Til bekæmpelse af hovedlus og luseæg med én eneste behandling

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1 Pronova Laboratories har udviklet Licener Single Treatment, en giftfri shampoo mod hovedlus, som dræber både lus og luseæg med én eneste behandling. Effekten opnås inden for 10 minutter. Licener er meget let at anvende. Der er ikke brug for ekstra hårvask eller kæmning efter behandlingen. Licener indeholder naturlige ingredienser. Produktets effektivitet har vist sig at være 100% i kliniske studier blandt børn med hovedlus. Licener kvæler lus og luseæg ved at lægge sig som en belægning omkring dem og derved blokere transporten af ilt. Der kan således ikke udvikles resistens mod Licener. Licener indeholder ingen farlige eller brandfarlige kemikalier. Til bekæmpelse af hovedlus og luseæg med én eneste behandling Én eneste behandling dræber både lus og luseæg En behandling tager bare 10 minutter 100% dokumenteret effektiv Baseret på naturlige aktive indholdsstoffer(neemextrakt) Ingen yderligere vask eller kæmning er nødvendig Hudvenlig Lugtfri Fri for insekticider Klinisk testet En flaske Licener indeholder 100 ml og rækker til én behandling. Licener er velegnet til voksne og børn fra 2 år. Licener har gennemgået omfattende tests, og er dokumenteret særdeles effektiv og sikker i brug. Licener er et medicinteknisk produkt (Medical Device Class 1) og CEmærket Fremstiller: Pronova Laboratories BV Kruitpad CP Muiden Nederländerna/Holland Distributør: Pharmaxim AB Stenbrovägen Helsingborg Sverige - Tlf:

2 LICENER Licener Single Treatment er en skånsom hårshampoo, som dræber både lus og luseæg ved én eneste behandling Hovedingrediensen i Licener, Neem-extrakt, er testet, og har dokumenteret 100% effekt. BÅDE lus og luseæg i alle stadier elimineres ved en behandling på 10 minutter Licener er en 100% effektiv, giftfri og meget mild shampoo Meget let at anvende og kræver ingen kæmning af håret Registreret som Medical Device Class 1 (CE-mærket) Pharmaxim -

3 LICENER vs. andre luseprodukter? Licener er et innovativt medicinteknisk produkt, som er overlegen overfor de luseprodukter, der findes på markedet i dag Én behandling vs. flere behandlinger Dræber både luseæg og hovedlus vs. kun lus Naturlige ingredienser vs. kemiske ingredienser 10 min behandlingstid vs. 15 min eller længere tid Naturlig duft vs. kemisk duft Mild mod hovedbunden vs. irritation Let at vaske ud vs. vanskelig at vaske ud/flere vaske Pharmaxim -

4 LICENER 1 Licener 1 Licener Licener Single Treatment Hedrin Once Nyda Prioderm Shampoo Paranix Double Action 2 Virkemåde 3 Test resultater Effektivitet 100% effektiv X X X X Bekvemmelighed Baseret på mild og let at bruge shampoo X X X Kun én behandling X X Ingen ekstra vask er nødvendig efter behandlingen X X X Behandlingstid 10 min 15 min 8 hrs 10 min 15 min Sikkerhed Dermatologisk sikker for hud og øjne X X X X Baseret på naturlige aktive ingredienser X X X X IKKE brandbar X X X X Volume Volume pr. flaske 100 ml 50 ml 50 ml 100 ml 40 gr Pharmaxim Pharmaxim -

5 LICENER Vigtigste egenskaber ved Licener: Én komplet behandling Eliminerer både lus og luseæg i alle stadier Klinisk testet - 100% effektiv Flere vigtige egenskaber ved Licener: Naturlige ingredienser Fri for insekticider Meget mild Hurtig og nem i brug Til børn fra 2 år samt voksne En Licener flaske indeholder 100 ml. Pharmaxim -

6 Virkemåde Licener er baseret på en mekanisk effekt fra Neem-ekstraktet Ekstraktet kryber ind i lusens åndingshuller og fortsætter til enden af trakeolerne (lusens ilttransporterende kanaler) Ilttransporterende kanaler stigmatiseres. Pharmaxim -

