Impact of ivermectin drug combinations on Pediculus humanus capitis infestation in primary schoolchildren of south Indian rural villages.
BACKGROUND
Antifilarial drug combinations including ivermectin provide antifilarial activity with ancillary benefits on intestinal helminths and ectoparasites, such as chiggers and lice. The impact of single oral dose of antifilarial drugs, viz; (1) diethylcarbamazine (DEC) alone, (ii) DEC + albendazole (ALB), (iii) ivermectin (IVR) + DEC and (iv) IVR + ALB, was determined, on the head louse (Pediculus humanus capitis) in primary school children in a rural community in south India.


METHODS
Primary school children (n = 534) of age 6-10 years from four villages of South India were examined for the presence of head lice before and after single dose of DEC + ivermectin drug combination. The effectiveness and the duration of cure sustained by these drugs were quantified. The head louse was examined by "combing method" during post-treatment periods at 15, 45, 60 and 75 days interval.


RESULTS
The antifilarial drug consumption rate was similar (96-98%) in all treatment arms. In pre-treatment survey the prevalence of head lice in children administered with DEC, DEC + ALB, IVR + DEC and IVR + ALB arm was 86%, 80%, 87% and 80%, respectively, with the latter two arms demonstrating significant reduction in louse infestation (P < 0.05) for 60 days.


CONCLUSIONS
Single dose with IVR combination demonstrates a greater impact in reducing head louse infestation in the endemic rural communities for nearly 60 days. Therefore, in regions such as Africa where ivermectin is part of the antifilariasis campaign, this drug will have an additional benefit in reducing head lice infestation.
Munirathinam
Arumugam
A
Center for Research in Medical Entomology (Indian Council of Medical Research), Madurai, Tamil Nadu, India.
Sunish
Ittoop Pulikkottil
IP
Rajendran
Rathinasamy
R
Tyagi
Brij Kishore
BK
D000284:Administration, Oral; D015766:Albendazole / Q000627:therapeutic use*; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D000977:Antiparasitic Agents / Q000627:therapeutic use*; D002648:Child; D004049:Diethylcarbamazine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D019353:Endemic Diseases / Q000706:statistics & numerical data; D005369:Filaricides / Q000627:therapeutic use; D006801:Humans; D007194:India; D007559:Ivermectin / Q000627:therapeutic use*; D010373:Lice Infestations / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D010374:Pediculus; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data
D000871:Anthelmintics; D000977:Antiparasitic Agents; D005369:Filaricides; D007559:Ivermectin; D015766:Albendazole; D004049:Diethylcarbamazine