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Ex vivo effectiveness of French over-the-counter products against head lice (Pediculus humanus capitis De Geer, 1778)

Abstract

Head lice infestation is still a public health problem worldwide, with an intracountry and intercountry prevalence variation of 0.7 to 59 %. There is a large variety of over-the-counter anti-louse products, but their efficacy is not always well assessed. Our objective was to test the pediculicidal and ovicidal efficacy of 21 over-the-counter head louse products, available in France during the period of 2008 to 2012. We tested children living in Tours City in central France and visiting preschools, primary schools, kindergarten, camps, and child care facilities, as well as children in their family houses, and were examined for the presence of lice. The products were collected from randomly selected pharmacies by covert investigators and then tested in the laboratory on an ex vivo sample of head lice and their eggs, collected from the hair of infested children. Living lice and unharmed eggs were collected from the scalps of 3–12 years old. The laboratory conditions for ex vivo testing mimicked the manufacturers’ instructions for exposure time and application method. In 21 runs, 3919 living lice and 4321 undamaged living eggs were collected from the scalp of over 400 children. The 21 products were classified in three groups: 6 products in a group of potentially 100 % pediculicidal activity and potentially 100 % ovicidal activity, 8 products in a group of potentially 100 % pediculicidal activity but insufficient ovicidal activity (including 2 products with claims of single application treatment), and 7 products in a group of insufficient pediculicidal activity and ovicidal activity. The pharmaceutical market for head lice products in France is swamped with poorly tested and ineffective products. Rigorous efficacy testing preregistration and periodic screening and testing of effectiveness in the post-registration period should be endorsed by the health authorities.

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Acknowledgments

We thank Jean-Pierre Cheneveau, head of Community Health Services in the city of Tours, for his ongoing support for this study, Sudarshan K Malhotra, PhD, and Jacqueline Miller, PhD, for their editorial suggestions and linguistic advice in writing the manuscript, Cecile Enguehard-Gueiffier, PhD, for her help with the chemical classification of active ingredients of head lice products, and last but not least, the school masters, nurses, kindergarden staff, social assistants, managers, and executives of camps and child care facilities as well as the media, pharmacists, physicians, and parents, who helped us to accomplish this study.

Conflict of interest

Combescot-Lang C. and Toubate B performed as university experts tests for the evaluation of numerous products, including products in this study. However, for this study, all tests were performed independently, with products bought by the researchers in pharmacies.

Mumcuoglu K.Y. has participated in the development of Paranix®.

Vander Stichele RH and Veirron E have no potential conflicts of interest to declare.

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Combescot-Lang, C., Vander Stichele, R.H., Toubate, B. et al. Ex vivo effectiveness of French over-the-counter products against head lice (Pediculus humanus capitis De Geer, 1778). Parasitol Res 114, 1779–1792 (2015). https://doi.org/10.1007/s00436-015-4363-9

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  • DOI: https://doi.org/10.1007/s00436-015-4363-9

Keywords

  • Pediculosis
  • Pediculus humanus capitis
  • Pediculicides
  • France
  • Effectiveness
  • Ex vivo assays