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Prevalence and risk factors of pediculosis in children of the Lacandon Jungle in Chiapas, Mexico

Authors:
  • Centro Regional de Investigacion en Salud Publica del INSP, Tapachula Chiapas
  • Servicios de salud de Nuevo León
383
salud pública de méxico / vol. 60, no. 4, julio-agosto de 2018
CARTAS AL EDITOR
tema de Información sobre Nacimientos. Ciudad
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Dilema ético: el caso
de la huelga de hambre
Señor editor: El Departamento de
Derechos Humanos del Colegio Mé-
dico de Chile acompañó la huelga
de hambre de cuatro imputados por
el caso “Iglesia” en Temuco-Chile.
Esta situación de conmoción para los
observantes de los derechos humanos
''++PRWLYDODSUHVHQWHUHÁH[LyQ
El caso de la huelga de hambre
se ha discutido con soporte ético en
el convenio de Malta adoptado por
OD   $VDPE OHD 0p GLFD 0 XQGLDO
$00\UHYLVDGRSRUOD$00
en Sudáfrica, en 2006.1
La huelga de hambre es una
medida extrema. Las personas que se
encuentran detenidas deciden libre y
conscientemente dejar de alimentarse
con el objetivo de reivindicar algún
derecho frente a las autoridades. Se
trata de personas que no quieren
morir pero que ofrecen su vida por
objetivos superiores.
¿Cómo cuidarlas sin intervenir
en su demanda social? Cuidar es
vida: todas las culturas desarrollan
normas de cuidado. Para Boff,2 cuidar
es entretejer una relación cariñosa
con la realidad y con cada ser de la
creación. La ONU3 señala que las
tareas de cuidado posibilitan el de-
sarrollo humano pues actúan como
medio para satisfacer las necesidades
del hombre y, con ello, optimizar los
recursos disponibles y posibilitar el
reconocimiento y aprecio que todo ser
humano requiere para su desarrollo.
En el ámbito sanitario, el cuidado
es parte fundamental de la relación
para promover, proteger o restaurar
la salud. Un viejo aforismo dice “en
salud se cura a veces, pero siempre
se cuida”. Así, el cuidado que acom-
paña las actividades de asistencia
introduce valores en las decisiones e
incrementa la calidad de la atención.
La salud traspasa el ámbito sanitario
y se convierte en un bien público y
político: más que la ausencia de en-
fermedades, la entendemos como un
derecho. Las culturas ancestrales ha-
blan del buen vivir, cada uno consigo
mismo, con los otros y con el entorno.
La ética del cuidado,5 basada en
la teoría intersubjetiva del desarrollo
moral, posiciona el bien de las per-
sonas en una relación que respeta la
alteridad y las emociones humanas:
responsabilidad con el otro, alteridad
con el legítimo otro, vuelco a la mismi-
dad para redescubrir que el otro es un
ser vulnerable; su fragilidad requiere
la pronta respuesta profesional.
El dilema es encontrar el equili-
brio entre la autonomía del huelguis-
ta y el mayor bienestar posible; evitar
el daño disminuyendo al mínimo el
riesgo de la salud del demandante
sin forzar ni presionar el término del
ayuno. La convención establece que
la alimentacn forzada nunca es
éticamente aceptable pues degrada
la decisión del huelguista.
Sociedades basadas en leyes
injustas generan respuestas extremas.
La ética del cuidado nos recuerda que
la humanidad tiene el don de cuidar.
Los problemas de las minorías son
problema de las mayorías.
