Titre :
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Comparison of wet combing with malathion for treatment of head lice in the UK : a pragmatic randomised controlled trial. (2000)
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Auteurs :
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R.J. ROBERTS ;
D. CASEY ;
D.A. MORGAN ;
M. PETROVIC ;
Department of Public Health. North Wales Health Authority. Mold. GBR
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Type de document :
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Article
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Dans :
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Lancet (The) (vol. 356, n° 9229, 2000)
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Pagination :
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540-544
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Langues:
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Anglais
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Mots-clés :
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Pédiculose
;
Parasitose
;
Infection
;
Pesticide
;
Thérapeutique
;
Etude comparée
;
Royaume Uni
;
Europe
;
Enfant
;
Homme
;
Enfant 6 9 ans
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Résumé :
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[BDSP. Notice produite par INIST bmUR0xvc. Diffusion soumise à autorisation]. Background Concern about the effectiveness and toxicity of insecticide lotions has led to promotion of mechanical methods to remove head lice. We compared the effectiveness of "bug-busting" (wet combing with a fine-toothed comb) and malathion lotion. Methods We screened 4037 schoolchildren in two counties in Wales, UK (intermediate resistance to malathion). Of 167 found to have head lice, 81 (aged 3-14 years) were eligible to participate in a randomised controlled trial that compared mechanical removal of lice by a commercial kit every 3-4 days for 2 weeks with two applications of 0.5% malathion lotion 7 days apart ; parents carried out both treatments. The outcome measure was the presence of live lice 7 days after the end of treatment. Analyses were by intention to treat. Findings 74 children completed the study and 72 were included in the analysis. The cure rate was 38% (12 of 32) for bug-busting and 78% (31 of 40) for malathion. Children assigned bug-busting were 2.8 (95% Cl 1.5-5.2) times more likely than those assigned malathion to have lice at the end of treatment (p=0.0006). Interpretation Malathion lotion was twice as effective as bug-busting, even in an area with intermediate resistance. Policies advocating bug-busting as first-line treatment for head lice in the general population are inappropriate. Assessment of the outcome of treatment 1-2 weeks after completion is essential for successful management. (...)
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