Impact of ivermectin administered for scabies treatment on the prevalence of head lice in Atoifi, Solomon Islands

Suny Coscione, Tommy Esau, Esau Kekeubata, Jason Diau, Rowena Asugeni, David MacLaren, Andrew C Steer, Christian Kositz, Michael Marks, Suny Coscione, Tommy Esau, Esau Kekeubata, Jason Diau, Rowena Asugeni, David MacLaren, Andrew C Steer, Christian Kositz, Michael Marks

Abstract

Background: Scabies and head lice are ubiquitous ectoparasitic infestations that are common across the Pacific Islands. Ivermectin is an effective treatment for both conditions, although the doses used vary. At a community level, mass drug administration (MDA) with ivermectin is an effective strategy to decrease prevalence of scabies. To what extent MDA with ivermectin will also reduce prevalence of head lice is unknown.

Methodology: Head lice prevalence was assessed before and after MDA with oral ivermectin (at a dose of 200 micrograms per kilogram of body weight) administered on day 1 and day 8. The primary outcome was the change in prevalence of head louse infestation at two weeks compared to baseline. Longer term efficacy was assessed three months after MDA.

Results: 118 participants were enrolled. Baseline prevalence of active head louse infestation was 25.4% (95% CI 18.4-34.0). At two-week follow-up, prevalence was 2.5% (95% CI 0.9-7.2), a relative reduction of 89.1% (95% CI 72.7-91.4%, p<0.001). At three-month follow-up, prevalence was 7.5% (95% CI 2.7-12.3), a relative reduction of 70.6% (95% CI 72.7%-91.4%, p <0.001). Head louse infestation was associated with younger age (age ≤10 years: prevalence 46.7%; adjusted odds ratio compared to adults of 7.2, 95%CI 2.0-25.9) and with having at least one other member of the household with active head louse infestation (adjusted odds ratio 4.3, 95%CI 1.7-11.1).

Conclusions: Head louse infestation is common in the Solomon Islands. This proof of principle study shows that oral ivermectin at a dose of 200 micrograms per kilogram can reduce the burden of active head louse infestation, offering an additional collateral benefit of MDA with ivermectin for scabies control.

Trial registration: ClinicalTrials.gov NCT03236168.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. Study enrolment and follow-up flow…
Fig 1. Study enrolment and follow-up flow diagram [modified from CONSORT guidelines [23]].