7 Virkemåde Trakeolerne indeholder vand, der bevarer membranen fugtig og transporterer ilt Vandets bevægelighed blokeres af Licener, og hermed forstyrres transporten af ilt Eftersom lusens hjerte slår hurtigt, får den umiddelbart efter berøring med Licener ikke ilt nok. Stofskiftet bliver forstyrret, og lusen dør inden for få minutter Pharmaxim -

8 Virkemåde Licener dræber også luseæg. Neem-ekstraktet lægger sig omkring hele luseægget, så skallen nedbrydes. Området mellem æggeskal og embryo fyldes ud, og embryoet drukner/kvæles Nymfen i ægget har samme åndingssystem som en voksen lus Vandets bevægelighed i nymfens åndingshul blokeres, ilttilførslen forhindres som i en voksen lus. Nymfen kvæles Pharmaxim -

9 Testresultater Licener har gennemgået omfattende tests: Effekten af Licener er testet in-vitro og in-vivo Kliniske studier har vist perfekte resultater for Licener Sikkerhedstests har vist særdeles gode resultater Der er udført en hudkompatibilitetstest sammen med Nivea shampoo Pharmaxim -

10 Testresultater Publiceret studie; august 2006*, in vivo effektivitetstest af Licener på hovedlus og luseæg indsamlet fra 60 meget svært angrebne børn (4-15 år). Efter 5, 10, 15 og 30 minutter blev shampooen skyllet ud, og lusene blev sorteret fra og undersøgt Licener viste sig at være meget effektiv mod lus på alle udviklingsstadier Der blev ikke observeret nogen forskel i produktets effektivitet mellem de forskellige eksponeringstidspunkter Der blev ikke observeret nogen bivirkninger som hudirritation, brændende følelse eller røde prikker i hovedbunden, panden eller i nakken *Bilag 1 Efficacy of neem seed extract shampoo on head lice of naturally infected humans in Egypt. Parasitol Res (2007) 100: , DOI /s Pharmaxim -

11 Testresultater Publiceret studie; april 2011*, in vitro effektivitetstest af Licener på hovedlus og luseæg. Licener blev anvendt på luseæg i 5, 10, 15, 20, 30 og 45 minutter for at vurdere, om der var forskel i udviklingen i æggene i forhold til de forskellige behandlingstider Udviklingen af lus i et luseæg tager normalt op til 9 dage. Dette blev overvåget dagligt Formålet med studiet var at se, om alle udviklingsstadier af æggene døde Resultatet viste, at ingen af de behandlede luseæg udviklede sig til lus. På 5-10 minutter dræbte Licener alle luseæg *Bilag 2 Ovicidal effects of a neem seed extract preparation on eggs of body and head lice. Parasitol Res, DOI /s Pharmaxim -

12 Testresultater Publiceret studie; maj 2011*, in vivo effektivitets- og sikkerhedstest med Licener mod hovedlus og luseæg fra 2 grupper; 12 børn (3-12 år), respektive 8 børn (8-13 år). Efter 10 respektive 20 minutters behandlinger med Licener blev der foretaget en observation med mikroskop under 22 h. Licener dræbte alle lus inden for 10 minutter. I hele forsøgsperioden og efter 22 timer var samtlige lus døde Licener viste sig at være et sikkert hudprodukt. Ingen børn oplevede bivirkninger ved brug Publiceret studie; maj 2011*, in vitro-test med Licener for at se, om en enkelt behandling med Licener er tilstrækkelig til at fjerne lus på hårdt angrebne børn. Studiet viste, at én eneste behandling i 10 minutter er tilstrækkelig til at fjerne/dræbe: Lus i alle levende stadier Luseæg i alle udviklingsstadier Det blev samtidig bevist, at Licener - ved behandling gennemført in vitro - eliminerer/dræber lus inden for 3 minutter *Bilag 3 Efficacy of a single treatment of head lice with a neem seed extract: an in vivo and in vitro study on nits and motile stages. Parasitol Res, DOI /s Pharmaxim -

