{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T13:20:50Z","timestamp":1788355250764,"version":"build-2803163510"},"reference-count":27,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,2]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    Pediculosis capitis remains a persistent public health issue, especially in developing countries where resistance to standard neurotoxic pediculicides like permethrin is increasingly prevalent. This study aimed to compare the effectiveness of alternative treatment options against the standard care in a resource-limited setting. We conducted a single-blind randomized controlled trial involving three primary schools in Chachoengsao Province, Thailand (ClinicalTrials.gov: NCT06332872). Eighty-five female participants ages 6\u201313 years with active infestations were enrolled. Schools were randomly assigned to three treatment arms: 1) oral ivermectin (200\n                    <jats:italic>\u00b5<\/jats:italic>\n                    g\/kg) on Days 0 and 7; 2) 1% permethrin shampoo on Days 0 and 7, or 3) 4% dimethicone liquid gel as a single dose on Day 0. The primary outcome was the cure rate, defined as the absence of live lice and viable nits upon clinical assessment on Day 9. Of the 66 participants included in the final per-protocol analysis, oral ivermectin achieved a cure rate of 95.5% (21\/22), which was significantly higher than that of the 1% permethrin standard of care (37.0%; 10\/27) and the 4% dimethicone physical suffocant (29.4%; 5\/17) (\n                    <jats:italic>P<\/jats:italic>\n                    &lt;0.001). Although dimethicone achieved high initial parasitic clearance on Day 0 (88.2%), a rapid reinfestation rate of 58.8% was observed by Day 9, indicating that a single-dose protocol may be clinically insufficient. Adverse events were mild and temporary across all groups. Oral ivermectin appears significantly more effective than both 1% permethrin and single-dose 4% dimethicone in this population. These findings suggest that permethrin resistance is clinically prevalent and relevant in this area.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.26-0082","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T14:09:01Z","timestamp":1784642941000},"page":"644-651","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Effectiveness of Oral Ivermectin, 1% Permethrin Shampoo, and 4% Dimethicone Liquid Gel in Treatment of Pediculosis Capitis among School Children in Chachoengsao Province, Thailand"],"prefix":"10.4269","volume":"115","author":[{"given":"Arisa","family":"Vannaratha","sequence":"first","affiliation":[{"name":"Phramongkutklao College of Medicine, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Supanut","family":"Buakaew","sequence":"additional","affiliation":[{"name":"Phramongkutklao College of Medicine, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitkamol","family":"Santiwananont","sequence":"additional","affiliation":[{"name":"Phramongkutklao College of Medicine, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thidaporn","family":"Srisub","sequence":"additional","affiliation":[{"name":"Phramongkutklao College of Medicine, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthitaya","family":"Sutthithum","sequence":"additional","affiliation":[{"name":"Phramongkutklao College of Medicine, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudarat","family":"Reugjui","sequence":"additional","affiliation":[{"name":"Phramongkutklao College of Medicine, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patanin","family":"Julsurang","sequence":"additional","affiliation":[{"name":"Phramongkutklao College of Medicine, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hatthakorn","family":"Lueang-urai","sequence":"additional","affiliation":[{"name":"Phramongkutklao College of Medicine, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wirakarn","family":"Liamsakul","sequence":"additional","affiliation":[{"name":"Phramongkutklao College of Medicine, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rungtawan","family":"Boonsombat","sequence":"additional","affiliation":[{"name":"Phramongkutklao College of Medicine, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patanawadee","family":"Luenpan","sequence":"additional","affiliation":[{"name":"Phramongkutklao College of Medicine, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Supasek","family":"Thangto","sequence":"additional","affiliation":[{"name":"Phramongkutklao College of Medicine, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toon","family":"Ruang-areerate","sequence":"additional","affiliation":[{"name":"Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuanlaong","family":"Kaeothaisong","sequence":"additional","affiliation":[{"name":"Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Detchvijitr","family":"Suwanpakdee","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Unit, Department of Pediatrics, Phramongkutklao Hospital, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Picha","family":"Suwannahitatorn","sequence":"additional","affiliation":[{"name":"Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"issue":"1","key":"b1","series-title":"Infect Dis Poverty","first-page":"58","article-title":"Human pediculosis, a global public health problem","volume":"11","author":"Fu","year":"2022"},{"issue":"4","key":"b2","series-title":"Pediatrics","first-page":"e2022059282","article-title":"Clinical report: Head lice","volume":"150","author":"Nolt","year":"2022"},{"issue":"4","key":"b3","series-title":"J Drugs Dermatol","first-page":"409","article-title":"International guidelines for effective control of head louse infestations","volume":"6","author":"Mumcuoglu","year":"2007"},{"issue":"5","key":"b4","series-title":"Korean J Parasitol","first-page":"499","article-title":"Prevalence and alternative treatment of head-lice