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A Multi-Methods Analysis of the Burden of Head Lice for Remote-Residing Children and Communities in the Kimberley, Western Australia
Background: Head lice is an ectoparasitic skin infection commonly seen in primary school-aged children. In remote Australia, where rates of other skin infections and rheumatic heart disease are endemic, the rate of head lice infestation are unknown.
Methods: This multi-methods study aimed to describe the burden of head lice for remote-residing children in the Kimberley, Western Australia. Qualitative and quantitative data collected by The See, Treat, Prevent Skin Sores and Scabies (‘SToP’) Trial at ten visits (May 2019-December 2022, excluding wet season) to nine remote communities were analyzed for head lice rates and community perspectives.
Findings: Seven hundred and seventy-seven children (of which >95% were Aboriginal) had at least one skin check. One hundred and fifty-two community members participated in yarns and head lice was mentioned in 42 yarning sessions. Across all nine communities, mean head lice prevalence was 48·4% (SD 15·3). Head lice was repeatedly detected in the same children at a rate of 66·8% (370/554). Amongst cases of head lice, impetigo, scabies, tinea, and boils were also common at 66·1% (366/554), 17·0% (94/554), 33·6% (186/554), and 15·7% (87/554), respectively. Community voice reflected that head lice are a detriment to the physical and psychological wellbeing of children. There was a focus on prevention of secondary bacterial infections and improving the health of the environment to reduce rates of head lice.
Interpretation: In remote-residing Australian Aboriginal children, there is a high burden of head lice concurrent with other skin infections. Community voice reflected the impact of head lice on children’s wellbeing and focused on addressing contributing environmental factors and preventing secondary bacterial infection.
Funding: As per The ‘SToP’ Trial; WA Department of Health, Australian National Health and Medical Research Council, and Healthway.
Declaration of Interest: All authors declare that they have no conflicts of interest.
Ethical Approval: This study was embedded within the SToP Trial, which following support from the Kimberley Aboriginal Health Planning Forum Research Subcommittee (2017–018), ethical approval was granted by the Child and Adolescent Health Service (RGS0000000584) and Western Australia Aboriginal Health Ethics Committee (approval number 819). Approval was also provided by the University of Western Australia (RA/4/20/4123), Catholic Education Western Australia (RP2017/57), Western Australia Department of Education (D18/0281633), University of Notre Dame (reference number 2021–128F), and Murdoch University (2022/196) for student projects.
Keywords: head lice, Pediculus humanus capitis, impetigo, scabies, Tinea
Barrow, Tina and Thomas, Hannah and Enkel, Stephanie Louise and Amgarth-Duff, Ingrid and McRae, Tracy and Anderson, Lorraine and Marsh, Julie and Burgess, Rachel and Newton, Rebekah and Bowen, Asha C. and Trial, SToP (See, Treat, Prevent skin sores and scabies), A Multi-Methods Analysis of the Burden of Head Lice for Remote-Residing Children and Communities in the Kimberley, Western Australia. Available at SSRN: https://ssrn.com/abstract=5061254 or http://dx.doi.org/10.2139/ssrn.5061254
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