Soundings: PIGPEN therapy for head lice
2003; BMJ; Volume: 326; Issue: 7403 Linguagem: Inglês
ISSN
0959-8138
Autores Tópico(s)Animal and Plant Science Education
ResumoBackground A review of the evidence suggests that chemical treatment is superior to combing in the treatment of head lice (BMJ 2003;326: 1256-8 [PubMed]). But there's combing and combing. Participants and methods Two hundred urchins were recruited from a school playground and randomised using a culturally congruent method (“Oi, you lot—number off”). Exclusion criteria included congenital alopecia (n=1), dreadlocks (n=4), and having a parent who showed enthusiasm for rubbing organophosphates into his or her child's head (n=0). The intervention group were each supplied with a plain white envelope (0.03p, Woolworths), a plastic nit comb (40p, Boots), and a magnifying glass (free with cornflakes). In phase 1, the child was offered 1p for every live louse caught in the envelope. The creatures were carefully counted and a strict taxonomy applied (“that's only a bit of skin,” “he's not wriggling,” etc), and the debt paid in cash. In phase 2, the stakes were raised to 10p, and in phase 3 to 50p. Results The mean fee paid to each child was: in phase 1, 31p (95% confidence interval 16 to 78); in phase 2, 63p (7 to 99); and in phase 3, 21p (0 to 157). No parent in the intervention group reported physical abuse from his or her child as a result of attempting to apply chemicals without full consent, and no child was rushed to casualty with organophosphates in the eyes. All were nit free a week later. By three months all had been reinfested—that's nits for you. Conclusion Parent-incentivised, graded, patient extraction of nits (PIGPEN) therapy is an acceptable, safe, and cost effective treatment. Discussion Previous studies of physical treatments for head lice have ignored the social and psychological dimensions. “Wet combing” using liberal application of hair conditioner requires passive co-operation from the child and runs counter to prevailing norms (see, for example, negative role models in popular culture—eg, Softie Walter,1 Draco Malfoy,2 Olive Oyl3). In contrast, PIGPEN therapy draws subliminally on contemporary peer written literature to develop a ghoulish interest in micro-organisms and apply creative schemes to extract money from parents.4
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