References

    1. Centre for Disease Control & Prevention (CDC). CDC—Head Lice—General Information. In: CDC [Internet]. [cited 30 Aug 2017]. Available:
    1. Van der Wouden JC, Klootwijk T, Le Cleach L, Do G, Vander Stichele R, Knuistingh Neven A, et al. Interventions for treating head lice Cochrane Database. Wiley Online Library; 2011; 10.1093/database/baq027
    1. Falagas ME, Matthaiou DK, Rafailidis PI, Panos G, Pappas G. Worldwide prevalence of head lice. Emerg Infect Dis. Centers for Disease Control and Prevention; 2008;14: 1493–4. 10.3201/eid1409.080368
    1. Speare R, Harrington H, Canyon D, Massey PD. A systematic literature review of pediculosis due to head lice in the Pacific Island Countries and Territories: what country specific research on head lice is needed? BMC Dermatol. 2014;14: 11 10.1186/1471-5945-14-11
    1. Chosidow O, Giraudeau B, Cottrell J, Izri A, Hofmann R, Mann SG, et al. Oral Ivermectin versus Malathion Lotion for Difficult-to-Treat Head Lice. N Engl J Med. Massachusetts Medical Society; 2010;362: 896–905. 10.1056/NEJMoa0905471
    1. Sanchezruiz WL, Nuzum DS, Kouzi SA. Oral ivermectin for the treatment of head lice infestation. Am J Health-Syst Pharm AJHP Off J Am Soc Health-Syst Pharm. American Society of Health-System Pharmacists; 2018; ajhp170464. 10.2146/ajhp170464
    1. Usha V, Gopalakrishnan Nair T. A comparative study of oral ivermectin and topical permethrin cream in the treatment of scabies☆, ☆☆. J Am Acad Dermatol.: Merck & Co, West Point (PA); 2000;42: 236–240. 10.1016/S0190-9622(00)90131-2
    1. Strong M, Johnstone PW. Interventions for treating scabies Cochrane Database of Systematic Reviews. Wiley Online Library; 2007. 10.1002/14651858.CD000320.pub2
    1. Ahmad HM, Abdel-Azim ES, Abdel-Aziz RT. Assessment of topical versus oral ivermectin as a treatment for head lice. Dermatol Ther. Wiley/Blackwell (10.1111); 2014;27: 307–310. 10.1111/dth.12144
    1. Nofal A. Oral ivermectin for head lice: a comparison with 0.5% topical malathion lotion. JDDG J Dtsch Dermatol Ges. 2010;8: 985–988. 10.1111/j.1610-0387.2010.07487.x
    1. Ameen M, Arenas R, Villanueva-Reyes J, Ruiz-Esmenjaud J, Millar D, Domínguez-Dueñas F, et al. Oral ivermectin for treatment of pediculosis capitis. Pediatr Infect Dis J. 2010;29: 991–3.
    1. Currie MJ, Reynolds GJ, Glasgow NJ, Bowden FJ. A Pilot Study of the Use of Oral Ivermectin to Treat Head Lice in Primary School Students in Australia. Pediatr Dermatol. 2010;27: 595–599. 10.1111/j.1525-1470.2010.01317.x
    1. Glaziou P, Nyguyen LN, Moulia-Pelat JP, Cartel JL, Martin PM. Efficacy of ivermectin for the treatment of head lice (Pediculosis capitis). Trop Med Parasitol Off Organ Dtsch Tropenmedizinische Ges Dtsch Ges Tech Zusammenarbeit GTZ. 1994;45: 253–4.
    1. Steer AC, Jenney AWJ, Kado J, Batzloff MR, La Vincente S, Waqatakirewa L, et al. High Burden of Impetigo and Scabies in a Tropical Country. Franco-Paredes C, editor. PLoS Negl Trop Dis. Fiji Ministry of Health; 2009;3: e467 10.1371/journal.pntd.0000467
    1. Romani L, Whitfeld M, Koroivueta J, Kama M, Wand H, Tikoduadua L, et al. The Epidemiology of Scabies and Impetigo in Relation to Demographic and Residential Characteristics: Baseline Findings from the Skin Health Intervention Fiji Trial. Am J Trop Med Hyg. 2017;97: 845–850. 10.4269/ajtmh.16-0753
    1. Mason DS, Marks M, Sokana O, Solomon AW, Mabey DC, Romani L, et al. The Prevalence of Scabies and Impetigo in the Solomon Islands: A Population-Based Survey Vinetz JM, editor. PLoS Negl Trop Dis. World Health Organisation, Department of Child and Adolescent Health and Development; 2016;10: e0004803 10.1371/journal.pntd.0004803
    1. Haar K, Romani L, Filimone R, Kishore K, Tuicakau M, Koroivueta J, et al. Scabies community prevalence and mass drug administration in two Fijian villages. Int J Dermatol. 2014;53: 739–745. 10.1111/ijd.12353
    1. Romani L, Whitfeld MJ, Koroivueta J, Kama M, Wand H, Tikoduadua L, et al. Mass Drug Administration for Scabies Control in a Population with Endemic Disease. N Engl J Med. 2015;373: 2305–2313. 10.1056/NEJMoa1500987
    1. Marks M, Taotao-Wini B, Satorara L, Engelman D, Nasi T, Mabey DC, et al. Long Term Control of Scabies Fifteen Years after an Intensive Treatment Programme Vinetz JM, editor. PLoS Negl Trop Dis. John Wiley & Sons, Ltd; 2015;9: e0004246 10.1371/journal.pntd.0004246
    1. Lawrence G, Leafasia J, Sheridan J, Hills S, Wate J, Wate C, et al. Control of scabies, skin sores and haematuria in children in the Solomon Islands: another role for ivermectin. Bull World Health Organ. Switzerland; 2005;83: 34–42. doi:
    1. Steer A, Tikoduadua L, M Manalac E, Colquhoun S, Carapetisd J, Maclennane C. Validation of an Integrated Management of Childhood Illness algorithm for managing common skin conditions in Fiji. Bull World Health Organ. 2009;87: 173–179. 10.2471/BLT.08.052712
    1. Hay RJ, Steer AC, Engelman D, Walton S, Carapetis J, Currie B. Scabies in the developing world-its prevalence, complications, and management Clin Microbiol Infect Off Publ Eur Soc Clin Microbiol Infect Dis. World Bank and Oxford Universiity Press Publications, New York; 2012;18: 313–23. 10.1111/j.1469-0691.2012.03798.x
    1. Consolidated Standards of Reporting Trials (CONSORT). CONSORT 2010 Key Documents [Internet]. 2010 [cited 29 Aug 2017]. Available:

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