DEET mosquito repellent provides personal protection against malaria: a household randomized trial in an Afghan refugee camp in Pakistan

Rowland, Mark; Downey, Gerald; Rab, Abdur; Freeman, Tim; Mohammad, Nurashikin; Rehman, Hamid; Durrani, Naeem; Reyburn, Hugh; Curtis, C. F.; Lines, Jo; Fayaz, Mohammad

doi:10.1111/j.1365-3156.2004.01198.x

Cited by 92 publications

(104 citation statements)

References 19 publications

(37 reference statements)

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“…The mosquito repellent used, Mosbar, was accepted by the community and had very few sideeffects. [5] In our study, staying indoors was found to be protective against contracting malaria. Conversely, outdoor activity increased the risk of contracting malaria.…”

Section: Discussionmentioning

confidence: 85%

Factors associated with contracting malaria in Ward 29 of Shamva District, Zimbabwe, 2014

et al. 2017

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Background. Malaria cases at Wadzanayi Clinic in Shamva District, Zimbabwe, increased drastically, surpassing the epidemic threshold, in week four of December 2013. This rise was sustained, which necessitated an investigation of the outbreak. Objectives. To identify risk factors and system weaknesses to improve epidemic preparedness and response.Methods. An unmatched 1:1 case-control study was conducted in Ward 29 of Shamva District in Zimbabwe. Epidemic preparedness and response were assessed using the Zimbabwean epidemic preparedness and response guidelines. Results. The sociodemographic characteristics of all participants were similar, except for gender. The risk factors for contracting malaria were performing early morning chores (odds ratio (OR) 2.75; 95% confidence interval (CI) 1.20 -6.32), having a body of water near the home (OR 3.41; 95% CI 1.62 -7.20) and having long grass near the home (OR 2.61; 95% CI 1.10 -6.37). Protective factors were staying indoors at night (OR 0.13; 95% CI 0.06 -0.28) and staying in a sprayed home (OR 0.36; 95% CI 0.21 -0.92). All cases were diagnosed with a malaria rapid diagnostic test. All complicated cases were treated with quinine. Four out of 58 uncomplicated cases were treated with quinine. The rest were treated with co-artemether. There was no documentation of the outbreak response by the district health executive. Respraying (indoor residual spraying) was carried out, with a coverage of 78% of rooms sprayed. One nurse out of seven at Wadzanayi Clinic was trained in integrated disease surveillance and response, and malaria case management. District malaria thresholds were outdated. Malaria commodities such as drugs and sprays did not have reorder limits. Conclusion. This study re-emphasises the importance of environmental-and personal-level factors as determinants of malaria. Poor outbreak preparedness and response may have propagated the malaria outbreak in this setting. Health education and the use of mosquito repellants should be emphasised. Larvicide may reduce the malaria burden. Epidemic preparedness and response need to be strengthened. Outbreak investigation remains important. This study emphasises the need for malaria interventions to be tailored to locally prevailing determinants to avert outbreaks.

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Section: Discussionmentioning

confidence: 85%

Factors associated with contracting malaria in Ward 29 of Shamva District, Zimbabwe, 2014

et al. 2017

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“…This technique has been used to estimate the size of area-wide effects in studies of LLINs for malaria control [61]. Unintended consequences of topical repellents can be avoided by randomising only a relatively low proportion of individuals or households in a village to receive the intervention [31,62,63]. Tackling the problem of human movement in dengue studies is more difficult because Aedes aegypti feeds during the day when people are engaged in their daily activities.…”

Section: Selection Of Sites For Entomological Monitoringmentioning

confidence: 99%

Evidence-based vector control? Improving the quality of vector control trials

Wilson

Boelaert

Kleinschmidt

et al. 2015

Trends in Parasitology

125

151

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Vector-borne diseases (VBDs) such as malaria, dengue, and leishmaniasis cause a high level of morbidity and mortality. Although vector control tools can play a major role in controlling and eliminating these diseases, in many cases the evidence base for assessing the efficacy of vector control interventions is limited or not available. Studies assessing the efficacy of vector control interventions are often poorly conducted, which limits the return on investment of research funding. Here we outline the principal design features of Phase III vector control field studies, highlight major failings and strengths of published studies, and provide guidance on improving the design and conduct of vector control studies. We hope that this critical assessment will increase the impetus for more carefully considered and rigorous design of vector control studies.Evidence-based policy making on vector control VBDs such as malaria, dengue, and leishmaniasis are responsible for considerable morbidity and mortality and fall disproportionately on the poorest communities in the developing world [1-4]. One of the key methods by which VBDs can be controlled and eliminated is through vector control [5-10]; for example, long-lasting insecticidal nets (LLINs) for malaria or indoor residual spraying (IRS) for Chagas disease.Development of vector control interventions follows a multistage process [11] (Figure 1). First, a draft target product profile should be generated. This document guides the development process by outlining the features and performance targets of the intended vector control tool. The next step is demonstrating the proof of concept by conducting Phase I studies (laboratory assays to determine the mode of action) and Phase II (semi-field and small-scale field) studies, which generally have entomological end points. Large-scale Phase III field studies (efficacy studies) (see Glossary) are then conducted, which measure the efficacy of the vector control tool against epidemiological outcomes when implemented under optimal conditions. Based on the results of Phase III trials, the World Health Organization (WHO) will make recommendations for pilot implementation. These Phase IV studies will assess the effectiveness of the vector control tool when it is delivered and used operationally (i.e., under 'real-world' conditions), as well as collecting information on feasibility, distribution mechanisms, acceptability, economics, and safety. Information gathered from the Phase III and IV studies will enable the WHO to draw up policy recommendations and, in parallel, member states will develop country-level policy.Evidence-based policy making on vector control tools is now regarded as essential and is adopted by the WHO [12,13] (Box 1). The quality of evidence on vector control interventions from epidemiological trials or systematic reviews needs to be rated before recommendations and policy can be formulated. Since 2008, the WHO has adopted the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology fo...

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“…It is a reasonable supposition that they also reduce malaria transmission, and some evidence to confirm this is now becoming available (Durrheim and Govere, 2002;Rowland et al, 2004). However, the cost of daily use of synthetic repellents is not affordable in malaria endemic areas, as they would have to be applied at least twice every night during the malaria season to give protection throughout the biting time of malaria vectors.…”

Section: Introductionmentioning

confidence: 94%

Ethnobotanical survey and testing of plants traditionally used against hematophagous insects in Eritrea

Waka

Hopkins

Curtis

2004

Journal of Ethnopharmacology

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DEET mosquito repellent provides personal protection against malaria: a household randomized trial in an Afghan refugee camp in Pakistan

Cited by 92 publications

References 19 publications

Factors associated with contracting malaria in Ward 29 of Shamva District, Zimbabwe, 2014

Factors associated with contracting malaria in Ward 29 of Shamva District, Zimbabwe, 2014

Evidence-based vector control? Improving the quality of vector control trials

Ethnobotanical survey and testing of plants traditionally used against hematophagous insects in Eritrea

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