Abstract

Pediculosis remains a public health problem among primary schoolchildren worldwide, including in Thailand. This study aimed to determine the prevalence of pediculosis and identify associated determinants among primary schoolgirls from different socio-geographic regions of Thailand to inform effective control strategies. A cross-sectional survey was conducted among 494 schoolgirls from eastern, northeastern, and southern provinces. Data on demographic characteristics, socioeconomic status, personal hygiene practices, parental knowledge and attitudes toward head lice, and school health policies were collected using questionnaires and interviews with school administrators. Univariable analyses and a generalized linear mixed model (GLMM) with school as a random effect were used to account for clustering. The overall prevalence of pediculosis was 50.81% (95% CI: 46.31–55.20), with significant variation across provinces. In univariable analysis, several factors were associated with infestation. However, after accounting for clustering, only class level (adjusted OR = 3.09; 95% CI: 1.31–7.29) and self-performed hair washing (adjusted OR = 2.93; 95% CI: 1.57–5.49) remained significantly associated with pediculosis, while other associations were attenuated. Parental knowledge was moderate, and commonly held beliefs regarding prevention and treatment varied. None of the participating schools had routine head lice screening policies. These findings indicate that pediculosis is likely influenced by both individual and school-level factors. Control efforts may benefit from coordinated school-based approaches, alongside improved access to effective treatment and targeted health education.