由已经接触头虱儿童的父母进行筛查
如果学龄儿童已经接触或者密切接触过头虱感染者,通常会要求其父母对其余无症状的孩子进行头虱感染筛查。 可能因前一个月中在某个教室、露营或不在家过夜的聚会中的接触。 应当向父母提供如何有效发现活虱的操作指南。 或者年幼学龄儿童的父母可假设在任何时候都可能发生接触,使用同样的有效技术(湿梳)每周对孩子进行活虱筛查。[8]American Academy of Pediatrics; Devore CD, Schutze GE. Head lice. Pediatrics. 2015;135:e1355-e1365.http://pediatrics.aappublications.org/content/135/5/e1355.longhttp://www.ncbi.nlm.nih.gov/pubmed/25917986?tool=bestpractice.com[28]American Academy of Pediatrics. Head lice. In: 2006 Red Book: report of the committee on infectious diseases. 27:448-492.[29]Public Health Medicine Environmental Group. Head lice: evidence-based guidelines based on the Stafford Report - 2012 update [internet publication].http://www.nhsggc.org.uk/media/239960/stafford-head-lice-2012.pdf
在学校环境中筛查
在学校环境中,对大批无症状儿童进行筛查需消耗大量时间,破坏学习环境,并且未被证明有效,虽然很多人觉得这是学校护士的应尽职责。[37]Pollack RJ. The role of the school in battling head lice. Our children (US National PTA). 2007. http://www.pta.org (last accessed 2 November 2016).https://identify.us.com/idmybug/head-lice/head-lice-documents/pta_battling_lice.pdf
执行这一评估的人应当有资格进行这一任务(受过正式培训),具有必要设备(一件适合的放大工具),并且得到合法赋权(具有医学博士或适当护理证书)以进行诊断。 教师、监护人和父母志愿者不能对儿童进行筛查,作出头虱感染的诊断。[32]Pollack RJ, Kiszewski AD, Spielman A. Overdiagnosis and consequent mismanagement of head louse infestation in North America. Pediatr Infect Dis J. 2000;19:689-693.http://www.ncbi.nlm.nih.gov/pubmed/10959734?tool=bestpractice.com[37]Pollack RJ. The role of the school in battling head lice. Our children (US National PTA). 2007. http://www.pta.org (last accessed 2 November 2016).https://identify.us.com/idmybug/head-lice/head-lice-documents/pta_battling_lice.pdf
学校护士应能够对转诊来进行头部检查的有症状儿童作出头虱感染的诊断。 如果被头虱感染儿童数量异常多,学校护士可通过评估高度风险暴露环境提供帮助,向教职员、学生和家长提供准确信息,并帮助筛查该情况下有限数量的儿童。[37]Pollack RJ. The role of the school in battling head lice. Our children (US National PTA). 2007. http://www.pta.org (last accessed 2 November 2016).https://identify.us.com/idmybug/head-lice/head-lice-documents/pta_battling_lice.pdf
尚未证明常规的教室或全校范围的筛查有帮助,因而不赞成进行这一筛查。 群体筛查可给出错误的安全感(因为很少使用湿梳,普通观察可漏诊很多病例)或导致比必要数量多很多的儿童被推荐进行治疗(当单独的卵或卵壳被用作诊断标准时)。[8]American Academy of Pediatrics; Devore CD, Schutze GE. Head lice. Pediatrics. 2015;135:e1355-e1365.http://pediatrics.aappublications.org/content/135/5/e1355.longhttp://www.ncbi.nlm.nih.gov/pubmed/25917986?tool=bestpractice.com[32]Pollack RJ, Kiszewski AD, Spielman A. Overdiagnosis and consequent mismanagement of head louse infestation in North America. Pediatr Infect Dis J. 2000;19:689-693.http://www.ncbi.nlm.nih.gov/pubmed/10959734?tool=bestpractice.com[26]Williams LK, Reichert A, MacKenzie WR, et al. Lice, nits, and school policy. Pediatrics. 2001;107:1011-1015.http://www.ncbi.nlm.nih.gov/pubmed/11331679?tool=bestpractice.com[27]Mumcuoglu KY, Meinking TA, Burkhart CN, et al. Head louse infestations: the "no nit" policy and its consequences. Int J Derm. 2006;45:891-896.http://www.ncbi.nlm.nih.gov/pubmed/16911370?tool=bestpractice.com
学校护士可充分利用时间把正确的诊断技巧教给家长,向诊断或治疗有困难的家庭提供其专业知识。[5]Counahan M, Andrews R, Buttner P, et al. Head lice prevalence in primary schools in Victoria, Australia. J Paediatr Child Health. 2004;40:616-619.http://www.ncbi.nlm.nih.gov/pubmed/15469530?tool=bestpractice.com[11]Meinking TL. Infestations: pediculosis. Curr Probl Dermatol. 1999;11:73-120.http://www.ncbi.nlm.nih.gov/pubmed/8743266?tool=bestpractice.com[32]Pollack RJ, Kiszewski AD, Spielman A. Overdiagnosis and consequent mismanagement of head louse infestation in North America. Pediatr Infect Dis J. 2000;19:689-693.http://www.ncbi.nlm.nih.gov/pubmed/10959734?tool=bestpractice.com[35]Hootman J. Quality improvement projects related to pediculosis management. J School Nursing. 2002;18:80-86.http://www.ncbi.nlm.nih.gov/pubmed/12017250?tool=bestpractice.com[37]Pollack RJ. The role of the school in battling head lice. Our children (US National PTA). 2007. http://www.pta.org (last accessed 2 November 2016).https://identify.us.com/idmybug/head-lice/head-lice-documents/pta_battling_lice.pdf