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Chapter 1

The Problem and Its Scope

Introduction

Oxalic acid has been identified as the principal acid in the (Averrhoa carambola) and the

(A. bilimbi). While quantitative levels have been reported for carambola, oxalic acid has only

been reported qualitatively for bilimbi. Vines and Grierson reported levels of 9.6 mg/g in ripe

carambola and 5.0 mg/g in green fruit. These levels represent seventy-four percent (74%) and

forty percent (40%) of total acid respectively in the fruit (Wagner et al.) reported oxalic acid

levels in ten selections and cultivars. They ranged from 0.39 mg/g in sweet cultivars to 6.79

mg/g in sour carambola cultivars (Wilson et al.) quantified the oxalic acid in carambola using the

HPLC technique. Levels ranging from 0.8 mg/g to 7.3 mg/g were reported (J. Joseph et al. 1991).

Pediculosis is a head infestation it is a colonization of a parasitic insect like the head

louse (Pediculos humanus capitis) that colonize to the hairy part of the body like head and also

in private areas like the pubic area which also has a lice called crab lice. Pediculicide is a

treatment for killing head lice. Permethrin is an example of pediculicide that paralyze and kill the

lice and even its egg.

Head louse (Pediculosis humanus capitis) is one of the most health problem issue that

worldwide has been tackling about, in the Philippines it is one of the common and social health

problem that people experience specially to those who are in primary school grade who’s the

most target in the said health problem, not just in the Philippines but also in other country since

the said treatment is quite expensive and not socially affordable to the people. Even though
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permethrin is introducing, still the rate of the children having a head lice problem is getting

higher. Head louse it is a parasitic insect that lives in human hair and feed on blood of the scalp.

The life cycle of a head lice repeats about 3 weeks; it has a length of 0.25-0.3cm in adult head

lice. Adult lice are no bigger than a sesame seed and are grayish-white or tan. Nymphs are

smaller and become adult lice about 1–2 weeks after they hatch (Kids Health, 2019).

Permethrin is a commercial pediculicidal product that usually people use in killing or

treating head lice. Permethrin is also now considered in medication with it comes to lice, it is

used to treat scabies and lice. Although permethrin is a little bit expensive and not really cheap

and affordable for all people to avail in curing pediculosis. The researchers now then introduce

the Averrhoa bilimbi which is organic and less cost for the people to use in treating head lice

which is more relevant are affordable for all people specially to those who had pediculosis which

are the primary school girl.

The Kamias (Averrhoa bilimbi) is cultivated and semi-cultivated throughout the

Philippines also introduced to tropical America. Its property considered as antibacterial,

astringent, antiscorbutic, febrifuge, antidiabetic, stomachic, refrigerant. Kamias has its different

uses such as it can be eaten raw, it can also prepare as relish and a food flavoring, used in making

juices, vinegar, pickles and wine. Study finds out that oxalic acid can be found in this fruit as a

stain remover for clothing and washing hands it can also remove rust and stains in metal blades

because of the high oxalic acid content (Godofredo U. Stuart Jr., M.D.).

The problem of having head lice is increasing especially in primary school girls that are

very prone to this kind of problem. That is why researchers had conducted a study to reduce and

help those who are struggling in killing head lice in an organic, efficient and affordable

pediculicide.
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Researchers was encouraged to conduct this study to test and examined the production of

pediculicide from the fruit of A. bilimbi using its extract to reduce the health society problem in

killing head lice (Pediculus humanus capitis).

