title: Prevalence of Head Lice Infestation and Its Associated Factors among Primary School Students in Iran: A Systematic Review and Meta-analysis.
abstract: OBJECTIVE
  Head lice infestation is one of the most important health problems, generally involving children aged 5-13 years. This study aims to estimate the prevalence of head lice infestation and its associated factors among primary school children using systematic review and meta-analysis methods.
  
  
  METHODS
  Different national and international databases were searched for selecting the relevant studies using appropriate keywords, Medical Subject Heading terms, and references. Relevant studies with acceptable quality for meta-analysis were selected having excluded duplicate and irrelevant articles, quality assessment, and application of inclusion/exclusion criteria. With calculating standard errors according to binomial distribution and also considering the Cochrane's Q test as well as I-squared index for heterogeneity, pediculosis prevalence rate was estimated using Stata SE V.11 software.
  
  
  RESULTS
  Forty studies met the inclusion criteria of this review and entered into the meta-analysis including 200,306 individuals. Using a random effect model, the prevalence (95% confidence interval) of head lice infestation among primary school children was estimated as 1.6% (1.2-2.05), 8.8% (7.6-9.9), and 7.4% (6.6-8.2) for boys, girls, and all the students, respectively. The infestation rate was found to be associated with low educational level of parents, long hair, family size, mother's job (housewife), father's job (worker/unemployed), using a common comb, lack of bathrooms in the house, and a low frequency of bathing.
  
  
  CONCLUSIONS
  This meta-analysis revealed that the prevalence of head lice infestation among Iranian primary school children is relatively high with more prevalence among girls. We also found that economic, social, cultural, behavioral, and hygienic factors are associated with this infestation.
authors.affiliation: Health Sciences Research Center, School of Public Health, Mazandaran University of Medical Science, Sari, Iran.
authors.forename: Mahmood
authors.initials: M
authors.lastname: Moosazadeh
authors.affiliation: Department of Community Medicine, Zabol University of Medical Sciences, Zabol, Iran.
authors.forename: Mahdi
authors.initials: M
authors.lastname: Afshari
authors.affiliation: Health Deputy, Mazandaran University of Medical Science, Sari, Iran.
authors.forename: Hormoz
authors.initials: H
authors.lastname: Keianian
authors.affiliation: Health Deputy, Mazandaran University of Medical Science, Sari, Iran.
authors.forename: Asghar
authors.initials: A
authors.lastname: Nezammahalleh
authors.affiliation: Health Sciences Research Center, School of Public Health, Mazandaran University of Medical Science, Sari, Iran.
authors.forename: Ahmad Ali
authors.initials: AA
authors.lastname: Enayati
keywords: head lice; infestation; pediculosis; prevalence; primary students
references.citation: Southeast Asian J Trop Med Public Health. 2006 May;37(3):536-43
references.pmid: 17120976
references.citation: J Res Health Sci. 2009 Jun 28;9(1):45-9
references.pmid: 23344146
references.citation: Turkiye Parazitol Derg. 2013;37(1):32-5
references.pmid: 23619043
references.citation: Int J Dermatol. 2008 Mar;47(3):249-55
references.pmid: 18289325
references.citation: Parasitol Res. 2010 Nov;107(6):1415-9
references.pmid: 20683614
references.citation: Int J Health Plann Manage. 2014 Jul-Sep;29(3):e277-90
references.pmid: 23630092
references.citation: Cent Eur J Public Health. 2013 Jun;21(2):104-8
references.pmid: 24053067
references.citation: Pediatr Dermatol. 2012 Jul-Aug;29(4):426-9
references.pmid: 22107034
references.citation: Eur J Epidemiol. 2004;19(5):491-5
references.pmid: 15233324
references.citation: Iran J Arthropod Borne Dis. 2010;4(1):42-6
references.pmid: 22808387
references.citation: Turkiye Parazitol Derg. 2011;35(3):151-3
references.pmid: 22203505
references.citation: J Med Entomol. 2014 Mar;51(2):400-7
references.pmid: 24724290
references.citation: Parasitol Res. 2009 Jun;104(6):1295-8
references.pmid: 19148682
references.citation: Trop Biomed. 2012 Jun;29(2):207-11
references.pmid: 22735841
references.citation: Int J Dermatol. 2012 Feb;51(2):168-72
references.pmid: 22250625
references.citation: East Mediterr Health J. 2005 Sep-Nov;11(5-6):988-92
references.pmid: 16761669
references.citation: Caspian J Intern Med. 2013 Winter;4(1):607-10
references.pmid: 24009945
references.citation: Rev Inst Med Trop Sao Paulo. 2011 Nov-Dec;53(6):325-7
references.pmid: 22183456
references.citation: Pediatr Dermatol. 2010 Nov-Dec;27(6):595-9
references.pmid: 21138467
references.citation: Asian Pac J Trop Biomed. 2012 Nov;2(11):901-4
references.pmid: 23569868
references.citation: J Res Health Sci. 2013 Sep 17;13(2):176-80
references.pmid: 24077476
references.citation: Int J Community Based Nurs Midwifery. 2014 Jul;2(3):196-200
references.pmid: 25349862
references.citation: Korean J Parasitol. 2011 Mar;49(1):95-8
references.pmid: 21461277
references.citation: BMJ. 2007 Oct 20;335(7624):806-8
references.pmid: 17947786
references.citation: Rev Chil Pediatr. 2014 Jun;85(3):312-8
references.pmid: 25697248
references.citation: J Community Health. 2015 Apr;40(2):222-6
references.pmid: 25086565
references.citation: Pak J Biol Sci. 2007 Oct 1;10(19):3473-5
references.pmid: 19090174
references.citation: Turkiye Parazitol Derg. 2014;38(1):32-6
references.pmid: 24659699
references.citation: Pak J Biol Sci. 2008 Jan 15;11(2):260-4
references.pmid: 18817200
references.citation: J Arthropod Borne Dis. 2012;6(1):79-85
references.pmid: 23293782
references.citation: East Mediterr Health J. 2012 Jan;18(1):43-8
references.pmid: 22360010
references.citation: J Egypt Soc Parasitol. 2001 Apr;31(1):43-50
references.pmid: 12557928