Obat Kutu Rambut, Adakah Efek Sampingnya?

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Pertanyaan: "Saya mau tanya dong efek samping dari Peditox - yg obat buat kutu rambut itu.. tx" Fee (email ada di redaksi) Jawaban: bat kutu rambut !edit"#, men$andun$ bahan akti% heksakl"r"sikl"heksan 0,&', (ertama kali di$unakan seba$ai (estisida (an$an dan insektisida (ada he)an ternak* +eksakl"r"sikl"heksan, disebut ,u$a lindane/lindan$, dikemban$kan kemudian dalam bentuk sam(" dan l"si"n untuk men$atasi kutu rambut (ada manusia* -adan .esehatan /unia (0+ ) men$klasi%ikasikan lindane seba$ai sen1a)a t"ksik menen$ah akut (ada manusia dan bersi%at ("lutan "r$anik 1an$ mudah terakumulasi dalam ,an$ka (an,an$ di lin$kun$an* Se,ak 2"3ember 2004, lindane dilaran$ di$unakan di &2 ne$ara dan dibatasi (en$$unaann1a di 33 ne$ara lainn1a* -a$aimana(un, di 5merika Serikat, lindane masih di(erb"lehkan di$unakan dalam tera(i lini kedua untuk men$atasi kutu rambut dan skabies* Seba$ai (ilihan (ertama, (en$$unaan krim (ermetrin dan l"si"n malathi"n lebih dian,urkan* /alam in%"rmasi (r"dukn1a, !edit"# di$unakan den$an di$"s"kkan di kulit ke(ala dan dibiarkan semalaman* 63aluasi (r"duk ini "leh !usat !enelitian 6k"l"$i .esehatan dan !usat !enelitian !en1akit 7enular, /e(artemen .esehatan 89, men1arankan (en$$unaan d"sis 1an$ lebih rendah serta (en$$unaan 1an$ lebih sin$kat untuk men$uran$i risik" kera:unan akibat (a(aran ,an$ka (an,an$* -erdasarkan (en$a)asan (as:a-(emasaran (post-marketing surveillance) 1an$ dilakukan F/5 (US Food and Drug Administration), e%ek sam(in$ 1an$ (alin$ serin$ dila("rkan (ada (en$$unaan (r"duk 1an$ men$andun$ lindane antara lain iritasi, kulit kerin$, $atal, dan sensasi terbakar* 6%ek sam(in$ 1an$ lebih (arah se(erti ke,an$-ke,an$ dan sakit ke(ala dila("rkan ,aran$ ter,adi* ;ebih lan,ut, (r"duk 1an$ men$andun$ lindane sebaikn1a di$unakan den$an (erhatian (ada )anita hamil, (enderita (en1akit hati, diabetesi, dan anakanak den$an berat badan di ba)ah &0 k$*

Sebelum men$$unakan (r"duk, (en$$unaan dalam ,umlah ke:il di area kulit ke(ala tertentu da(at dilakukan untuk melihat adan1a res("n aler$i atau e%ek sam(in$ 1an$ da(at ter,adi* <ika $e,ala $atal tidak dirasa berkuran$ setelah (en$"batan (ertama, sebaikn1a dik"nsultasikan lebih lan,ut ke d"kter* Referensi

1. F/5 !ubli: +ealth 5d3is"r1: Sa%et1 "% T"(i:al ;indane !r"du:ts %"r the Treatment

"% S:abies and ;i:e (htt(://)))*%da*$"3//ru$s//ru$Sa%et1/!"stmarket/ru$Sa%et19n%"rmati"n%"r!atients and!r"3iders/u:m1108=&*htm) 2. ;indane Sham("" and ;indane ;"ti"n- >uesti"ns and 5ns)ers (htt(://)))*%da*$"3//ru$s//ru$Sa%et1/!"stmarket/ru$Sa%et19n%"rmati"n%"r!atients and!r"3iders/u:m1108=8*htm)
3. ;indane - 0iki(edia (htt(://en*)iki(edia*"r$/)iki/;indane?:ite_n"te-@"mmissi"n-

11) =* Sere$e$, 9*A*, Su(ra(tini, 6* ;aks"n", 1BBC, 63aluasi +e#a:hl"r":1:l"he#ane 0,&' 6@ terhada( 8hi(i:e(halus san$uineus, @ermin /unia .ed"kteran 11C: =3-=4*

(enulis: /"ti !arames)ari re%erensi: F/5 !ubli: +ealth 5d3is"r1: Sa%et1 "% T"(i:al ;indane !r"du:ts %"r the Treatment "% S:abies and ;i:e (htt(://)))*%da*$"3//ru$s//ru$Sa%et1/!"stmarket/ru$Sa%et19n%"rmati"n%"r!atientsand!r"3 iders/u:m1108=&*htm) ;indane Sham("" and ;indane ;"ti"n- >uesti"ns and 5ns)ers (htt(://)))*%da*$"3//ru$s//ru$Sa%et1/!"stmarket/ru$Sa%et19n%"rmati"n%"r!atientsand!r"3 iders/u:m1108=8*htm) ;indane - 0iki(edia (htt(://en*)iki(edia*"r$/)iki/;indane?:ite_n"te-@"mmissi"n-11) Sere$e$, 9*A*, Su(ra(tini, 6* ;aks"n", 1BBC, 63aluasi +e#a:hl"r":1:l"he#ane 0,&' 6@ terhada( 8hi(i:e(halus san$uineus, @ermin /unia .ed"kteran 11C: =3-=4*

