Dr Nigel Hill Obituary

Nigel Hill (1961 – 2010)

With great sorrow we mourn the untimely death on 5 January 2010 of the medical entomologist, Dr Nigel Hill. He was head of the Disease Control and Vector Biology Unit, London School of Hygiene & Tropical Medicine (LSHTM) and worked on a wide range of insect pests including head lice.

Best known for his outstanding work on “low technology” control of malaria vectors, those of us who are concerned with head lice, will remember Nigel particularly for key contributions on insecticide resistance and mechanical cure.  His 1994 report on the identification of resistance mechanisms in UK head lice to the insecticides, carbaryl and malathion, provided evidence that these were losing effectiveness, confirming the suspicions of community health services. In 1998 he undertook to lead a large-scale evaluation of the Bug Buster combing kit as used by families to treat head lice. Supported by LSHTM experts in clinical trial design, Nigel produced the appropriate trial protocol and raised funding to run it from the National Lottery Charities Board. To date, this trial remains unique among evaluations of products to control head lice because it addressed sustainability over an entire year, in this case of the Bug Busting approach versus malathion or permethrin treatments, in addition to their initial comparative effectiveness. Most trials do not examine long-term sustainability, and often the end results are measured at two weeks with no further follow-up.

Whatever type of vector control Nigel worked in, mosquitoes, house dust mites or head lice, his work was distinguished by a concern to identify health protection measures which are accessible to the whole community at risk. He was an advocate of integrated pest control, judging the full range of chemical and physical methods on their respective merits with an open mind. Regarding head lice, he considered that rapid and accurate detection constitute an underlying principle of effective control and found that Bug Busting wet combing is an ideal way for parents to diagnose lice, monitor the effectiveness of formulated treatments and, when applied systematically, an acceptable, cost-effective treatment.

Warm-hearted and generous by nature, Nigel maintained a high regard for scientific rigour and had a great gift for teaching.  He will be sorely missed by his students, colleagues and the communities where his work has made a lasting contribution to health and well-being.

Joanna Ibarra and Clarice Wickenden (Community Hygiene Concern)

References

• Hill, N. Preliminary studies on the evaluation of possible resistance mechanisms to anticholinesterase insecticides in UK field populations of the head louse, Pediculus capitis. In Towards the establishment of Bug Busting in the public health calendar. CHC Report to the King’s Fund, London, 1994: 116-9
• Hill, N.; Moor, G.; Cameron, M.M.; Butlin, A.; Preston, S.; Williamson, M.S.; Bass, C.; Single blind, randomised, comparative study of the Bug Buster kit and over the counter pediculicide treatments against head lice in the United Kingdom. British Medical Journal, 2005; 331(7513):384-7
• Hill, N.; Moor, G.; Cameron, M.M. et al. Clinical evaluation of the Bug Buster kit for the control of head lice at the community level: Effectiveness, acceptance and sustainability. (Presentation to the Third International Congress on Phthiraptera, Buenos Aires, 16-20 October 2006)
• Hill N. Control of head lice: past, present and future. Expert Review of Anti-infective Therapy, 2006; 4 (5): 887-894 http://www.expert-reviews.com/doi/abs/10.1586/14787210.4.5.887