13 Testresultater Publiceret studie; februar 2006*, in-vitro effektivitetstest af Licener på hovedlus, der blev indsamlet fra 2 børn og 2 voksne fra 2 skoler i Australien. Sammenlignet med et Permethrinprodukt (kemisk baseret) er Licener meget mere effektiv; 100% Test resultater Dødeligheden hos lusene viste sig at være 100% ved behandling med Licener. Efter 5 minutter fandtes ingen livstegn og heller ikke efter 3 timer ubliceret studie; Februar 2006*, in-vitro effektivitetstest af Licener på hovedlus der blev indsamlet fra 2 børn og 2 voksen fra 2 skoler i Australien *Bilag 4 A new schampoo based on neem (Azadirachta indica) is highly effective against head lice in vitro. Parasitol Res (2006) 99: , DOI /s Sammenlignet med et Permethrinprodukt (kemiskt baseret) er Licener meget mere effektiv; 100% Dødeligheden viste sig at være 100% ved behandling med Licener, efter 5 minutter fandtes ingen livstegn og heller ikke efter 3 timer Mortality % "Mortality" of head lice Control Permethrin Licener Time (min) 4 A new schampoo based on neem (Azadirachta indica) is highly effective against head lice in vitro. arasitol Res (2006) 99: , DOI /s Pharmaxim -

14 Testresultater Dermatologisk plastertest; april 2011*, 30 mennesker (18 år og ældre) med hudtyper fra meget tør, tør, fedtet og til normal følsom hud. Et plaster tilført Licener blev sat på huden på testpersonerne Huden blev undersøgt af dermatologer efter 24, 48 og 72 timer. Hudpartier, der havde været under plasteret, blev vurderet og gradueret Testen gav Licener bedømmelsen: VERY GOOD KONKLUSION: Licener gav ingen anledning til irriteret hud eller allergisk reaktion Testen blev udført i overensstemmelse med de internationale guidelines ICDRG (International Contact Dermatitis Research Group). *Bilag 5 Dermatological report on human Patch Test. Test for primary skin irritation and hyper sensitivity of human subjects after single application. Licener Single treatment. Dermatest Research Institute for Reliable Result, Muenster Bilag 6 Dermatest certificate Pharmaxim -

15 Testresultater Hudtest; maj 2008*, in vitro sammenligningstest med Nivea Silky Shine Frivillige testpersoner Licener blev med sin biologisk aktive patenterede substans Neem-ekstrakt 10 % samt gode shampookomponenter sammenlignet med Nivea Silky Shine, der markedsføres som en shampoo i høj kvalitet Hårprodukterne Licener og Nivea Silky Shine har en beslægtet produktbase, når det drejer sig om indholdssammensætningen. Desuden indeholder Licener Neem-ekstrakt og ingen parfumekomponenter. Således blev det fundet interessant at gennemføre en sammenligningstest mellem de to produkter Testen blev udført for at vurdere effekten at begge produkter på huden og for at bedømme, om der var risiko for hudirritation ved brug af produkterne KONKLUSION; Licener viste sig at være sammenlignelig med Nivea Silky Shine; et udemærket, effektivt og kompatibelt produkt til huden. Ingen af produkterne gav anledning til hudirritation. Resultatet fra testen bekræfter samtidig resultatet fra den dermatologiske test**. *Bilag 6 Treatment Against Blood-Sucking Insects Without Skin Irritation SÖFW-Journal Pharmaxim -

16 Testresultater Ekspertudtalelse fra Profesor Dr. H. Mehlhorn, Afdelingen for parasitologi, Heinrich-Heine Universitet, Düsseldorf, Tyskland: Licener dræber lusen på alle udviklingsstadier Lus og luseæg dræbes inden for 10 minutter ved behandling med Licener *Bilag 3 Efficacy of a single treatment of head lice with a neem seed extract: an in vivo and in vitro study on nits and motile stages. Parasitol Res, DOI /s Pharmaxim -

