مقايسه كارايي شامپو پرمترين 1% و لوسيون دايمتيكون 4%، حشره‌كش‌هاي ضد شپش سر رايج در ايران: يك كارآزمايي باليني

Study on efficacy of 1% permethrin shampoo and 4% dimethicone lotion as pediculicide products used in Iran: a clinical trial

زمينه و هدف: شپش سر، انگل اجباري انسان بوده و به‌طور عمده از طريق تماس مستقيم از فردي به فرد ديگر انتقال مي‌يابد. درمان شپش سر با چالش‌هايي مانند عدم بهبودي كامل بيماران و نياز به تكرار درمان، مواجه است. اين مطالعه با هدف ارزشيابي كارايي حشره‌كش‌هاي ضد شپش، شامپو پرمترين 1% و لوسيون دايمتيكون 4% صورت گرفت. روش بررسي: در اين مطالعه نيمه‌تجربي (Quasi experimental study) و يك‌سوكور 140 مورد فرد آلوده به شپش سر در مراكز جامع سلامت شهري تحت پوشش دانشگاه علوم پزشكي قم از فروردين تا اسفند 1396 به‌طور تصادفي تحت درمان با شامپو پرمترين 1% و لوسيون دايمتيكون 4% قرار گرفتند. پيامد درمان شامل رفع آلودگي به شپش سر و رشك آن در روزهاي 14 و 21 پس از شروع درمان، در نظر گرفته شد. يافته‌ها: ميزان موفقيت درمان در صورت دو بار استفاده (به‌فاصله يك هفته) با شامپو پرمترين 1% و لوسيون دايمتيكون %4 به‌ترتيب 65/7% و 62/9% بود. اختلاف آماري معناداري بين اندازه اثر درماني روش‌هاي ياد‌شده مشاهده نشد (2/5-0/6CI=، 0/59P=، 1/22odds ratio=). شانس بهبودي مردان نسبت به زنان 3/8 برابر (0/036P=)، شانس رفع آلودگي در گروه شغلي خانه‌دار نسبت به دانش‌آموزان 3/1 برابر (0/05P=) و شانس بهبودي در خانواده‌هاي با يك نفر آلودگي سه برابر خانواده‌هاي بيش از يك نفر آلودگي بوده (0/034P=) و بعد خانوار از مهمترين متغيرهاي تاثيرگذار در افزايش معنادار اثر

Background: Head lice (Pediculus humanus capitis) are obligate ectoparasites of mankind, and are mainly transmitted head to head directly from one person to another. Human head lice treatment is faced with some challenges such as lack of complete treatment and the need for treatment repeatedly. The aim of this study was to evaluate the efficacy of two pediculicide products (substances used to treat human head lice infestation); 1% permethrin shampoo and 4% dimethicone lotion. Methods: In this clinical trial, 140 cases of head lice infested people that were referred to the urban comprehensive health centers of Qom provincial health center related to Qom University of Medical Sciences and Health Services, Iran, from April to March 2017. The cases randomly were treated with two pediculicide products; 1% permethrin shampoo and 4% dimethicone lotion. The outcome of the treatment included removal of adult human head lice, nymphs, and nits in confirmed human cases at 14 and 21 days after starting treatments were considered. Results: The success rate of human head lice infestation treatment in case of double use (at one-week intervals) with 1% permethrin shampoo and 4% dimethicone lotion was 65.7% and 62.9%, respectively. There was no statistical significance between the therapeutic effects of the two above-mentioned methods (odds ratio=1.22, P=0.59, CI=0.6-2.5). While the recovery rate of men compared to women was 3.8 (P=0.036), it was 3.1 (P=0.05) for housewives compared to students, and in families with one case compared to ones with more than one patient, this rate was found to be 3 (P=0.034). Family size was one of the most important variables that had a significant effect on the therapeutic rate of 1% permethrin shampoo and 4% dimethicone lotion. Conclusion: The findings of this study do not support the reduction in efficacy of 1% permethrin shampoo and 4% dimethicone lotion as pediculicide products.