Treatment of head lice with dimeticone 4% lotion: comparison of two formulations in a randomised controlled trial in rural Turkey

<p>Abstract</p> <p>Background</p> <p>Dimeticone 4% lotion was shown to be an effective treatment for head louse infestation in two randomised controlled trials in England. It is not affected by insecticide resistance but efficacy obtained (70-75%) was lower than expected. This study was designed to evaluate efficacy of dimeticone 4% lotion in a geographically, socially, and culturally different setting, in rural Turkey and, in order to achieve blinding, it was compared with a potential alternative formulation.</p> <p>Methods</p> <p>Children from two village schools were screened for head lice by detection combing. All infested students and family members could participate, giving access to treatment for the whole community. Two investigator applied treatments were given 7 days apart. Outcome was assessed by detection combing three times between treatments and twice the week following second treatment.</p> <p>Results</p> <p>In the intention to treat group 35/36 treated using dimeticone 4% had no lice after the second treatment but there were two protocol violators giving 91.7% treatment success. The alternative product gave 30/36 (83.3%) treatment success, a difference of 8.4% (95% CI -9.8% to 26.2%). The cure rates per-protocol were 33/34 (97.1%) and 30/35 (85.7%) respectively. We were unable to find any newly emerged louse nymphs on 77.8% of dimeticone 4% treated participants or on 66.7% of those treated with the alternative formulation. No adverse events were identified.</p> <p>Conclusion</p> <p>Our results confirm the efficacy of dimeticone 4% lotion against lice and eggs and we found no detectable difference between this product and dimeticone 4% lotion with nerolidol 2% added. We believe that the high cure rate was related to the lower intensity of infestation in Turkey, together with the level of community engagement, compared with previous studies in the UK.</p> <p>Trial Registration</p> <p>Current Controlled Trials ISRCTN10431107</p

The Follow-Up of Treatment Process of Malaria By Real-Time Polymerase Chain Reaction: In Vivo Model

Microscopic methods are accepted as the gold standard in the diagnosis of malaria and in the follow-up of treatment. However, as the microscopical methods require experienced personnel, it is important to confirm the diagnosis with a different method for accurate diagnosis and treatment follow-up. In our study, we aimed to investigate the utility of the use of real time reverse transcriptase polymerase chain reaction (rRT-PCR), as well as microscopic methods for malaria treatment follow-up. In our study, we formed five groups each consisting of five male Balb/c mice. Each mouse was injected intraperitoneally with 10(7)/ml Plasmodium berghei parasites. After 48 hours following the injection, the mice in the first, second and third groups received 50 mg/kg/day of chloroquine treatment for one, two and three days, respectively. The fourth group was not treated and the fifth group of mice received saline for three days. The parasitemia was monitored for 21 days by blood smears prepared from the end of tail of the mice and searching the presence of the target gene region of the parasite by rRT-PCR. Both the blood smears and rRT-PCR results were positive for groups I, II, IV and V. Both blood smears and rRT-PCR results of mice in groups other than the third group were found to be positive. Blood smears of the mice in third group were found to be positive on the 5th and 7th days of the infection, and the subsequent preparations were evaluated as negative. rRT-PCR results showed positivity on day seven, but no presence of the target gene region of the parasite was detected on the other days. The comparison of microscopy and rRT-PCR methods, had shown parallel results. Apart from the microscopic examination method, it was concluded that the rRT-PCR method is important in the diagnosis of malaria and in the follow-up of the patient during the treatment process, and that different methods that support each other should be used