Efficacy of topical mosquito repellent (picaridin) plus long-lasting insecticidal nets versus long-lasting insecticidal nets alone for control of malaria: a cluster randomised controlled trial

Sluydts, Vincent; Durnez, Lies; Heng, Somony; Gryseels, Charlotte; Canier, Lydie; Kim, Saorin; Roey, Karel Van; Kerkhof, Karen; Khim, Nimol; Sokny, Mao; Uk, Sambunny; Sovannaroth, Siv; Grietens, Koen Peeters; Sochantha, Tho; Ménard, Didier; Coosemans, Marc

doi:10.1016/s1473-3099(16)30148-7

Cited by 73 publications

(106 citation statements)

References 26 publications

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“…While it might be possible to address the former limitation by supplementing with topical repellents applied to exposed skin, 58 these only provide short-lived protection and require frequent reapplications, so they may be too expensive and impractical for effective, continuous, indefinite use in many low-income and middle-income country (LMIC) contexts. 59 Furthermore, their active ingredients are often actually irritants rather than repellents in the strict sense, 60 so they can exacerbate existing inequities by diverting mosquitoes to feed on unprotected non-users nearby 61 62 and undermine the impact of existing lethal interventions. 41 64 65 Encouragingly, one of the most widely used of these existing vapour-phase insecticides has recently been reformulated into low-technology emanator formats that provide protection lasting several months, at costs that should be affordable even in LMICs.…”

Section: Recommendations For Policymentioning

confidence: 99%

Developing an expanded vector control toolbox for malaria elimination

et al. 2017

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Vector control using long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) accounts for most of the malaria burden reductions achieved recently in low and middle-income countries (LMICs). LLINs and IRS are highly effective, but are insufficient to eliminate malaria transmission in many settings because of operational constraints, growing resistance to available insecticides and mosquitoes that behaviourally avoid contact with these interventions. However, a number of substantive opportunities now exist for rapidly developing and implementing more diverse, effective and sustainable malaria vector control strategies for LMICs. For example, mosquito control in high-income countries is predominantly achieved with a combination of mosquito-proofed housing and environmental management, supplemented with large-scale insecticide applications to larval habitats and outdoor spaces that kill off vector populations en masse, but all these interventions remain underused in LMICs. Programmatic development and evaluation of decentralised, locally managed systems for delivering these proactive mosquito population abatement practices in LMICs could therefore enable broader scale-up. Furthermore, a diverse range of emerging or repurposed technologies are becoming available for targeting mosquitoes when they enter houses, feed outdoors, attack livestock, feed on sugar or aggregate into mating swarms. Global policy must now be realigned to mobilise the political and financial support necessary to exploit these opportunities over the decade ahead, so that national malaria control and elimination programmes can access a much broader, more effective set of vector control interventions.

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Section: Recommendations For Policymentioning

confidence: 99%

Developing an expanded vector control toolbox for malaria elimination

et al. 2017

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“…More recently this was demonstrated in a study looking at the additive impact of topical repellents with LLINs on plasmodium species-specific prevalence among malaria endemic villages in Cambodia. Despite instruction and promotion of the repellent's daily use, usage was suboptimal and in combination with LLINs showed no difference in plasmodium prevalence compared to LLINs alone (Sluydts et al, 2016).…”

Section: Discussionmentioning

confidence: 93%

New Tools for the Schistosomiasis Elimination Toolbox: Barriers and Opportunities for Development of a Topical Cercarial Anti-Penetrant

Downs¹,

Massoudi²,

Dick

et al. 2017

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This PDF document was made available from www.rti.org as a public service of RTI International. More information about RTI Press can be found at http://www.rti.org/ rtipress. RTI International is an independent, nonprofit research organization dedicated to improving the human condition by turning knowledge into practice. The RTI Press mission is to disseminate information about RTI research, analytic tools, and technical expertise to a national and international audience. RTI Press publications are peerreviewed by at least two independent substantive experts and one or more Press editors. Suggested CitationDowns, P.W., Massoudi, N., Dick, A., Kabore, A., Rothrock, G., and Blough, B. (2017

