in the treatment of head louse infection.
J R Soc
Health 1991;111:90-1.
-
Fan PC, Chung WC, Kuo CL, Lin CY, Hsu HM, Chuang
CH, et al. Evaluation of efficacy of four pediculicides against
head louse (Pediculus
capitis) infestation. Kao Hsiung I Hsueh Ko Hsueh Tsa Chih
1992;8:255-65.
- Clore ER, Longyear LA. A
comparative study of seven pediculicides and their packaged nit removal combs.
J Pediatr Health Care 1993;7:55-60. -
Burgess IF, Brown CM, Burgess NA. Synergized
pyrethrin mousse, a new approach to head lice eradication: efficacy in field
and laboratory studies. Clin Ther 1994;16:57-64. -
Chosidow O, Chastang C, Brue C, Bouvet E, Izri M,
Monteny N, et al. Controlled study of malathion and (delta)-phenothrin
lotions
for Pediculus humanus var capitis-infested schoolchildren. Lancet
1994;344:1724-7. -
Rousset JJ, Agoumi A, Jean-Pastor MJ. Etude
bioclinique d'une lotion pressurisee a base de pyrethrinoide synergise
dans le
traitement de la pediculose. Extrait des Comptes Rendus de Therapeutique et
de Pharmacologie clinique 1988;67:1-4.
- Harper EI, Taylor RJ.
Comparison of permethrin creme rinse with a leading malathion-containing
product in head louse
infestation--a clinical review. BQ10/90/8. Wellcome
Foundation Ltd: Group Research and Development.
London: Wellcome Foundation,
1990: 1-45.
- Taplin D, Meinking TL.
Pyrethrins and pyrethroids in dermatology. Arch Dermatol
1990;126:213-21.
-
Maunder JW. Resistance to organochlorine
insecticides in head lice, and trials using alternative compounds.
Medical
Officer 1971;125:27-9.
- Van Everdingen WAG.
Bestrijding van de hoofdluis.
Ned Tijdschr Geneeskd 1950;94:2640-4.
- Coates KG. Control of
head infestation in school children. Community Med 1971;126:148-9.
- Maguire J, McNally AJ.
Head infestation in school children: extent of the problem and treatment.
Community Med 1972;128:374-5.
- Chalmers I, Hetherington
J, Elbourne D, Keirse MJNC, Enkin M. Materials and methods used in
synthesizing evidence to
evaluate the effects of care during pregnancy and
childbirth. In: Chalmers I, Enkin M, Keirse MJNC, eds. Effective care in
pregnancy and childbirth. Oxford: Oxford University Press, 1989: 39-65.
- Brookes BC. Bradford's
law and the bibliography of science. Nature 1969;224:953-6.
-
Beaver PC, Jung C, Cupp EW. Clinical parasitology.
Philadelphia: Lea and Febiger, 1984.
- Maunder JW. Strategic
aspects of insecticide resistance in head lice. J R Soc Health
1991;111:24-6.
-
Andrews EB, Joseph MC, Magenheim MJ, Tilson HH,
Doi PA, Schultz MW. Postmarketing surveillance study of
permethrin creme
rinse.
Am J Public Health 1992;82:857-61. -
Kucirka SA, Parish LC, Witkowski JA. The story of
lindane resistance and head lice review. Int J Dermatol 1983;22:551-5.
-
Meinking TL, Taplin D, Kalter DC, Eberle MW.
Comparative efficacy of treatments for Pediculosis capitis infestations.
Arch Dermatol 1986;122:267-71.
(Accepted 14 July 1995)
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