Conceptual Framework

The study was anchored on the study conducted by Benitez, Cimafranca, Gimenez and

Cutamora (2015), entitled “Effectiveness of Custard Apple (A. squamosa) Seed Extract in

Treating Pediculus capitis” The main task accomplished in the study was the determination of

Pediculicidal effects of A. squamosa seed extract of different concentrations. Methodology

utilized a true experimental design done in 30 trials, 10 live head lice were observed under each

concentrations of 25%, 50%, 75% atis seed extract from experimentation and 75% permethrin

concentration as a controlled group. In vitro testing was used and the subjects were put for

experimentation in prepared petri dishes. It was found out in the study that 75%, 59%, 25%

concentration of Annona squamosa seed extract is as effective as commercial pediculicide

(Permethrin) in killing Pediculus humanus capitis. 50% concentration was the most effective in

killing head lice. Our study “Pediculicidal Activity of Averrhoa bilimbi towards P. humanus

capitis” intends to adopt the methods done in this study in order to obtain the extract needed to

kill head lice. This study also gave the idea of determining the effectivity of the pediculicidal

extract in different concentrations.

Connected to this study, we will adopt the methods and process in “Effectiveness of

Custard Apple (A. squamosa) Seed extract in Treating Pediculus humanus capitis” that they did

in order for us to know the result and efficacy of our conducted research using the variable A.

bilimbi also known as Kamias in killing Humanus capitis. Which we will make the pure extract
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of kamias as a controlled group with 75% concentration and the rest of the concentration that

ranges to 25%, 50% and 75% will be added an ethyl so that it can assure that head lice will be

killed easily in the specific time allotted with 30 minutes, 60 minutes and 90 minutes.

Since, the Kamias has a component of oxalic acid and we all know that oxalic acid can be

used in removing stains in cloths also other components of Averrhoa bilimbi has a many uses

with its very components. The researchers now then pledge that they will make a pediculicidal

treatment using the kamias in killing head lice with a very efficient and affordable product so

that the health problem issue of killing head lice will be ease and reduce.

The Figure 1 showed the illustration and process that the researchers did. The

independent and dependent variables approach that the independent variable was the Kamias

(Averrhoa bilimbi) which is the most highlight in making this study and for the dependent

variables was the efficacy of the product with the time allotted in killing the head lice, and the

concentration which has a specific percent given like 25%, 50% and 75%. And for the

intervening variable that aided in making the pediculicidal aside from the main components, is

the distilled water.

PROCESS
INPUT OUTPUT
MACERATION Efficacy (time allotted)
Kamias (Averrhoa of Averrhoabilimbi
Bilimbi) Concentration (25%,
50% & 75%)

Figure 1. Schema of the Study

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Statement of the Problem.

The study aimed to examined the different concentration in killing head lice

(Pediculus Humanus Capitis) using the extract of Kamias (Averrhoa bilimbi). That sought to

answer the following questions.

1. What is the efficacy of Averrhoa bilimbi extract in terms of time allotted for killing a

certain number of head lice (P. humanus Capitis)?

2. What concentration of Averrhoa bilimbi extract is most effective in killing P. humanus

capitis?

3. Is there a significant difference between permethrin (commercial pediculicide) and

Averrhoa bilimbi extract in eradicating Pediculus humanus capitis?

Hypotheses

Based on the stated research problem, the sole hypothesis is hereby presented:

H0: There is no significant difference between the pediculicidal treatment of (Averrhoa bilimbi)

and the commercial pediculicidal treatment (Permenthrin) in terms for the time allotted and the

effectiveness of the extract of kamias in killing the head lice (P. humanus capitis) in each

concentration given.

Significance of the Study

This study seeks to provide information to give knowledge and to help people

understand that killing head lice is now easy and affordable with the help of this research in

reducing the health problem of having a head louse in the society specially to those who are
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prone to this kind of parasitic insect. Now we can use Averrhoa bilimbi as a pediculicidal and

treatment in killing head lice and not just an ordinary fruit that can be eaten raw or an ingredient

to be put in a food.

This study is deemed beneficial to the following:

Students. (who are experiencing Pediculosis especially primary school girls). This study can be

very beneficial to them since the treatment use is organic and affordable surely there’s no side

effects in it since it is organic unlike the commercial pediculicidal that can be bought in stores.