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“…Two RCTs, McGready 2001 and Soto 1995, and eight cRCTs — Chen-Hussey 2013, Hill 2007, Hill 2014, Rowland 1999, Rowland 2004, Sangoro 2014a, Sluydts 2016, and Syafruddin 2014 — met the inclusion criteria of this Cochrane Review. Data from McGready 2001 was obtained after we contacted the study author: the author provided the number of events (malaria cases) per treatment arm including the number of individuals who had more than one episode of P. falciparum or P. vivax .…”

Section: Resultsmentioning

confidence: 99%

“…Two studies investigated the impact of spatial repellents compared to placebo or no treatment (Hill 2014; Syafruddin 2014). One study was conducted in China with 1026 households in both the intervention and control arms.…”

Section: Resultsmentioning

confidence: 99%

“…One study was conducted in China with 1026 households in both the intervention and control arms. We extracted data from Syafruddin 2014 and Hill 2014 by using inverse variance from adjusted odds ratio and confidence intervals reported in the articles. The study conducted in China had a trial duration of six months and investigated 0.03% transfluthrin coils in combination with or without LLINs (Hill 2014).…”

Section: Resultsmentioning

confidence: 99%

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Mosquito repellents for malaria prevention

Maia

Kliner

Richardson

et al. 2018

Cochrane Database of Systematic Reviews

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BackgroundMalaria is an important cause of illness and death across endemic regions. Considerable success against malaria has been achieved within the past decade mainly through long-lasting insecticide-treated nets (LLINs). However, elimination of the disease is proving difficult as current control methods do not protect against mosquitoes biting outdoors and when people are active. Repellents may provide a personal protection solution during these times.ObjectivesTo assess the impact of topical repellents, insecticide-treated clothing, and spatial repellents on malaria transmission.Search methodsWe searched the following databases up to 26 June 2017: the Cochrane Infectious Diseases Group Specialized Register; the Central Register of Controlled Trials (CENTRAL), published in the Cochrane Library; MEDLINE; Embase; US AFPMB; CAB Abstracts; and LILACS. We also searched trial registration platforms and conference proceedings; and contacted organizations and companies for ongoing and unpublished trials.Selection criteriaWe included randomized controlled trials (RCTs) and cluster-randomized controlled trials of topical repellents proven to repel mosquitoes; permethrin-treated clothing; and spatial repellents such as mosquito coils. We included trials that investigated the use of repellents with or without LLINs, referred to as insecticide-treated nets.Data collection and analysisTwo review authors independently reviewed trials for inclusion, extracted the data, and assessed the risk of bias. A third review author resolved any discrepancies. We analysed data by conducting meta-analysis and stratified by whether the trials had included LLINs. We combined results from cRCTs with individually RCTs by adjusting for clustering and presented results using forest plots. We used GRADE to assess the certainty of the evidence.Main resultsEight cRCTs and two RCTs met the inclusion criteria. Six trials investigated topical repellents, two trials investigated insecticide-treated clothing, and two trials investigated spatial repellents.Topical repellentsSix RCTS, five of them cluster-randomized, investigated topical repellents involving residents of malaria-endemic regions. Four trials used topical repellents in combination with nets, but two trials undertaken in displaced populations used topical repellents alone. It is unclear if topical repellents can prevent clinical malaria (RR 0.65, 95% CI 0.4 to 1.07, very low certainty evidence) or malaria infection (RR 0.84, 95% CI 0.64 to 1.12, low-certainty evidence) caused by P. falciparum. It is also unclear if there is any protection against clinical cases of P. vivax (RR 1.32, 95% CI 0.99 to 1.76, low-certainty evidence) or incidence of infections (RR 1.07, 95% CI 0.80 to 1.41, low-certainty evidence). Subgroup analysis of trials including insecticide-treated nets did not show a protective effect of topical repellents against malaria. Only two studies did not include insecticide-treated nets, and they measured different outcomes; one reported a protective effect against clinical case...

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Efficacy of topical mosquito repellent (picaridin) plus long-lasting insecticidal nets versus long-lasting insecticidal nets alone for control of malaria: a cluster randomised controlled trial

Abstract: Bill & Melinda Gates Foundation.

Cited by 73 publications

References 26 publications

Developing an expanded vector control toolbox for malaria elimination

Developing an expanded vector control toolbox for malaria elimination

New Tools for the Schistosomiasis Elimination Toolbox: Barriers and Opportunities for Development of a Topical Cercarial Anti-Penetrant

Mosquito repellents for malaria prevention

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