Jeanette Pérez-Jiménez, D en C Educ .(1)
jeperez@uct.cl
(1) Facultad de Ciencias Religiosas y Filosofía,
Universidad Católica de Temuco. Temuco, Chile.
https://doi.org/10.21149/9138
Referencias
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Prevalence and risk factors
of pediculosis in children
of the Lacandon Jungle in
Chiapas, Mexico
Dear editor: The head louse, Pediculus
humanus capitis, has been linked to
humans for thousands of years and
even today affects millions of people.1
Per general is not considered a major
disease.2 Personal characteristics, so-
cioeconomic and cultural conditions
and the development of insecticide
UHVLVWDQFH KDYH DOVR LQÁXHQFHG WKH
spread of this disease.3 In Mexico,
there are only a few studies about
the topic or its relation to Rickettsia
transmission, with emphasis on body
lice surveillance. A cross sectional
study was carried out in Lacanja
Chansayab, in Lacandon Jungle of
Chiapas, from May to June 2015. The
FRPPXQLW\KDV D SRSXODWLRQ RI
inhabitants, whom at least 68 are chil-
GUHQRIWR\HDUVROG7KHVDPSOH
VL]H  ZDV REWD LQHG ZLWK  ,&  
children were included. Homes were
CARTAS AL EDITOR
384
salud pública de méxico / vol. 60, no. 4, julio-agosto de 2018
visited to inform parents/guard-
ians about the study and request
the participation through informed
consent (COBICIS-56/02/2016/02-
UBE-RMSC).
Parents also answered a survey
related with overcrowding degree,
which included questions about
housing and family members. We
observed high head lice prevalence
  6RFLRHFR QRPLF VWDWX V K\-
giene, cultural practices and hair
characteristics of children underwent
visual inspection. Children were
checked in detail using a plastic
lice-comb. Children from 10 to 13
years of age were the most affected,
ZLWKVLJQLÀFDQW GLIIHUHQFHp 
between the age groups (table I).
More boys than girls were in-
cluded. Statistical analysis did not
UHYHDODVLJQLÀFDQWGLIIHUHQFHEHWZHHQ
infestation percentage and gender
(p 9DULDEOHVWKDWLQÁXHQFHWKH
transmission are: 1) number of house-
hold members (pKDLUOHQJWK
(p<0.001) and 3) hair color (p 
We believe that sisters transmitted
lice to brothers because they typi-
cally wear long hair as well as sharing
fomites and beds. We must also con-
sider that the population studied has
limited access to interact with people
outside their community. Therefore,
this condition is likely an overestima-
tion in marginalized communities of
other ethnicities. The head louse has
greatly affected this indigenous group;
60% of the records in Mexico.5
Although overcrowding is com-
mon during historical head lice out-
breaks, it is not a determining factor.3
However, the need for a regular sur-
veillance and control program exists
whenever there is a susceptible popu-
lation and it is neglected in outbreak
reports or suspected Rickettsiosis
cases. For years, head lice have been
given little attention as a disease vec-
tor and transmitter of pathogens like
Rickettsia o Bartonella. Old and new
reports all indicate that a lack of sur-
veillance plays more than a small role
during transmission.6 It also exposes
the need to regularly carry out thor-
ough entomologic and epidemiologic
surveillance for head lice infestations,
as well as a program for direct patient
attention in highly vulnerable popu-
lations with little access to health care
systems. Research was supported by
'6$352'(3
Maricela Laguna-Aguilar, D en C ,(1)
Rosa M Sánchez-Casas, D en C,(2,3)
Esteban E Díaz-González,QBP, D en C,(2)
Samanta Del Río-Galván, D en C ,(4)
Jesús J Hernández-Escareño, D en Sanid y Anatom Anim,(3)
Ildefonso Fernández-Salas, PhD, M Entomol.(2,4)
Ildefonso.fernandez@insp.mx
(1) Cátedra Conacyt, Centro Regional de Investigación
en Salud Pública, Instituto Nacional de Salud Pública.
Chiapas, México.
(2) Centro de Investigación y Desarrollo
en Ciencias de la Salud, Universidad Autónoma
de Nuevo León. Nuevo León, México.
(3) Facultad de Medicina Veterinaria y Zootecnia,
Universidad Autónoma de Nuevo León.
Nuevo León, México.
