Worldwide Prevalence of Head Lice

5. Miller RW, Rabkin CS. Merkel cell car-cinoma and melanoma: etiological similarities and differences. Luthra UK. Analysis by polymerase chain reaction of the physical state of human papillomavirus type 16 DNA in cervi-cal preneoplastic and neoplastic lesions. To the Editor: Pediculosis capitis has been well-known since antiquity (1). Human infestation can result in psychological frustration for parents and children (2); furthermore, preventive and therapeutic practices, such as head shaving and the " no-nit " policy of excluding infected children from school, can also induce social stress. We sought to synthesize the available evidence regarding the worldwide prevalence of lice infestation in the 21st century by conducting a literature search of PubMed and Scopus databases in which we searched for the term pediculosis. We also searched Google for the terms head lice/pedic-ulosis capitis and individual country names and evaluated references of the articles and reports retrieved through this search. Eligible studies were ar-Most studies had been conducted in Asia; Turkey was overrepresented. Prevalence varied from 0.7% to 59% and was higher in girls and women. Of the 29 studies, 24 involved schoolchil-dren; the other studies involved refugee children, child laborers, the general population, street children, jail inmates, and children accompanying their mothers in prison. In Europe, prevalence varied from 0.48% to 22.4%. However, 1 study reported a much higher annual incidence (37.4%) in England (3). A study in the Ukraine showed increasing adult representation in the overall affected population (4). Six studies involved schoolchildren; the remaining studies involved refugees, homeless persons, and the general population. Data from Africa, with the exception of 1 study in South Africa, were derived from Egypt. Prevalence varied from 0% to 58.9% and was higher in females. The study in South Africa (5) challenges the generally accepted concept that head lice infestation refers to lower socioeconomic status; of 2 schools, 1 in a low socioeconomic status area, populated by black students only, and the other in a high socioeconomic status area, populated by students of various races, head lice infestation was found only in the second school, solely among white pupils. Of 6 studies in Egypt, 4 involved diverse populations: urban poor preschool children, orphanage children, and the general population. Most studies in the Americas were conducted in Brazil, although we also found data from the United States, Cuba, and Argentina. Prevalence varied from 3.6% to 61.4% and was higher in females. Of 7 studies, 4 …