Parents. To the parents who are already stress in combing and removing head lice in their

children’s head there is now a better and efficient way in killing those parasitic insect that

doesn’t need to spend money in getting rid of those lice, just do the organic and adopt the very

affordable way in killing lice, Averhhoa bilimbi that can be easily found in the near place or in

neighbor’s backyard.

Doctors. The conduct study was also beneficial to doctors for them to use the Averrhoa bilimbi

as a reliable and efficient way in treating pediculosis, and also a recommendable pediculicidal

that is very cheap and affordable since one of the most problem of people is to buy a very

expensive commercial pediculicidal treatment in killing head lice.

Companies. (which produces in making commercial pediculicidal in treating head lice). The

company owners can get information and knowledge with regards of the methods and process

that the researchers made in doing the organic pediculicidal in A. bilimbi as a treatment which

can be sell in affordable and cheap price unlike the usual commercial pediculicidal.
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Community. The conduct study was also deemed beneficial to the community since it gives

them knowledge and information as possible way to reduce the rate of children who experiencing

on having head lice that is very common and one of the societal problems that our country

struggling about. Through this study people can now treat those who are in the stage of having

head lice in an affordable and natural way.

Scope and Limitations of the Study

The study emphasizes about the efficacy and effectiveness of Averrhoa bilimbi treatment

to Head lice (Pediculus humanus capitis) in school aged children. The procedure to be done is

used to extract compounds from A. bilimbi as a treatment and substitute for commercial

shampoo for treating and paralyzing head lice which is a communicable cause of infestation and

a societal problem.

Conceptual Definition of Terms

The following are the terms defined operationally by the researchers:

Pediculicide -An agent for destroying lice.

Pediculosis- Infestation with lice.

Head louse (Pediculus humanus capitis)- Is an obligate ectoparasite of humans that causes

head lice infestation. Head lice are wingless insects spending their entire lives on the human

scalp and feeding exclusively on human blood.

Maceration -A process that the substances have contact to merge with a solution.
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Kamias (Averrhoa bilimbi) -Tree-fruit that has vitamins and minerals and also had the potential

aid against Pediculus humanus capitis.

Chapter 2

Review of Related Literature and Studies

This chapter presents related literature and studies that corresponds the present study.

This helps us to establish the relationship between the variables of the study.

I. Related Literature

Averrhoa bilimbi is also known as Kamias. (A. Bilimbi) contains large number of leaflets,

smaller fruit with rounded, longitudinal lobes and consists of seeds without an aril (Flora of

Pakistan, 2015). A small tree up to 15 meters high. Fruits are relatively a tube-shaped. And it can

produce for a year but they had harvest seasons for about two months. Fruit development takes

about 90-110 days (Ravindran 2016). During maturity stage occur the maximum increase in

fruits weight and dimensions, and their external green colour changes into light yellow.
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Kamias is commonly used as a traditional remedy since and Medicinal uses are attributed

to Averrhoa bilimbi. And found in the forests of Philippines and Southeast Asia, where the fruit

of the plant is commonly used as an ingredient for cooking but can also be used in treating

wounds, rheumatism, venereal diseases, poisonous bites and beriberi. The leaves can be used for

cough and relief of rectal inflammation, while the flowers can be useful for coughs and thrush

(Anitha et.al 2011). Bilimbi’s flower were also gathered, washed and used to preserve in sugar

syrup. (Ravindran, 2016).

A. Bilimbi belongs to the family of the Oxalidaceae. It is generally cultivated in the

tropics. The fruit contains a concentrated juice which has a component of high potential of oxalic

acid. It has a concentrated juice which contains high potential of oxalic acid. A colorless oxalic

acid that occurs naturally on plant’s leaves. Therefore, it can be used to remove iron-rust stains

from clothes and to expose shine to brassware oxalic acid and vitamin C. Ripe fruits had the

highest levels of total soluble solids (TSS), vitamin C and lowest levels of oxalic acid,

independently of the weather conditions.

