RESEARCH ARTICLE


Diagnosis of Head Lice Infestations: An Evidence-Based Review



Hermann Feldmeier*
Institute for Microbiology and Hygiene, Charité University Medicine, Campus Benjamin Franklin, Hindenburgdamm 27, D-12203 Berlin, Germany.


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Creative Commons License
© 2010 Hermann Feldmeier

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Institute for Microbiology and Hygiene, Charité University Medicine, Campus Benjamin Franklin, Hindenburgdamm 27, D-12203 Berlin, Germany; Tel: +49 4181 281628; Fax: +49 4181 36943; E-mail: hermann.feldmeier@charite.de


Abstract

The diagnosis of head lice infestation is made through visual inspection of the hair and the scalp or by dry/wet combing. The choice of the method essentially depends whether the examiner aims at the detection of active infestation – presence of trophic stages and/or viable eggs 7ndash; or wants to identify a historical infestation (presence only of nits/dead eggs). For the latter purpose, visual inspection of the hair at five predilection sites (temples, behind the ears, neck) is the method of choice (sensitivity 80% - 90%). The optimal method for the diagnosis of active head lice infestation is wet combing with a sensitivity ≥ 90%, even in children with a low infestation intensity. In resource-pour settings, where pediculosis capitis is very common and infestation intensity is high, self-diagnosis by affected individuals or their caretakers is an accurate alternative.

Keywords: Head lice infestation, diagnosis, sensitivity, specificity, prevalence.