Multicountry review shows that Bug Buster Kits reduce head lice and social stigma

Working with parents and schools to provide a bug busting approach to head lice is helping to reduce infestation levels, tackle health inequalities and reduce healthcare costs, according to a review in the October issue of Journal of Clinical Nursing.

A team from the UK charity Community Hygiene Concern led a review of studies carried out in the UK, Belgium and Denmark since 1996.

“The best results are obtained when parents are supplied with a free Bug Buster Kit, which includes special combs and instructions on how to detect and eradicate head lice with normal shampoos and conditioners” explains Joanna Ibarra, Programme Co-ordinator for the charity.

“The Bug Buster Kit can be reused by a whole family for a year or more” she adds. “This enables families of all socio-economic classes to participate in a whole-school approach.

“In the UK, promoting the bug busting approach is reducing primary care expenditure on treatment for head lice and professional time spent with worried families. As a result, healthcare providers can spend more time with the few families who need one-to-one guidance.”

The review was carried out with the help of experts from each of the three countries featured.

Key findings included:

• In Chester (UK), the local primary care trust saw a 24 per cent reduction in prescribing costs for lice medication between April 2004 and March 2005 and local healthcare staff reported spending less time advising parents. Demand for insecticide medication fell and demand for Bug Buster Kits rose.

• 677 children from three schools took part in the Ghent (Belgium) study, with active infestation rates in the schools ranging from 13 per cent to 20 per cent. Involving the whole school community in a bug busting approach – including children, parents and school, health and community staff – reduced infestations by two-thirds.

• Parents who took part in the Portland (UK) study reported that lice problems had been minimised and could be easily controlled. The majority of the families studied in detail were using the Bug Buster Kits weekly or monthly and only a small minority needed hands-on help to boost their confidence and skills.

• Bug Buster Kits became available in all pharmacists in Copenhagen (Denmark) in 2000 and an annual Great Louse Day event was launched in 2002. Parents who bought the kits said that they found them easy to use and that they were effective when it came to detecting and treating head lice. They were also much more affordable than insecticides of dubious efficacy and safety.

• Head teachers of schools who took part in a bug busting initiative in Milton Keynes (UK) reported that complaints about head lice had gone from common to rare. “Having 27 motivators – the average number of pupils in a class – makes all the difference” said one head teacher. Four out of every ten families returned a confidential questionnaire and of those nearly two-thirds of those said they’d found lice using the kit.

“Evidence from the UK and other European countries shows that getting the whole school community involved in bug busting makes it much easier to control infestations and reduce health inequalities” concludes Joanna Ibarra.

“Parents support the bug busting approach because everyone is treated equally and the stigma associated with catching head lice is reduced.

“They also prefer a system that uses normal shampoos and conditioners to mechanically remove lice, rather than expensive formulated products to kill them.

“Costs are reduced for healthcare systems that provide such medication on prescription, and for parents living in countries where they are not available on prescription. This is a particular advantage for low-income families who struggle to afford them.

“Another advantage is that health professionals can focus their time on the small number of families who need extra support.”

Community Hygiene Concern (www.chc.org), which plays a key role in the UK’s national bug busting days, was established with funding from the Department of Health and King’s Fund. It is currently advising schools on local initiatives for the next national event on 31 October.

• Overcoming health inequalities by using the Bug Busting ‘whole-school approach’ to eradicating head lice. Ibarra et al. Journal of Clinical Nursing. 16, 1955-1965. October 2007.

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