(4) Centro Regional de Investigación en Salud Pública,
Instituto Nacional de Salud Pública. Chiapas, México.
https://doi.org/10.21149/8909
References
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WMSRF]XLILIEHPSYWIPediculus capitis4YFPMG
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Efectividad del diagnóstico
clínico de las arbovirosis
(dengue, Zika y chikungunya)
en la Jurisdicción Tijuana BC
México, 2015-2016
Señor editor: Para presentar el re-
sultado del análisis de los casos
asociados con el diagnóstico clínico
de las arbovirosis en la Jurisdicción
de Tijuana Baja California, se rea-
lizó el cálculo de la sensibilidad y
especificidad de las definiciones
operacionales (DO) de dengue, Zika
y chikungunya (CHIK).
Table I
PREVALENCE AND FACTORS BY AGE GROUP
OF HEAD LICE OBSERVED IN LACANDON CHILDREN,
LACANJA CHANSAYAB, CHIAPAS, MEXICO (N=54). 2015
Infestation of head lice Age group Gender
6-9 n(%) 10-13 n(%) Total n(%) Female Male r2 p value
2IKEXMZI     
Positive      
8SXEP    
... only below Chiapas (28.2%), and has a Mayan-speaking population concentrated in municipalities of the southern and eastern part of the state where poverty also prevails. Pediculosis has an important psychological and social impact on the patients and their families since they are stigmatized as having poor hygiene and living in marginalized conditions, a misconception that must be combated through health education to avoid harming the indigenous population in Yucatan(Laguna-Aguilar et al., 2018;Hatam-Nahavandi et al., 2020). As far as we know, no F I G U R E 2 Maximum-likelihood phylogenetic tree generated using the Kimura two-parameter model (K2) with Gamma distribution (+G) and Invariant sites (+I) with a total of 731 bp of the 16S-rDNA, and rpoB genes concatenated from a few members of the genus Acinetobacter. ...
... The sequences exhibited 99.66% (588/590 bp) similarity to sequences from Wolbachia sp. detected in PHC from Canada (AY331114.1).In Mexico, pediculosis has been shown that it affects up to 60% of school children, with an average prevalence that goes from 15% to 30%(Hatam-Nahavandi et al., 2020;Sánchez-Casas et al., 2021).However, in the present study, the overall prevalence of head lice ulosis affects several vulnerable groups, such as indigenous communities(Ortega-Marin et al., 2013;Laguna-Aguilar et al., 2018). ...
... mainly those of the Pediculidae and Phthiridae families(Kyei-Poku et al., 2005;Covacin & Barker, 2007).Due to the findings generated in the present study, it is important to perform surveillance of PHC populations to identify the degree of spread of these pathogens and their impact on populations throughout Yucatan as well as nationwide.F I G U R E 3 Maximum-likelihood phylogenetic tree generated using the Tamura three-parameter model (T92) with Gamma distribution (+G) for a total of 347 bp of the gltA gene from a few members of the genus Bartonella. The diamond indicates sequences generated in Yucatan, Mexico. ...
Article
Lice represent one of the most neglected group of vectors worldwide, particularly in Latin America. Records of bacterial agents related to head lice are non‐existent in this region of the continent. Many of these communities often do not have adequate access to public services and/or health protection. The normalization of this condition prevents them from manifesting discomfort, such as bites and itching, which further aggravates the situation, as they can be vectors of important diseases. For this reason, the aim of this work was to identify the richness of bacterial pathogens (Acinetobacter, Bartonella, and Rickettsia) and endosymbionts (Wolbachia) in head lice of paediatric patients from the indigenous municipality of Hoctun, Yucatan, Mexico. DNA extraction was performed using the QIAamp DNA Mini Kit. For the detection of bacterial pathogens, fragments of the gltA, rpoB, and 16S rDNA genes were amplified. For the detection of Wolbachia, the wsp gene was amplified. Of the 28 lice analysed, the presence of two genera of bacterial pathogens was detected Acinetobacter (42.9% = 12/28) and Bartonella (7.14% = 2/28). We also detected the endosymbiont Wolbachia (71.42% = 20/28). Our results showed that DNA from three bacteria species (Acinetobacter baumannii, Bartonella quintana, and Wolbachia pipientis) was present with frequencies ranging from 3.57% to 71.42%. This work represents the first exploratory study of the diversity of agents associated with head lice (Pediculus humanus capitis) in Mexico and Latin America. Due to the findings generated in the present study, it is important to perform surveillance of head lice populations to identify the degree of spread of these pathogens and their impact on populations in the region.