Pediculus humanus capitis or commonly known as Head louse, clearly the most common

species. Head louse is a wingless and has a white and gray pigment, flatted and segmented

abdomen. Long body and narrow anterior mouth parts. Males are less large than females and has

an average size of head louse is about 1-2 millimeter and had a pair of three clawed legs. Life

span of each Pediculus humanus capitis is an average of thirty (30) days. (Lyn CC Guenther,

Aug 16, 2019).

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Pediculus humanus capitis has increased their rate of quantity and experiencing uneven

treatment. The presence of each head louse had the most crucial in terms of health concerns since

many humans are being infestated by it.

Pediculosis capitis is a public health concern. The children are commonly infestated by

lice with an age of 5 to 11 years old. Pediculicides are the most effective treatment and each

household member or any close participants should be assessed and treated concurrently if

infested. The children should be discouraged to direct head contact with the others or sharing the

same items that may contact with hair. Each child should be allowed to return to their schools

after a proper treatment. (Leung AK, et.al J Pediatr Health Care 2005).

II. Related Studies

In the research study undertaken by Rafaela D. Sā (2014), The two species of the genus

Averrhoa L. is Averrhoa bilimi and A. Carambola has its own, leaves that its effectivity on using

in some folk medicine as an facilitates in treating diabetes and other species may contain its

calcium oxalate crystals that proceeds to in its use. This study supports the identification and

quality control of A. bilimbi and a carambola and come up with a new data of its oxalic acid

content in which they happen to be very crucial and in terms of medicinal uses of these species.

According to Md. Ashrafudoulla et.al (2015), Averrhoa bilimbi leaves are 30-60 cm long,

with 12-36 sub-opposite leaflets. And 1.2-1.25 cm wide, upper side is medium-green and it’s

extremely acid [17]. Cultivated in Myanmar, Philippines, Sri Lanka, Thailand, Venezuela and

US [17]. Averrhoa bilimbis are important since the natural source for bilimbis are useful drugs.

Because these plants contain phytochemicals. This plant can be utilized and can be useful in

times of treating any disease and it’s used in the pharmaceutical and cosmetic industries.
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As Aju Joseph Kurian (2018) stated that the plant has enormous economic significance

since its leaves, flower, fruit, bark, seeds, roots or the entire plant are utilized to treat a variety of

infections in the alternative arrangement of medicine. In the present work, attempt was made to

isolate a flavonoid compound from Averrhoa bilimbi. From the methanolic extract of the fruits of

Averrhoa bilimbi, a pentahydroxyl flavanol has been isolated as a major compound for the first

time in this plant. The plant is known for its antidiabetic, antihyperlipidemic and antibacterial

activity. The fruit extracts contain Saponins, Flavonoids, and Triterpenoid. The phyto

constituents of A. bilimbi include amino acids, citric acid, cyanidin–3–O–h–D–glucoside,

phenolics, potassium ion, vitamin A and sugars. Because of the diverse pharmacological activity

of this, the present work has been carried out in the view to isolate flavonoids from the

methanolic extract of the fruits of Averrhoa bilimbi which will be useful in assessing the

instrument behind its activity.

Vines & Grierson reported levels of 9.6 mg/g in ripe carambola and 5.0 mg/g in green fruit.

These levels represent seventy-four percent (74 %) and forty percent (40%) of total acid

respectively in the fruit. Nakata (2012) supported that there are still some studies that may relate

the content of oxalic acid that is present in them, which may lead to threat in its usage when the

presence of predisposition of individuals.