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25 Bilag 3 Parasitol Res DOI /s ORIGINAL PAPER Efficacy of a single treatment of head lice with a neem seed extract: an in vivo and in vitro study on nits and motile stages Fathy Abdel-Ghaffar & Saleh Al-Quraishy & Khaled A. S. Al-Rasheid & Heinz Mehlhorn Received: 23 May 2011 /Accepted: 30 May 2011 # Springer-Verlag 2011 Abstract An anti-louse shampoo (Licener ) based on a neem seed extract was tested in vivo and in vitro on its efficacy to eliminate head louse infestation by a single treatment. The hair of 12 children being selected from a larger group due to their intense infestation with head lice were incubated for 10 min with the neem seed extractcontaining shampoo. It was found that after this short exposition period, none of the lice had survived, when being observed for 22 h. In all cases, more than dead lice had been combed down from each head after the shampoo had been washed out with normal tap water. A second group of eight children had been treated for 20 min with identical results. Intense combing of the volunteers 7 days after the treatment did not result in the finding of any motile louse neither in the 10-min treated group nor in the group the hair of which had been treated for 20 min. Other living head lice were in vitro incubated within the undiluted product (being placed inside little baskets the floor of which consisted of a fine net of gauze). It was seen that a total submersion for only 3 min prior to washing 3 for 2 min with tap water was sufficient to kill all motile F. Abdel-Ghaffar Department of Zoology, Faculty of Science, Cairo University, Giza, Egypt S. Al-Quraishy : K. A. S. Al-Rasheid Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia H. Mehlhorn (*) Department of Parasitology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany stages (larvae and adults). The incubation of nits at 30 C into the undiluted product for 3, 10, and 20 min did not show differences. In all cases, there was no eyespot development or hatching larvae within 7 10 days of observation. This and the fact that the hair of treated children (even in the short-time treated group of only 10 min) did not reveal freshly hatched larval stages of lice indicate that there is an ovicidal activity of the product, too. Introduction Head louse infestations increase recently in child yards, primary schools, and even among children up to the age of 15 years. This development has different backgrounds. On one side, there is an increasing spread of resistance of head lice against long-used insecticides such as permethrin, allethrin, malathion, etc., while other compounds (e.g., lindane, malathion) became recently forbidden in several countries (Burgess 2004; Clark 2009; Downs et al. 2002; Durand et al. 2007; Falagas et al. 2008; Gao et al. 2006; Kristensen et al. 2006; Lebwohl et al. 2007; Mougabure- Cueto et al. 2008; Yoon et al. 2004; Mehlhorn 2008, 2011). Furthermore, the groups of kids in the institutions have been enlarged, so that there are closer and more often hairto-hair contacts among the individuals (Burkhart and Burkhart 2001; Toloza et al. 2009; Mumcuoglu et al. 2009; Mougabure-Cueto and Picollo 2010; Bauer et al. 2009; Meinking et al. 2002; Lebwohl et al. 2007; Mehlhorn and Mehlhorn 2010). In addition, the high costs of anti-lice products (especially in the USA, where treatments cost US $150 upwards; Gur and Schneeweiss 2009) make people hesitate to buy and use effective products at an early stage of the louse infestation, so that infestations spread from these

