Effectiveness of neem seed oil methanolic extract shampoo versus permethrin shampoo in the reduction of head lice infestation in children

Lawrence Anne  N. Sabellina,; Christine Sascha  S. Salamanca,; Donn Enrico  A. Santos,; Mariel Anne  C. Seron,; Atria  B. Planes,; Maria Alyssa  Y. Policarpio,; John Michael  A. Ramos,; Ivan Anthony  Y. Resurreccion,; Aristotle  F. Reyes,; Jose Ronilo  G. Juangco,

Effectiveness of neem seed oil methanolic extract shampoo versus permethrin shampoo in the reduction of head lice infestation in children

Abstract:

Introduction : This study compared the effectiveness and safety of neem (Azadirachta indica) seed oil methanolic extract shampoo against permethrin shampoo in reducing head lice infestation among children. Methods : A single-blind, non-inferiority, randomized clinical trial was conducted on children aged 6-14 years with pediculosis. Using block randomization, the participants were assigned to receive either 10% neem seed oil methanolic shampoo, 1% permethrin shampoo, or pure shampoo for three treatment applications at 10-day intervals. The presence of head lice after each application was determined by standard quadrant counting and compared with the baseline count within and among treatment groups. Results : There was a statistically significant difference in lice count after treatment for both neem and permethrin, with mean reductions of 17.8 ± 23.97 (p = 0.043) and 22.5 ± 23.47 (p = 0.014), respectively. Repeated Measures ANOVA showed a summary p-value of 0.041 for neem, 0.013 for permethrin, and 0.193 for the shampoo alone with a linear trend indicating a significant decrease in the lice counts from the baseline to the third application of neem and permethrin shampoo, but not in the shampoo group. There was no significant difference in the mean decrease in lice count from baseline to the third application between the neem and permethrin shampoo groups. Conclusion : Neem seed oil methanolic extract shampoo is non-inferior and comparable to permethrin in the reduction of head lice count. There were no reported dermatologic adverse effects such as burning sensations, redness, skin irritation, and allergic reactions.

References:

Khopkar U, Madke B. Pediculosis capitis: An update. Indian J Dermatol Venereol Leprol 2012; 78(4): 429-38.
Buxton PA. The louse. An account of the lice which infest man, their medical importance and control. Anzeiger für Schädlingskunde 1948; 21(3): 45-6.
Rossini C, Castillo L, González A. Plant extracts and their components as potential control agents against human head lice. Phytochemistr Rev 2007; 7(1): 51-63.
Laus-David LD, Cloma-Rosales VO. Comparison of school-based and home-based application of permethrin shampoo for the treatment of pediculosis captitis – apragmatic cluster-randomized trial. PIDSP J 2015; 16(1):4-11.
Durand R, Bouvresse S, Berdjane Z, Izri A, Chosidow O, Clark JM. Insecticide resistance in head lice: clinical, parasitological and genetic aspects. Clin Microbiol Infect 2012; 18(4): 338-44.
Mehlhor n H, Abdel-Ghaffar F, Al-Rasheid KAS, Schmidt J, Semmler M. Ovicidal effects of a neem seed extract preparation on eggs of body and head lice. Parasitol Res 2011; 109(5): 1299-302.
De Leon, L, De Vera, K, Debuque M, Decena KA. Randomized control trial on the effectivity of Anacardium occidentale (cashew nut) shell liquid formulated as a pediculicide shampoo in reducing the common head lice (Pediculus humanus capitis). College of Medicine, Department of Preventive and Community Medicine Research Projects 2012-2013.
Canyon DV, Speare R. Indirect transmission of head lice via inanimate objects. Open Dermatol J 2010; 4(3): 72-6.
Meinking TL, Entzel P, Villar ME, Vicaria M, Lemard GA, Porcelaine SL. Comparative efficacy of treatments for pediculosis capitis infestations. Arch Dermatol 2001; 137: 292-8.
Bugayong AM, Araneta KT, Cabanilla JC, et al. Effect on dryon, suffocation-based treatment on the prevalence of pediculosis among school children in Calagtagan Village, Miag-ao, Iloilo. Philipp Science Letters 2011; 4(1): 33-7.
Abd El Raheem T, El Sherbiny N, Elgameel A, El-Sayed G, Moustafa N, Shahen S. Epidemiological comparative study of pediculosis capitis among primary school children in Fayoum and Minofiya Governorates, Egypt. J Community Health 2015; 40(2): 222-6.
Willems S, Lapeere H, Haedens N, Pasteels I, Naeyaert JM, De Maeseneer J. The importance of socioeconomic status and individual characteristics on the prevalence of head lice in school children. Eur J Dermatol 2005; 15: 387-92.
Mordue AJ, Nisbet AJ. Azadirachtin from the neem tree Azadirachta indica: its action against insects. An Soc Entomol Brasil 2000; 29(4): 615-32.
Asher KR. Non-conventional insecticidal effects of pesticides available from the neem tree, Azadirachta indica. Arch Biochem Physiol 1993; 22: 433-49.
Schmall G, Al-Rasheid, KAS, Abdel-Ghaffar F, Klimpel S, Mehlhorn, H. The efficacy of neem seed extracts (Tresan, MiteStop) on a broad spectrum of pests and parasites Parasitol Res 2010; 107: 261-9.
Deshmukh S, Kaushal B, Ghode S. Formulations and evaluation of herbal shampoo and comparative studies with herbal marketed shampoo. Int J Pharm Bio Sci 2012; 3: 638-45.
Sinha S, Mur thy PS, Rao CV, Ramapr asad G, Sitaramaiah S, Kumar DG, Kumar Savant S. Simple method for enrichment of azaridachtin from neem seeds. J Scient Indust Res 1999; 58: 990-4.