Prevalence, Disease Burden and Factors Associated with Head Lice Infestation among Primary School Girls in Galle Educational Division, Southern Sri Lanka

Background: Head lice infestation (HLI) remains a common public health problem among school-aged children worldwide, particularly among girls in developing countries. Despite its considerable physical, psychological, educational, and economic burden, evidence regarding HLI among Sri Lankan school children is limited. This study aimed to assess the prevalence, disease burden, and factors associated with HLI among primary school girls in the Galle Educational Division, Southern Sri Lanka.
Methods: A school-based, descriptive cross-sectional study was conducted among grade four and five girls attending government primary schools in the Galle Educational Division, Sri Lanka. A multistage cluster random sampling technique was used to recruit participants. Data were collected using pre-tested self-administered questionnaires completed by parents. Direct scalp examinations were performed by the investigator to confirm head lice infestation. Descriptive statistics were used to summarize the data, while Chi-square tests and binary logistic regression analyses were performed to identify factors associated with HLI.
Results: A total of 380 participants were included in the study, yielding a response rate of 90.5%. The prevalence of HLI was 58.2% (n = 221). Among the identified cases, 209 were reported by parents, while an additional 12 cases were detected through scalp examination. Manual removal was the most commonly used treatment method (31.1%). Parents reported significant impacts of HLI on children’s personality (65.1%), education (64.6%), academic activities (52.6%), and sleep (50.7%). Multivariable logistic regression identified larger family size (Odds Ratio; OR = 2.216) and sharing personal combs (OR = 2.737) as significant risk factors for HLI, while older age (OR = 0.506) and higher monthly family income (OR = 0.480) were identified as protective factors.
Conclusions: HLI is highly prevalent among primary school girls in the Galle Educational Division and imposes substantial psychosocial, educational, and economic burdens on affected children and families. Strengthening school-based screening programs, parental health education, early detection strategies, and community-level interventions is essential for effective prevention and control of HLI among school children in Sri Lanka.