According to Sirawut Sittichok et.al (2018) Head louse (Pediculus humanus capitis) De

Geer (Pediculidae: Phthiraptera) is small and an ectoparasitic, wingless insect with a dimension

of 2.5-4.5 millimeter. That feeds only on human blood more than three times a day especially on

children. Common symptoms of headlice infestations are red spots, irritation of the scalp, and the

secondary symptoms are sleep loss, blood loss, anemia and psychological distress.
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As Fathy Abdel-Ghaffar Mohammed et.al (2016) supported that head lice infections are growing

conflicts in the public and increased the migration of large population as well as the increasing

current refugee flows and poor hygienic conditions. These infections are related with the

significantly reduced the quality of life and medical consolations can help. The approved drugs

for the treatment of head lice infections have some disadvantages in the treatment despite their

good efficacy. In addition to irritant-toxic compounds that can cause harmful reactions to

patients, a partial development of resistance has occurred and an application is necessary to

achieve adequate efficacy. As Fadime (2016) reported the environmental and demographic

changes affecting occurrence of Pediculosis capitis.

The aim of this study was to investigate the commonness of P. capitis and external factors

affecting the distribution of P. capitis. Health staff member must improve health education

programs in primary-school students especially girl students.

According to their study by, María C.Carpinella PhD & Sara M.Palacios PhD (2006) the

resistance to synthetic pediculicidal drugs of each head louse is increasing and it’s difficult to

control. Both vegetable products tested either individually or in combinations, showed high

levels of mortality on adult lice, with values ranging between 62.9% and 96.5%. The highest

mortality rate was obtained with a combination of 20% ripe fruit extract with 10% ripe fruit oil.

A formulation made with both extract and oil at 10% plus the addition of emulsifier and

preserving agents showed 92.3% pediculicidal activity.

Gastón Mougabure Cueto et.al (2010) stated that response of body lice to immersion in

water and ethanol 70% and determined the optimal times for measuring knockdown. After

immersion in water, all lice were still alive from 5 min to 22 h for both times of exposure. A

low proportion of lice were affected after 2 min of immersion in ethanol in the 10-min
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exposure test, but recovered completely after 5 min. Different quantity of lice were affected

between 2 and 7 h after immersion in ethanol, depending on the immersion time. However, a

high quantity of lice recovered after 22 h. The results suggest that the optimal times for

measuring early knockdown effects of insecticides are the 5-min to 7-h interval for water and

5-min to 1-h interval for ethanol. On the other hand, the best time for measuring mortality is

22 h after immersion. These results should improve the interpretations of the effects of

pediculicides in process like immersions.

Another study of Anabella Gallardo et.al. (2011) examined the effectiveness of a fine

comb for detaching lice from human head. It’s the relevant tool for both diagnoses of

infestations and as part of a control strategy of head lice. The aim of this study was to

compare in vivo the efficacy of metal and plastic combs that are currently used in the removal

of head lice and eggs worldwide. 

As Mayura Soonwera (2014) observed the Head lice resistance is increasing, chemical

pediculicides have lost their efficacy, and, therefore, alternative pediculicides such as herbal

shampoos have been proposed to treat head lice infestation. Thus, the present study investigated

the efficacy of three herbal shampoos based on native plants in Thailand (Acorus calamus Linn.,

Phyllanthus emblica Linn., and Zanthoxylum limonella Alston) against head lice and compared

them with carbaryl shampoo (Hafif shampoo®, 0.6 % w/v carbaryl), malathion shampoo (A-Lice

shampoo®, 1.0 % w/v malathion), and commercial shampoos (Babi Mild Natural’ N Mild® and

Johnson’s baby shampoo®) in order to assess their in vitro and in vivo efficacy. The mortalities

of head lice were recorded at 5, 15, 30, and 60 min. The results revealed that all herbal shampoo

was more effective on pediculicidal activity than chemical and commercial shampoos with
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100 % mortality at 15 min; LT50 values ranged from 0.25 to 1.90 min. The most effective

pediculicide was Z. limonella shampoo, followed by A. calamus shampoo, P. emblica shampoo,

carbaryl shampoo, Malathion shampoo, and commercial shampoo.