Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia.
Pharmacy, University of Tasmania, Hobart, Tasmania, Australia.
BMJ Paediatr Open. 2021 May 10;5(1):e001129. doi: 10.1136/bmjpo-2021-001129. eCollection 2021.
Head lice infestation is a major public health problem around the globe. Its treatment is challenging due to product failures resulting from rapidly emerging resistance to existing treatments, incorrect treatment applications and misdiagnosis. Various head lice treatments with different mechanism of action have been developed and explored over the years, with limited report on systematic assessments of their efficacy and safety. This work aims to present a robust evidence summarising the interventions used in head lice.
This is a systematic review and network meta-analysis which will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement for network meta-analyses. Selected databases, including PubMed, Embase, MEDLINE, Web of Science, CINAHL and Cochrane Central Register of Controlled Trials will be systematically searched for randomised controlled trials exploring head lice treatments. Searches will be limited to trials published in English from database inception till 2021. Grey literature will be identified through Open Grey, AHRQ, Grey Literature Report, Grey Matters, ClinicalTrials.gov, WHO International Clinical Trials Registry and International Standard Randomised Controlled Trials Number registry. Additional studies will be sought from reference lists of included studies. Study screening, selection, data extraction and assessment of methodological quality will be undertaken by two independent reviewers, with disagreements resolved via a third reviewer. The primary outcome measure is the relative risk of cure at 7 and 14 days postinitial treatment. Secondary outcome measures may include adverse drug events, ovicidal activity, treatment compliance and acceptability, and reinfestation. Information from direct and indirect evidence will be used to generate the effect sizes (relative risk) to compare the efficacy and safety of individual head lice treatments against a common comparator (placebo and/or permethrin). Risk of bias assessment will be undertaken by two independent reviewers using the Cochrane Risk of Bias tool and the certainty of evidence assessed using the Grading of Recommendations, Assessment, Development and Evaluations guideline for network meta-analysis. All quantitative analyses will be conducted using STATA V.16.
The evidence generated from this systematic review and meta-analysis is intended for use in evidence-driven treatment of head lice infestations and will be instrumental in informing health professionals, public health practitioners and policy-makers.
CRD42017073375.
头虱感染是全球范围内的一个主要公共卫生问题。由于现有治疗方法的耐药性迅速出现、治疗应用不当和误诊等原因，导致产品治疗失败，治疗具有挑战性。多年来，已经开发并探索了各种具有不同作用机制的头虱治疗方法，但关于其疗效和安全性的系统评估报告有限。本研究旨在提供一份关于头虱干预措施的综合证据总结。
这是一项系统评价和网络荟萃分析，将按照网络荟萃分析的系统评价和荟萃分析报告的首选报告项目进行报告。将系统地搜索包括 PubMed、Embase、MEDLINE、Web of Science、CINAHL 和 Cochrane 中央对照试验注册中心在内的选定数据库，以寻找探索头虱治疗方法的随机对照试验。搜索将限于自数据库成立以来至 2021 年发表的英文试验。通过 Open Grey、AHRQ、Grey Literature Report、Grey Matters、ClinicalTrials.gov、世界卫生组织国际临床试验注册平台和国际标准随机对照试验编号注册中心，确定灰色文献。将从纳入研究的参考文献中寻找其他研究。由两名独立评审员进行研究筛选、选择、数据提取和方法学质量评估，意见分歧由第三名评审员解决。主要结局测量指标为初始治疗后 7 天和 14 天的治愈率相对风险。次要结局测量指标可能包括药物不良反应、杀卵活性、治疗依从性和可接受性以及再次感染。直接和间接证据的信息将用于生成比较个别头虱治疗与常见对照（安慰剂和/或扑灭司林）疗效和安全性的效应大小（相对风险）。两名独立评审员将使用 Cochrane 偏倚风险工具评估偏倚风险，并使用网络荟萃分析的推荐评估、制定与评价分级指南评估证据确定性。所有定量分析均将使用 STATA V.16 进行。
本系统评价和荟萃分析生成的证据旨在用于头虱感染的循证治疗，并将有助于为卫生专业人员、公共卫生从业人员和政策制定者提供信息。
PROSPERO 注册号：CRD42017073375。