26 Parasitol Res heads leading finally to repeated ping-pong infestations among group members. And there are also several products not only from the green side which have no or only a reduced efficacy and thus leave survivors, which become the progenitors of new generations. Even if products are effective, success of the control measures may not be reached, if these products are wrongly used or in an underdosage application. Besides all of this, the biggest enemy of a successful battle against the nasty bloodsuckers is the fact that people believe that having lice is identical with being dirty and caused by an unhygienic life style. Since they fear to be mobbed, many women hesitate or neglect to inform the mothers of the comrades of their kids that there are lice. This has the consequence that ping-pong reinfestations persist for long in a group of neighbors and/or in child yards and primary schools. Therefore, sound information and the development of safe and efficacious products are badly needed. Materials and methods Test persons Twelve children (group 1) had been selected (according to the intensity of louse infestation) from a group of about 20 after their mothers had combed their hair previously. The group consisted exclusively of girls with shoulder-long hair (aging from 3 to 12 years). A second group (group 2) was formed from the remnant eight children (ages 8 13), who were less intensively infested with lice than the members of group 1. Procedures of treatment Persons Since the hair of most children were sticky due to sandy inclusions, the mothers wettened the hair before the testing. After wetting of the hair, the kids were dried with a towel. Then, the product, a neem seed-based formulation (Licener ), was thoroughly applied by the mothers by covering all hair from the scalp to the very end of the hair. In the case of kids with head-long hair, 50 ml of the product was sufficient; in the case of shoulder-long (or longer) hair, 100 ml was used. After that, the children had to wait for 10 (group 1, n=12) or 20 min (group 2, n= 8) until the mothers washed the hair for 3 4 min with clear tap water. Then, the hair were combed for about min with a finely toothed lice comb, and the lice dropping down onto a white towel were collected inside a plastic petri dish (on white filter paper) for control with a stereomicroscope and/or magnification glass on movements or other signs of life. In vitro tests of motile lice Groups of 20 lice that had been combed down from the heads of untreated children were collected in small plastic vessels, the floor of which consisted of a fine gauze net, so that fluids could enter or leave. After this was done, the little baskets (2.5 cm in diameter) were incubated for 3 min in the undiluted neem-based anti-louse shampoo (Licener ). After this, the baskets with the lice were placed three times for 1 min in fresh tap water and slightly shaken before being finally sprayed by tap water for final cleaning from the residuals of the anti-louse product. After this procedure, the lice were placed on dry white filter paper inside closed plastic petri dishes for the next 22 h. At intervals of 30 min for the first 3 h and later at intervalsof2to4huntil22hpastthetreatment,thelice were inspected for signs of life while two baskets with untreated, but water-dipped, lice were kept as controls. The room temperature was around 30 C. In vitro investigations of nits Hair with nits glued close to the scalp were cut off with a pair of scissors and placed into the baskets described above. Then, they were incubated for 3, 10, and 20 min into the undiluted anti-louse shampoo (Licener ). Afterwards, they were dipped three times for 1 min into clear tap water and slightly shaken prior to being sprayed with clear tap water to remove remnants of the anti-louse shampoo. After this procedure, the nits were placed into covered plastic petri dishes, the floor of which had been covered with white and dry filter paper, being investigated for the next 7 days, whether there is development inside (e.g., eyespot development) and hatching of larval stages. Some nits were just dipped into water and further on used as controls. Results Treated persons, group 1 The 12 girls (ages 3 12) had been selected since the initial short combing showed that there was a huge infestation with larval and adult head lice. After treating their hair once for 10 min (time measured after application of the rather fluid product thoroughly on all hair from the scalp to the tips of rather long hair head long or shoulder long), the hair were washed with tap water. Immediately after this washing, the mothers combed thoroughly the long hair by help of a tight louse comb, collecting the dropping down lice stages on a white towel. From there, the lice stages were transferred into a plastic petri dish for further observation.

