Tropical Medicine and International Health
Volume 9, Issue 3, 2004, Pages 335-342

DEET mosquito repellent provides personal protection against malaria: A household randomized trial in an Afghan refugee camp in Pakistan (Article)

Rowland M.* , Downey G. , Rab A. , Freeman T. , Mohammad N. , Rehman H. , Durrani N. , Reyburn H. , Curtis C. , Lines J. , Fayaz M.
  • a HealthNet International, Peshawar, Pakistan, London Sch. of Hyg. and Trop. Med., London, United Kingdom, HealthNet International, 11A Circular Lane, Peshawar, Pakistan
  • b London Sch. of Hyg. and Trop. Med., London, United Kingdom, Department of Parasitology, London Sch. of Hyg. and Trop. Med., Keppel Street, London WC1E 7HT, United Kingdom
  • c HealthNet International, Peshawar, Pakistan, HealthNet International, 11A Circular Lane, Peshawar, Pakistan
  • d HealthNet International, Peshawar, Pakistan, HealthNet International, 11A Circular Lane, Peshawar, Pakistan
  • e HealthNet International, Peshawar, Pakistan, HealthNet International, 11A Circular Lane, Peshawar, Pakistan
  • f HealthNet International, Peshawar, Pakistan, HealthNet International, 11A Circular Lane, Peshawar, Pakistan
  • g HealthNet International, Peshawar, Pakistan, HealthNet International, 11A Circular Lane, Peshawar, Pakistan
  • h HealthNet International, Peshawar, Pakistan, London Sch. of Hyg. and Trop. Med., London, United Kingdom, HealthNet International, 11A Circular Lane, Peshawar, Pakistan
  • i London Sch. of Hyg. and Trop. Med., London, United Kingdom, Department of Parasitology, London Sch. of Hyg. and Trop. Med., Keppel Street, London WC1E 7HT, United Kingdom
  • j London Sch. of Hyg. and Trop. Med., London, United Kingdom, Department of Parasitology, London Sch. of Hyg. and Trop. Med., Keppel Street, London WC1E 7HT, United Kingdom
  • k HealthNet International, Peshawar, Pakistan, HealthNet International, 11A Circular Lane, Peshawar, Pakistan

Abstract

Synthetic repellents based on di-ethyl 3-methyl benzamide (DEET) are a popular method of obtaining protection from mosquitoes and yet clear evidence for a protective effect against malaria has hitherto never been convincingly demonstrated. A household randomized trial was undertaken among a study population of 127 families (25%) in an Afghan refugee village in Pakistan to compare the efficacy of repellent soap (Mosbar™ containing 20% DEET and 0.5% permethrin) vs. a placebo lotion. Cases of falciparum and vivax malaria were detected by passive case detection at the camp's clinic. At the end of the 6 month trial 3.7% (23 of 618) of individuals in the Mosbar group had presented with one or more episodes of falciparum malaria compared with 8.9% (47 of 530) of the placebo group (odds ratio 0.44, 95% CI 0.25-0.76). 16.7% of the Mosbar group (103 of 618) presented with vivax malaria compared with 11.7% (62 of 530) of the placebo group, and thus no effect was shown against vivax malaria (odds ratio 1.29, 95% CI 0.86-1.94). A considerable proportion of individuals (22%) had presented with vivax malaria during the 7 months leading up to the trial and thus any intervention effect would be partially masked by relapsed infections. The distribution of mosquitoes among households was broadly similar between Mosbar and placebo groups. The repellent was popularly received and very few side-effects were reported. There is a case for giving repellents more prominence in public health as a preventive measure in regions where vectors bite in the early evening or in emergency situations such as epidemics or newly established refugee camps.

Author Keywords

Emergency Di-ethyl 3-methyl benzamide Cluster randomized trial Malaria Repellent Mosquito epidemic Refugee

Index Keywords

Pakistan Afghanistan Eurasia household refugee controlled clinical trial insect repellent clinical trial mosbar Insect Repellents DEET Hexapoda Arachnida water oil cream lotion human skin irritation Refugees Asia controlled study mosquito Malaria randomized controlled trial malaria control Animals Insecta diethyltoluamide relapse permethrin Confidence interval South Asia Humans side effect Adolescent male female Child, Preschool placebo Disease Outbreaks Recurrence Article disease control Plasmodium vivax Malaria, Vivax adult Malaria, Falciparum malaria falciparum age distribution normal human Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-12144286336&doi=10.1111%2fj.1365-3156.2004.01198.x&partnerID=40&md5=64a72668263c56c549f35ec964683385
DOI: 10.1111/j.1365-3156.2004.01198.x
ISSN: 13602276
Cited by: 60
Original Language: English