Volume 14, Number 9September 2008 Letter

Worldwide Prevalence of
"rticle #ontent$

ead !ice

Letter References Technical Appendix[50 KB - 8 pages !"ggested #itati$n

Su$$ested :itati"n %"r this arti:le T the Edit r: !edi:ul"sis :a(itis has been )ell-kn")n sin:e antiDuit1 ( )* +uman in%estati"n :an result in (s1:h"l"$i:al %rustrati"n %"r (arents and :hildren (!)E %urtherm"re, (re3enti3e and thera(euti: (ra:ti:es, su:h as head sha3in$ and the Fn"-nitG ("li:1 "% e#:ludin$ in%e:ted :hildren %r"m s:h""l, :an als" indu:e s":ial stress* 0e s"u$ht t" s1nthesiHe the a3ailable e3iden:e re$ardin$ the )"rld)ide (re3alen:e "% li:e in%estati"n in the 21st :entur1 b1 :"ndu:tin$ a literature sear:h "% !ub7ed and S:"(us databases in )hi:h )e sear:hed %"r the term pediculosis. 0e als" sear:hed A""$le %"r the terms "ead lice#pediculosis capitis and indi3idual :"untr1 names and e3aluated re%eren:es "% the arti:les and re("rts retrie3ed thr"u$h this sear:h* 6li$ible studies )ere ar:hi3ed %r"m <anuar1 1, 2000, t" <anuar1 18, 2008* 0e retrie3ed && studies (Te:hni:al 5((endi# I!/F - &0 .- - 8 (a$esJ)* 7"st studies re%erred t" s:h""l:hildren, but s"me in3"l3ed re%u$ees, urban slums, :hild lab"r, ,ails, "r(hana$es, and %ishin$ :"mmunities* 7"st studies had been :"ndu:ted in 5siaE Turke1 )as "3erre(resented* !re3alen:e 3aried %r"m 0*C' t" &B' and )as hi$her in $irls and )"men* % the 2B studies, 2= in3"l3ed s:h""l:hildrenE the "ther studies in3"l3ed re%u$ee :hildren, :hild lab"rers, the $eneral ("(ulati"n, street :hildren, ,ail inmates, and :hildren a::"m(an1in$ their m"thers in (ris"n* 9n 6ur"(e, (re3alen:e 3aried %r"m 0*=8' t" 22*='* +")e3er, 1 stud1 re("rted a mu:h hi$her annual in:iden:e (3C*=') in 6n$land ($)* 5 stud1 in the Kkraine sh")ed in:reasin$ adult re(resentati"n in the "3erall a%%e:ted ("(ulati"n (%)* Si# studies in3"l3ed s:h""l:hildrenE the remainin$ studies in3"l3ed re%u$ees, h"meless (ers"ns, and the $eneral ("(ulati"n* /ata %r"m 5%ri:a, )ith the e#:e(ti"n "% 1 stud1 in S"uth 5%ri:a, )ere deri3ed %r"m 6$1(t* !re3alen:e 3aried %r"m 0' t" &8*B' and )as hi$her in %emales* The stud1 in S"uth 5%ri:a (&) :hallen$es the $enerall1 a::e(ted :"n:e(t that head li:e in%estati"n re%ers t" l")er s":i"e:"n"mi: statusE "% 2 s:h""ls, 1 in a l") s":i"e:"n"mi: status area, ("(ulated b1 bla:k

