Burden and Experiences of Head Lice Infestation Among Children in Western Australia.

Abstract

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 downstream sequelae are endemic, the rate of head lice infestation is unknown.

Methods: This multimethod observational study is aimed at describing the burden of head lice for remote-residing children from nine communities in the Kimberley, Western Australia. Qualitative and quantitative data collected by the See, Treat, Prevent Skin Sores and Scabies ('SToP') Trial at 10 timepoints between May 2019 and December 2022 were analysed to understand head lice rates and community perspectives.

Findings: Across the Kimberley over the course of the study, the mean head lice prevalence was 48.4% (SD 15.3). Of children with head lice detected at any timepoint (n = 554), repeated detection occurred at a rate of 66.8% (370/554). Head lice was mentioned in 42 yarning sessions with community members and service providers. Community voice reflected repeated head lice infestation to be detrimental to the physical and psychological well-being of children. Much of the discussion focussed on prevention of secondary bacterial infections and improving the quality and maintenance of housing to provide for healthy practices to reduce the rates of head lice.

Conclusion: In remote-residing Australian Aboriginal children, there is a high burden of head lice. Community members reflected the impact of head lice on children's well-being and focused on addressing contributing environmental factors and preventing secondary bacterial infection.

Trial registration: Australian New Zealand Clinical Trials Registry Number: ACTRN12618000520235.