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Head lice Outbreak in Primary Girls School Riyadh, 2010


Head lice infestation is one of the most common parasitic infections in childhood. Pediculosis capitis is known to be especially prevalent in school children, and studies performed in different countries suggest broadly varying infestation rates. The principal of primary girl's school noticed an infestation of head lice in the students so she requested help in investigating this outbreak and controlling the problem. Field Epidemiology Training Program sent a team to the school and started to verify the extent of the outbreak of head lice, identify the possible risk factors associated with the occurrence of this outbreak and to provide recommendations for disease control and prevention of its recurrence.


A case control study was conducted. A case was defined as any student in the primary school who develops one of the following symptoms, head itching, and head wound, and feeling movement in hair. A control was defined as any student in the primary school in the same classroom as a case but not infected by lice at the same period. Self-administered questionnaires were distributed to study subjects and to collect information about use of common items and contact.


Out of the total of 388 students 82 students were infected by head lice comprising (21.1%) .Due to incompleteness of questionnaires, 76 cases and 144 controls where included in the study. All the studied subjects were Saudi females. Their age ranged between 7 and 11 years with a mean of 9.7 years (SD ±2.43). Considering risk factor for infestation by head lice among school girls it was found that the hair ribbon was shared by (77.6%) of cases compared to (12.5 %) of controls. This difference was statistically significant (OR=24.2, 95% CI 11.1 - 54.4).The scarf was also shared commonly among cases (77.6%) than control (13.2%) attaining statistical significance (OR=22.8, 95% CI 10.5 - 50.6). Sharing hairclip was also statistically significantly associated with infestation where it was shared by (82.9%) of cases and only (20.8%) of control (OR=18.4 with 95% CI 8.5 - 40.6). Statistically significant different also existed between cases and control in sharing hair comb as we found that is (OR=7.5, 95% CI 3.9-14.8).


This outbreak of head lice in the girl's elementary school is mainly transmitted by sharing other accessories especially hair ribbon, hair clip and scarf .Health education and encouraging of personal hygiene and preventing using of other accessories will be the best methods to control and prevent head lice.