Pediculosis capitis among school-age students worldwide as an emerging public health concern: a systematic review and meta-analysis of past five decades

Pediculosis by Pediculus humanus capitis is still an important health issue in school-age students worldwide. Although pediculicidal agents effectively kill head lice, the re-infestation rate is still high. This study was conducted to provide a summary of evidence about the prevalence of pediculosis capitis among school-age students worldwide. Different databases including MEDLINE/PubMed, Scopus, and Web of Science were searched for publications related to pediculosis capitis in school-age students from 1977 to 2020. All peer-reviewed original research articles describing pediculosis capitis among school-age students were included. Statistical heterogeneity of the different years among studies was assessed using the standard chi squared and I2 tests. Due to the significant heterogeneity, a random effect model was adopted to estimate the pooled, continent, and gender-specific prevalence of pediculosis. Two hundred and one papers met the inclusion criteria of this review and entered into the meta-analysis including 1,218,351 individuals. Through a random effect model, the prevalence of pediculosis capitis among school students was estimated as 19% (CI 95% = 0.18–0.20%, I2 = 99.89%). The prevalence of pediculosis capitis among boys was 7% (CI 95% = 0.05–0.10) compared to 19% (CI 95% = 0.15–0.24) in girls. The highest prevalence was in Central and South America (33%, CI 95% = 0.22–0.44, I2 = 99.81%) and the lowest was in Europe (5%, CI 95% = 4–6, I2 = 99.28%). Relatively high pediculosis capitis prevalence among school-age students observed in this study emphasizes the need for implementing screening and prophylaxis tailored to the local context.