Correct diagnosis of current head lice infestation made by affected individuals from a hyperendemic area

[Extract] Head lice infestations are common in many resource-poor communities throughout the world. Pediculosis in these settings is regarded as a minor problem of low priority by both residents and health professionals. A cost- and time effective approach to diagnosis is therefore warranted, as scarce resources in health personnel should be directed towards more important health priorities. The aim of this study was to evaluate the positive predictive value (PPV) of residents’ self-reporting of active pediculosis in a resourcepoor community. If the PPV is high, primary healthcare services could provide treatment on this basis alone without expending time in confirming the diagnosis. We undertook a study in an urban slum in Fortaleza, the capital of the state of Ceará (north-east Brazil). The prevalence of pediculosis (active and inactive infection) in the area is more than 40%, and socio-economic conditions are precarious