... Despite significant health advances in various societies, parasitic infection, including head lice, is still a health problem in poor and developing countries. According to the World Health Organization, the head lice infestation is also common in Iran. 10 in different countries such as Turkey (in primary school girls), 14 Ethiopia (in children aged 9-11 years), 15 Brazil (in children and the elderly), 16 Poland (in youth), 17 Mexico (in children aged 10-13 years), 18 and Iraqi Kurdistan (in children 1-5 years), 19 respectively. Studies conducted in different parts of Iran have differently reported the overall prevalence of the head lice infection in different groups of society. ...
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Background and aims: Pediculosis is one of the most common parasitic diseases that affect a wide range of age groups. The prevention of head lice infections promotes the physical and mental health of people in the community. Thus, the aim of this study was to investigate the prevalence of head lice infections and the factors affecting them in those who referred to health centers in Gerash County from 2011 to 2018. Methods : This descriptive cross-sectional study was conducted on patients suspected with head lice infections in health centers in Gerash. These infections were diagnosed by observing adult lice, nymphs, or nits on the head with the help of a magnifying glass. The collected data were then analyzed using SPSS software, version 22 and P ˂ 0.05 was considered as the significance level. Results : In general, 66410 patients suspected with head lice were examined, of whom 2,547 cases (3.83%) were reported with confirmed infections including 2395 female (94.03%) and 152 male (5.97%) cases. The highest levels of infections were reported in the age group of 6-10 years while the lowest levels of infections were found in children less than 6 years of age. A significant statistical relationship was observed between head lice and gender, age, season, and the place of residence, and year of infection ( P <0.05). Conclusion : Due to the increasing trend of head lice infections in recent years, pediculosis is still considered a health problem. Therefore, training on personal hygiene, adequate access to health services, and early diagnosis and treatment can play an important role in the prevention and elimination of head lice.
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The prevalence of pediculosis in Mexican children was studied in San Nicolas and Tapachula, Mexico. A cross-sectional study included 888 students between six and 12 years old from two urban communities with an unequal socioeconomic status between September 2015 and March 2016. A Pearson χ2 and multivariate logistic analysis were carried out to associate risk factors to pediculosis. The overall prevalence of pediculosis from both localities was 23.9%. The female gender; long and medium hair; living with someone infested; previously infested by head lice and curling hair were variables linked to a significantly higher prevalence of pediculosis (p < 0.01). Nevertheless, no significant differences were observed in the age groups, localities and socioeconomic status for human lice infection. Socioeconomic variables such as numbers of inhabitants, floors of house, beds and rooms; and parents’ qualification did not show a significative association for pediculosis. Health education in schools is needed for pediculosis prevention and remove the stigmatization of this disease related to poverty.
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Homeless persons in San Francisco, California, USA, have been shown to have head and body lice infestations and Bartonella quintana infections. We surveyed a self-selected population of homeless persons in San Francisco to assess infestations of head and body lice, risks of having body lice, and presence of B. quintana in lice. A total of 203 persons who reported itching were surveyed during 2008-2010 and 2012: 60 (30%) had body lice, 10 (4.9%) had head lice, and 6 (3.0%) had both. B. quintana was detected in 10 (15.9%) of 63 body lice pools and in 6 (37.5%) of 16 head lice pools. Variables significantly associated (p <= 0.05) with having body lice in this homeless population included male sex, African-American ethnicity, and sleeping outdoors. Our study findings suggest that specific segments of the homeless population would benefit from information on preventing body lice infestations and louseborne diseases.
