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BMJ 2005;330:1510 (25 June), doi:10.1136/bmj.330.7506.1510-c
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EDITORSladden and Johnson reviewed common skin infections in children.1 The life cycle of head lice (Pediculosis capitis) was well described and is similar to that of pubic lice. I worked in chronic emergencies in Somalia in 1993 and Sudan 1996-7 among internally displaced populations and in the nomadic Karimajong of Uganda in 1998-9, whose poor hygiene would have been a good breeding ground for head lice. However, head lice were never a clinical problem because these populations know how to interrupt its lifecycle: they shave off their hair, the only place where the eggs (nits) are anchored and glued close to the skin. Lice outside the hair are not transmissible and do not cause infestation.
I recall massive poisoning and some deaths in one institution for mentally handicapped children in Uganda in the 1970s because children licked their hair after it had been treated with insecticide.
Anthony Lwegaba, lecturer in public health
School of Clinical Medicine and Research, University of West Indies, Cave Hill, Barbados lwegaba@lycos.com
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