students "nl1, and the "ther in a hi$h s":i"e:"n"mi: status area, ("(ulated b1 students "% 3ari"us ra:es, head li:e in%estati"n )as %"und "nl1 in the se:"nd s:h""l, s"lel1 am"n$ )hite (u(ils* % 4 studies in 6$1(t, = in3"l3ed di3erse ("(ulati"ns: urban (""r (res:h""l :hildren, "r(hana$e :hildren, and the $eneral ("(ulati"n* 7"st studies in the 5meri:as )ere :"ndu:ted in -raHil, alth"u$h )e als" %"und data %r"m the Knited States, @uba, and 5r$entina* !re3alen:e 3aried %r"m 3*4' t" 41*=' and )as hi$her in %emales* % C studies, = in3"l3ed ("(ulati"ns "ther than s:h""l:hildren t" s"me e#tent: urban slum residents, %ishin$ :"mmunit1 residents, ad"les:ents and adults sam(led rand"ml1 %r"m the $eneral ("(ulati"n, elderl1 nursin$ h"me residents, and (ers"ns li3in$ )ith re(eatedl1 in%ested :hildren* 5 re:ent stud1 in -raHil (') n"ted that (re3alen:e rates determined b1 3isual ins(e:ti"n are t)i:e that "% rates determined b1 hair anal1sis* nl1 1 stud1 has been (er%"rmed in :eania* This stud1 in 5ustralia re("rted (re3alen:e "% 13' and that $irls )ere m"re likel1 t" ha3e a:ti3e in%e:ti"n* ur re3ie) sh")s that (edi:ul"sis :a(itis is )ides(read thr"u$h"ut the )"rld and d"es n"t dis:riminate "n s":i"e:"n"mi: status $r"unds* The traditi"nal (er:e(ti"n "% head li:e as a (arasit"sis e#:lusi3el1 ass":iated )ith s:h""l:hildren "% l") s":i"e:"n"mi: status is :hallen$ed b1 s"me "% the re("rts (Te:hni:al 5((endi# I!/F - &0 .- - 8 (a$esJ)* 7"st studies underestimate "3erall (re3alen:e b1 assessin$ it in a s(e:i%i: time%rameE t" the :"ntrar1, head li:e in%estati"n is a d1nami: (r":ess that :an s(read h1(er$e"metri:all1 in :l"sed en3ir"nments su:h as s:h""ls and in the :"mmunit1 (()* The ("int-(re3alen:e re("rted b1 +eukelba:h et al ()) ma1 re(resent a m"re a::urate indi:at"r* 5lth"u$h s":i"e:"n"mi: status seems t" be an indi:at"r "% the ma$nitude "% li:e in%estati"n, m"re s(e:i%i: determinants are the d1nami: (r":esses "% h1$ieni: status and "3er:r")din$* 5 re:ent stud1 in Turke1 :"m(ared 2 nei$hb"rin$ 3illa$es )ith di%%erent s":i"e:"n"mi: status* The "nl1 %a:t"r that )as statisti:all1 si$ni%i:antl1 related t" (edi:ul"sis :a(itis )as siHe "% the h"useh"ldE L4 inhabitants )as ass":iated )ith in:reased (re3alen:e (*)* 5n"ther (arameter that ma1 indire:tl1 in%luen:e "3erall (re3alen:e and a::"unt %"r the le3elin$ "% the (re3alen:e $radient bet)een ri:h and (""r is a)areness "% head li:e and (re3enti3e and thera(euti: (ra:ti:es* 5 stud1 in 5ustralia sh")ed that alth"u$h (arents (re%er t" (la1 a ma,"r r"le in (re3enti"n and treatment, the1 ma1 la:k insi$ht int" re:ent ad3an:es and dilemmas re$ardin$ these measures ( +)* Mariati"ns in re("rted (re3alen:e )ere %"und e3en in data %r"m the same :"untr1* These di%%eren:es :an result %r"m sur3e1s bein$ :"ndu:ted durin$ di%%erent seas"ns, 3ari"us e#aminati"n te:hniDues, re("rtin$ "% a:ti3e in%estati"n "r (resen:e "% nits, and ("tential intr"du:ti"n "% e%%e:ti3e (edi:uli:ides* 5lth"u$h head li:e a::"unt %"r a substantial number "% missed s:h""lda1s in :hildren, am"n$ "thers, it is sur(risin$ that (edi:ul"sis :a(itis is n"t m"nit"red and (re3alen:e is n"t re$ularl1 re("rted* 5lth"u$h )e :ann"t e#tin$uish the (arasite, e%%e:ti3e m"nit"rin$ and (lannin$ )ill enable us t" limit the (re3alen:e and distributi"n "% this (arasit"sis*
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A"th$r affiliati$ns/ Alfa -nstit"te $f Bi$+edical !ciences) Athens) .reece 0%.'. (alagas) *.K. %atthai$") ,.-. Rafailidis) .. ,an$s) .. ,appas12 3enr4 *"nant 3$spital) Athens 0%.'. (alagas) ,.-. Rafailidis12 T"fts 5ni6ersit4 !ch$$l $f %edicine) B$st$n) %assach"setts) 5!A 0%.'. (alagas12 -nstit"te $f #$ntin"ing %edical 'd"cati$n $f -$annina) -$annina) .reece 0.. ,appas12

%eference$
1. ($"rnier ,') 7dih$8"9&a4$ :B) ."idran :) Kell4 ,:) Ra$"lt *. 3"+an path$gens in 9$d4 and head lice. '+erg -nfect *is. 200228/1515; 8.,"9%ed 2. %"+c"$gl" K<) %ein8ing TA) B"r8hart #7) B"r8hart #.. 3ead l$"se infestati$ns/ the =n$ nit> p$lic4 and its c$nse?"ences. -nt : *er+at$l. 200@2A5/8B1;@. *C-,"9%e http/DD&&&nc.cdc.g$6DeidDarticleD1ADBD08-03@8Earticle.ht+