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We conducted an analytical cross-sectional survey to estimate the prevalence of and factors associated with active head lice infestation. In total 140 children, aged 6 to 16-years, from a public school in rural Yucatan, Mexico, were examined by wet-combing. A structured questionnaire was used to collect information on individuals and the conditions in the surrounding environment. Head lice infestation was found in 19 out of the 140 children tested (13.6%) and this was associated with both lower income (OR 9.9, 95% CI 2.15-45.79, p = 0.003) and a higher frequency of hair washing (OR 8, 95% CI 1.58-50, p = 0.012). Intersectoral control programs that take into account the socioeconomic differences of children should be implemented.
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Head lice infestations are common in sub-Saharan Africa, but knowledge, attitudes and practices have never been studied in this region. This population-based study was conducted in a small rural community (population = 590) in Kwara State, Central Nigeria. Inhabitants of the community were interviewed regarding head lice infestations, using a pre-tested structured questionnaire, and examined regarding the presence of active pediculosis. Of the 496 participants included, 367 (74.0%) had experienced head lice infestations, but only 26 (11.1%) of the individuals older than 15 years knew the correct mode of transmission. Of 142 individuals with active pediculosis, only 1 (0.7%) felt ashamed. Treatment was most commonly done by grooming (46.3%), followed by combing (27.2%). Only 4.6% used pediculicides, and 21.8% did not apply any treatment. Opinions about difficulties in controlling head lice were asked in three groups: biological, technical and social. In the first group, the most common difficulty noted was detecting head lice (52.1%), followed by possible resistance that would lengthen the time of infestation (38.9%). Technical constraints included concerns on the safety and effectiveness of products (48.7%) and difficulties in obtaining treatment (46.2%). Social contraints included difficulty in treating children (24.4%), lack of knowledge (23.5%), and the social behavior of children (22.2%). Head lice were not perceived as an important disease in a rural Nigerian community, and feelings about the infestation were mostly indifferent. Despite its common occurrence, knowledge on head lice was limited.
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In developing countries skin disease prevalences may affect over 60% of the community and are often poorly managed. The impact of ineffective treatment of skin disease on family life in rural Mexico was investigated. In the community of Cayaco, a house to house questionnaire survey was conducted to study the distribution of skin disease and the use and cost of treatments. The diagnosis of skin lesions was validated by physical examination and in a separate random survey in 120 primary school children. Regression analysis was carried out. 380 households with 1528 people (713 males, 815 women) were surveyed, of whom 207 reported skin disease. 131 attended the outpatient clinic (41 males, 90 females). The commonest skin disease among them was pyoderma (27 patients), followed by scabies (26), pityriasis alba (23), acne (8), dermatophytosis (8), viral warts (8), and pediculosis capitis (8). 66 had other skin conditions ranging from urticaria (2) to scrofuloderma (1). 58 patients had more than one condition, a total of 189 dermatoses. Six conditions accounted for 102 of the dermatoses. 15 patients with scabies and 21 with pyoderma had received ineffective treatment over the previous six months at a mean cost of 66 new pesos and 136 new pesos, respectively. Many of the affected children had missed school: eight days for scabies (12 patients) and 15 days for pyoderma (10 patients). 68 of the 120 primary school children in the random survey had at least one treatable skin condition. In half of the households people had symptoms, and 57% of the children had at least one treatable skin disease. The mean total cost of ineffective treatment for the two commonest conditions over six months was a major financial burden on families where the mean daily wage was 15.2 new pesos. Both diseases are readily curable by eliminating scabies. In the area a new system of community dermatology is implemented with close collaboration between specialists and primary health care workers.