27 Parasitol Res Intense combing of each child led to the falling down of more than 50 up to 120 louse stages, which were motionless from the early beginning. This non-motility persisted until the end of the observation period (i.e., 22 h past treatment) thus concluding that these specimens are dead. Until 3 h after treatment, some larval stages showed intestinal constrictions, but did not move their legs even after they were touched with a fine pincer. Combing was repeated 7 days later, and no living lice stages were found. Group 2 The hair of these eight children (aged 8 13 years) were incubated into the anti-louse shampoo for 20 min. Previous combing of the girls had resulted in a less high infestation than in kids of group 1. After these 20 min of incubation (mode, see above, group 1) the hair were washed by their mothers with tap water and combed. The combing was done until at least 20 lice had been collected from each on a white towel (maximum was around 50). All stages did not show any motility during the next 22 h. The slight pulsation of the intestine in some specimens stopped finally after 4 h in all cases. Thus, they were definitively dead. The combing 7 days later (after wettening the hair with tap water) led to the finding of several dried lice carcasses, but no living lice stages were found. In vitro tests of motile lice The lice stages obtained by combing were submersed within their small baskets for 3 min in the undiluted shampoo. None of these stages started movements within the next 22 h of observation. Some slight intestinal pulsations stopped after 3 4 h. In vitro tests of nits Nits that had been incubated into undiluted shampoo for 10 min did not develop larvae and showed no hatching of larvae as well as no development of eyespots as could be observed by means of microscopy during 7 10 days (at 30 C) of observation. Discussion The obtained results in this trial with an anti-louse shampoo (based on a neem seed extract) correspond to those obtained with similar formulations of the neem seed (Heukelbach et al. 2006; Abdel-Ghaffar and Semmler 2007; Abdel-Ghaffar et al. 2010a, b), which can also be used in an aqueous solution against mites, ticks, and many insects (Semmler et al. 2010; Schmahl et al. 2010). The experimental design of the present study (with only 12 but highly lice-infested children) allows the conclusion that, in principle, a single treatment would be sufficient to eradicate lice from an infested head. This conclusion is supported by the fact that even a head treatment period of only 10 min or a 3-min in vitro exposition to the undiluted shampoo was sufficient to kill all motile lice stages plus those stages in the nits. The latter conclusion was supported by the absence of larval stages 7 days after the treatment when combing the hair of the children and by the non-hatching of larvae from any nit being treated in vitro. The finding of some living adult lice by Abdel- Ghaffar and Semmler (2007) on the heads of treated kids 7 days after treatment is best explained by the fact that there has been apparently a reinfestation of these children by hair-to-hair contact with their untreated sisters sharing a common bed. This finding leads to the problem that is posed by the possibility of a reinfestation of the next day after a successful treatment in those cases when treated kids play with untreated ones. In the cases of a single treatment even if the products are 100% active reinfections might prohibit a longer lasting cure. On the other hand, a second treatment after 8 10 days will eliminate those lice stages obtained from playing comrades before their mothers have treated them. According to our experience, it always takes several days until the news has been spread among parents that there is an outbreak of lice in a child yard, a primary school, or in other communities, and mothers start to treat the previously untreated kids. A second treatment even if the first had been 100% effective in the case of correct application (all hair have to be covered from the scalp to the tip of the hair) would bring more security for a longlasting success also in those cases, where the anti-louse product was not correctly used (e.g., if it was diluted too much or if some hair remained untreated thus offering safe retreats for the rather quickly running lice thus avoiding contact with the anti-louse shampoo. The results of the present in vitro results with treated motile lice and nits underline the in vivo obtained results. This is not astonishing, since the in vivo and in vitro conditions were nearly identical. The results are also in agreement with previous results of Abdel-Ghaffar et al. (2010a) and recent ones of Mehlhorn et al. (2011). Thus, the users of good and safely acting products (like the tested one here) have to develop special treatment tactics. In cases of a few infested kids in a group and when they are only slightly infested, a single treatment course is reasonable. However, in cases of many infested kids with high infestation rates, a repeated application after 9 10 days seems more reasonable. In any way, however, it is recommended to use an effective anti-lice treatment like