infestation in rural Thailand: A community-based study","volume":"57","author":"Singhasivanon","year":"2019"},{"key":"b5","series-title":"J Southeast Asian Med Res","first-page":"e0248","article-title":"A comprehensive review of epidemiology, resistance and treatment of Pediculus capitis in Thailand","volume":"9","author":"Suwannahitatorn","year":"2025"},{"issue":"8","key":"b6","series-title":"Arch Dermatol","first-page":"994","article-title":"Permethrin-resistant human head lice, Pediculus capitis, and their treatment","volume":"139","author":"Yoon","year":"2003"},{"issue":"11","key":"b7","series-title":"Parasitol Res","first-page":"132","article-title":"Treatment failure of over-the-counter pediculicide shampoos in Thai schoolgirls: Evidence of insecticide resistance","volume":"124","author":"Thanchomnang","year":"2025"},{"issue":"10","key":"b8","series-title":"Arch Dermatol Res","first-page":"684","article-title":"The association between knockdown resistance and treatment outcome of 1% permethrin lotion in head lice infestations in Nonthaburi province, Thailand","volume":"316","author":"Brownell","year":"2024"},{"issue":"6","key":"b9","series-title":"PLoS One","first-page":"e0287616","article-title":"Comparative efficacy of chemical and botanical pediculicides in Thailand and 4% dimeticone against head louse, Pediculus humanus capitis.","volume":"18","author":"Yingklang","year":"2023"},{"issue":"9","key":"b10","series-title":"Trends Parasitol","first-page":"445","article-title":"Ivermectin: Panacea for resource-poor communities?","volume":"30","author":"Omura","year":"2014"},{"issue":"10","key":"b11","series-title":"N Engl J Med","first-page":"896","article-title":"Oral ivermectin versus malathion lotion for difficult-to-treat head lice","volume":"362","author":"Chosidow","year":"2010"},{"key":"b12","series-title":"BMC Pharmacol","first-page":"3","article-title":"The mode of action of dimeticone 4% lotion against head lice, Pediculus capitis.","volume":"9","author":"Burgess","year":"2009"},{"issue":"2","key":"b13","series-title":"JRMC","first-page":"192","article-title":"Comparison of oral ivermectin and permethrin 1% shampoo in the treatment of Pediculosis capitis.","volume":"25","author":"Afridi","year":"2021"},{"key":"b14","series-title":"BMC Dermatol","first-page":"5","article-title":"Single application of 4% dimeticone liquid gel versus two applications of 1% permethrin creme rinse for treatment of head louse infestation: A randomised controlled trial","volume":"13","author":"Burgess","year":"2013"},{"key":"b15","series-title":"BMC Infect Dis","first-page":"115","article-title":"A highly efficacious pediculicide based on dimeticone: Randomized observer blinded comparative trial","volume":"8","author":"Heukelbach","year":"2008"},{"key":"b16","series-title":"BMJ","first-page":"e081123","article-title":"CONSORT 2025 statement: Updated guideline for reporting randomised trials","volume":"389","author":"Hopewell","year":"2025"},{"issue":"3","key":"b17","series-title":"Arch Dermatol","first-page":"309","article-title":"Accuracy of diagnosis of pediculosis capitis: Visual inspection vs wet combing","volume":"145","author":"Jahnke","year":"2009"},{"key":"b18","article-title":"Treatment of Head Lice.","year":"2024"},{"issue":"2","key":"b19","series-title":"Our Dermatol Online","first-page":"131","article-title":"Home remedies for Pediculus humanus capitis infection among schoolchildren","volume":"9","author":"Obaid","year":"2018"},{"key":"b20","series-title":"BMC Public Health","first-page":"441","article-title":"Treatment of head lice with dimeticone 4% lotion: Comparison of two formulations in a randomised controlled trial in rural Turkey","volume":"9","author":"Kurt","year":"2009"},{"key":"b21","series-title":"BMC Dermatol","first-page":"14","article-title":"An ex vivo, assessor blind, randomised, parallel group, comparative efficacy trial of the ovicidal activity of three pediculicides after a single application","volume":"11","author":"Barker","year":"2011"},{"issue":"12","key":"b22","series-title":"Iran J Public Health","first-page":"1923","article-title":"Prevalence and risk factors of pediculosis in primary school children in South West of Iran","volume":"47","author":"Nejati","year":"2018"},{"issue":"11","key":"b23","series-title":"Asian Pac J Trop Biomed","first-page":"901","article-title":"Epidemiology of pediculosis capitis among schoolchildren in the eastern area of Bangkok, Thailand","volume":"2","author":"Rassami","year":"2012"},{"issue":"6","key":"b24","series-title":"Osong Public Health Res Perspect","first-page":"346","article-title":"Prevalence of head lice infestation and its associated factors among primary school students in Iran: A systematic review and meta-analysis","volume":"6","author":"Moosazadeh","year":"2015"},{"issue":"9","key":"b25","series-title":"Emerg Infect Dis","first-page":"1493","article-title":"Worldwide prevalence of head lice","volume":"14","author":"Falagas","year":"2008"},{"key":"b26","article-title":"National Drug Information (NDI): Median Price.","year":"2024"},{"issue":"13","key":"b27","series-title":"Am J Health Syst Pharm","first-page":"937","article-title":"Oral ivermectin for the treatment of head lice infestation","volume":"75","author":"Sanchezruiz","year":"2018"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/115\/3\/article-p644.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/115\/3\/article-p644.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/115\/3\/article-p644.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T12:54:47Z","timestamp":1788353687000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/115\/3\/article-p644.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,2]]},"references-count":27,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.26-0082","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,2]]}}}