Head lice in Norwegian households: actions taken, costs and knowledge

Abstract

Introduction: Head lice infestations cause distress in many families. A well-founded strategy to reduce head lice prevalence must shorten the infectious period of individual hosts. To develop such a strategy, information about the actions taken (inspection, treatment and informing others about own infestations), level of knowledge and costs is needed. The present study is the first to consider all these elements combined.

Materials and methods: A questionnaire was answered by 6203 households from five geographically separated municipalities in Norway.

Results: 94% of the households treated members with pediculicides when head lice were discovered. Nearly half of the households checked biannually or not at all. Previous occurrence of head lice and multiple children in a household improved both checking frequency and method. More than 90% of the households informed close contacts about their own pediculosis. Direct costs of pediculosis were low (less than €6.25 yearly) for 70% of the households, but the ability to pay for pediculicides decreased with the number of head lice infestations experienced. One in three households kept children from school because of pediculosis. Other widespread misconceptions, such as that excessive cleaning is necessary to fight head lice, may also add unnecessary burden to households. School affiliation had a significant effect on checking frequency and method, knowledge and willingness to inform others about own pediculosis.

Conclusions: Increased checking frequencies appear to be the most important element to reduce head lice prevalence in Norway and should be a primary focus of future strategies. National campaigns directed through schools to individual households, might be an important tool to achieve this goal. In addition to improving actions taken, such campaigns should also provide accurate information to reduce costs and enhance the level of knowledge about head lice in households.

Figure 1. Head lice-checking frequencies.

Checking frequencies in households with and without earlier head lice infestations as well as in all households combined. The exact proportion is written above each bar; n = 5791.

Figure 2. Checking methods for head lice.

Checking methods in households with and without earlier head lice infestations as well as in all households combined. The exact proportion is written above each bar; n = 5418.