28 Parasitol Res the tested one, since only then would treatment be successful and not too costly. With respect to these findings of a very quick and efficacious knock out of the submersed head lice stages, the question arises, why this quick reaction is possible, while it takes many hours in the case of other products that are based on silicon oil (cyclo- and dimethicones). The explanation is rather simple, since it was found that the present neem formulation is rather liquid, thus is able to enter easily the fine-branched channels of the breathing system of the lice (tracheoles). At the terminal ends of these tracheoles, the product blocks the entering of the oxygen into the cells of the lice and the release of CO 2 thus suffocating the nasty bloodsuckers within minutes. Such a very quick reaction as in Licener occurs only in very few products such as in Wash Away Louse, Picksan, Licatack, and Linicin (Abdel-Ghaffar et al. 2010a, b). Conclusions The single use if all louse stages are covered for 10 min with a neem-based extract (Licener ) would be sufficient to clean even highly infested heads from all head lice stages. Acknowledgments Hereby we gratefully acknowledge the support of the Center of Excellence of the College of Science of the King Saud University, Riyadh, Saudi Arabia. References Abdel-Ghaffar F, Semmler M (2007) Efficacy of neem seed extract shampoo on head lice of naturally infected humans in Egypt. Parasitol Res 100: Abdel-Ghaffar F, Semmler M, Al-Rasheid K, Klimpel S, Mehlhorn H (2010a) Comparative in-vitro test on the efficacy and safety of 13 anti-head-lice products. Parasitol Res 106: Abdel-Ghaffar F, Semmler M, Al-Rasheid K, Klimpel S, Mehlhorn H (2010b) Efficacy of a grapefruit extract on head lice. Parasitol Res 106: Bauer E, Jahnke C, Feldmeier H (2009) Seasonal fluctuations of head lice infestation in Germany. Parasitol Res 104: Burgess IF (2004) Human lice and their control. Annu Rev Entomol 49: Burkhart CN, Burkhart CG (2001) Recommendation to standardize pediculicidal and ovicidal testing for head lice (Anoplura, Pediculidae). J Med Entomol 38: Clark JM (2009) Determination, mechanism and monitoring of knockdown resistance in permethrin-resistant human head lice (Pediculus humanus capitis). J Asia Pac Entomol 12:1 7 Downs AMR, Stafford KA, Hunt LP, Ravenscroft JC, Coles GC (2002) Widespread insecticide resistance in head lice to the overthe counter pediculocides in England, and the emergence of carbaryl resistance. Br J Dermatol 146:88 93 Durand R, Millard B, Bouge-Michel C, Bruel C, Bouvresse S, Izri A (2007) Detection of pyrethroid resistance gene in head lice in school children from Bobigny, France. J Med Entomol 44: Falagas M, Matthaiou D, Rafailidis P, Panos G, Pappas G (2008) Worldwide prevalence of head lice. Emerg Infect Dis 14: Gao JR, Yoon KS, Frisbie RK, Coles GC, Clark JM (2006) Esterasemediated malathion resistance in the human head louse, Pediculus capitis (Anoplura: Pediculidae). Pestic Biochem Physiol 85:28 37 Gur I, Schneeweiss R (2009) Head lice treatments and school policies in the US in an era of emerging resistance. A cost effectiveness analysis. Pharmacoeconomics 27: Heukelbach J, Oliveira FA, Speare R (2006) A new shampoo based on neem (Azadirachta indica) is highly effective against head lice in-vitro. Parasitol Res 99: Kristensen M, Knorr M, Rasmussen AM, Jespersen JB (2006) Survey of permethrin and malathion resistance in human head lice populations from Denmark. J Med Entomol 43: Lebwohl M, Clark L, Levitt J (2007) Therapy for head lice based on life cycle, resistance and safety consideration. Pediatrics 119: Mehlhorn H (ed.) (2008) Encyclopedia of Parasitology. 3rd ed. 2 volumes. Springer, New York Mehlhorn H (2011) Head lice and their control. A long lasting story. In: Preedy VR (ed) Handbook of hair in health and disease. Wageningen Academic Publishers, Wageningen Mehlhorn B, Mehlhorn H (2010) Louse alarm. Düsseldorf University Press, Düsseldorf Mehlhorn H, Abdel-Ghaffar F, Al-Rasheid KAS, Schmidt J, Semmler M (2011) Ovicidal effects of a neem seed extract preparation on eggs of body and head lice. Parasitol Res. doi: /s Meinking TL, Serrano L, Hard B et al (2002) Comparative in vitro pediculicidal efficacy of treatments in a resistant head lice population in the United States. Arch Dermatol 138: Mougabure-Cueto G, Picollo MI (2010) Response of Pediculus humanus humanus to water or 70% ethanol immersion and determination of optimal times for measuring toxic effects. Parasitol Res 106: Mougabure-Cueto G, Zerba E, Picollo MI (2008) Evidence of pyrethroid resistance in eggs of Pediculus humanus capitis (Phthiraptera: Pediculidae) from Argentina. J Med Entomol 45: Mumcuoglu KY, Gilead L, Ingber A (2009) New insights in pediculosis and scabies. Exp Rev Dermatol 4: Schmahl G, Al-Rasheid KAS, Abdel-Ghaffar F, Klimpel S, Mehlhorn H (2010) The efficacy of neem seed extracts (Tresan, Mite- Stop ) on a broad spectrum of pests and parasites. Parasitol Res 107: Semmler M, Abdel-Ghaffar F, Al-Rasheid K, Klimpel S, Mehlhorn H (2010) Repellency against head lice (Pediculus humanus capitis). Parasitol Res 106: Toloza AC, Vassena C, Gallardo A, Gonzalez-Audino P, Picollo MI (2009) Epidemiology of pediculosis capitis in elementary schools of Buenos Aires, Argentina. Parasitol Res 104: Yoon KS, Gao J, Lee SH, Coles GC, Meinking T, Taplin D, Edman J, Tacano-Lee M, Clark JM (2004) Resistance and cross resistance to insecticides in human head lice from Florida and California. Pestic Biochem Physiol 80:

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