Factors influencing the use of topical repellents: implications for the effectiveness of malaria elimination strategies

Gryseels, Charlotte; Uk, Sambunny; Sluydts, Vincent; Durnez, Lies; Phoeuk, Pisen; Suon, Seila; Set, Srun; Heng, Somony; Sovannaroth, Siv; Gerrets, René; Sochantha, Tho; Coosemans, Marc; Grietens, Koen Peeters

doi:10.1038/srep16847

Cited by 78 publications

(84 citation statements)

References 43 publications

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“…However, these data suggest that a strategy tailored to those at highest risk and with asymptomatic infection might be required to eliminate malaria since bed-nets will not protect those working in forest plantations at dawn and dusk [14]. Targeted interventions have been trialed in other areas with varying degrees of success, including: insecticide-treated clothing and hammocks (for use in the forest); toxic mosquito baits; and personal insect-repellents [39]. Targeted mass administration of anti-malarials to specific demographic groups is another option [40].…”

Section: Discussionmentioning

confidence: 99%

Malaria epidemiology in central Myanmar: identification of a multi-species asymptomatic reservoir of infection

Ghinai

Cook

Hla

et al. 2017

Malar J

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BackgroundThe spread of artemisinin-resistant Plasmodium falciparum is a global health concern. Myanmar stands at the frontier of artemisinin-resistant P. falciparum. Myanmar also has the highest reported malaria burden in Southeast Asia; it is integral in the World Health Organization’s plan to eliminate malaria in Southeast Asia, yet few epidemiological data exist for the general population in Myanmar.MethodsThis cross-sectional, probability household survey was conducted in Phyu township, Bago Region (central Myanmar), during the wet season of 2013. Interviewers collected clinical and behavioural data, recorded tympanic temperature and obtained dried blood spots for malaria PCR and serology. Plasmodium falciparum positive samples were tested for genetic mutations in the K13 region that may confer artemisinin resistance. Estimated type-specific malaria PCR prevalence and seroprevalence were calculated, with regression analysis to identify risk factors for seropositivity to P. falciparum. Data were weighted to account for unequal selection probabilities.Results1638 participants were sampled (500 households). Weighted PCR prevalence was low (n = 41, 2.5%) and most cases were afebrile (93%). Plasmodium falciparum was the most common species (n = 19. 1.1%) and five (26%) P. falciparum samples harboured K13 mutations. Plasmodium knowlesi was detected in 1.0% (n = 16) and Plasmodium vivax was detected in 0.4% (n = 7). Seroprevalence was 9.4% for P. falciparum and 3.1% for P. vivax. Seroconversion to P. falciparum was 0.003/year in the whole population, but 16-fold higher in men over 23 years old (LR test p = 0.016).DiscussionThis is the first population-based seroprevalence study from central Myanmar. Low overall prevalence was discovered. However, these data suggest endemic transmission continues, probably associated with behavioural risk factors amongst working-age men. Genetic mutations associated with P. falciparum artemisinin resistance, the presence of P. knowlesi and discrete demographic risk groups present opportunities and challenges for malaria control. Responses targeted to working-age men, capable of detecting sub-clinical infections, and considering all species will facilitate malaria elimination in this setting.

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Section: Discussionmentioning

confidence: 99%

Malaria epidemiology in central Myanmar: identification of a multi-species asymptomatic reservoir of infection

Ghinai

Cook

Hla

et al. 2017

Malar J

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“…Using footwear as a delivery format of spatial repellents will also overcome the challenge of limited mobility of recently developed emanator formats, that require the host to be within the treated air space of stationary emanators [37][38][39]. Integrating insecticide into footwear that is locally made, low cost and worn ubiquitously across communities on a daily basis will likely promote uptake and the attendant effectiveness as it does not require any change in human behaviour [27,47,48].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of personal protection afforded by repellent-treated sandals against mosquito bites in south-eastern Tanzania

Sangoro

Gavana

Finda

et al. 2020

Malar J

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Background: Outdoor and early evening mosquito biting needs to be addressed if malaria elimination is to be achieved. While indoor-targeted interventions, such as insecticide-treated nets and indoor residual spraying, remain essential, complementary approaches that tackle persisting outdoor transmission are urgently required to maximize the impact. Major malaria vectors principally bite human hosts around the feet and ankles. Consequently, this study investigated whether sandals treated with efficacious spatial repellents can protect against outdoor biting mosquitoes.Methodology: Sandals affixed with hessian bands measuring 48 cm 2 treated with 0.06 g, 0.10 g and 0.15 g of transfluthrin were tested in large cage semi-field and full field experiments. Sandals affixed with hessian bands measuring 240 cm 2 and treated with 0.10 g and 0.15 g of transfluthrin were also tested semi field experiments. Human landing catches (HLC) were used to assess reduction in biting exposure by comparing proportions of mosquitoes landing on volunteers wearing treated and untreated sandals. Sandals were tested against insectary reared Anopheles arabiensis mosquitoes in semi-field experiments and against wild mosquito species in rural Tanzania. Results:In semi-field tests, sandals fitted with hessian bands measuring 48 cm 2 and treated with 0.15 g, 0.10 g and 0.06 g transfluthrin reduced mosquito landings by 45.9%, (95% confidence interval (C.I.) 28-59%), 61.1% (48-71%), and 25.9% (9-40%), respectively compared to untreated sandals. Sandals fitted with hessian bands measuring 240 cm 2 and treated with 0.15 g and 0.10 g transfluthrin reduced mosquito landings by 59% (43-71%) and 64% (48-74%), respectively. In field experiments, sandals fitted with hessian bands measuring 48 cm 2 and treated with 0.15 g transfluthrin reduced mosquito landings by 70% (60-76%) against Anopheles gambiae sensu lato, and 66.0% (59-71%) against all mosquito species combined. Conclusion:Transfluthrin-treated sandals conferred significant protection against mosquito bites in semi-field and field settings. Further evaluation is recommended for this tool as a potential complementary intervention against malaria. This intervention could be particularly useful for protecting against outdoor exposure to mosquito bites. Additional studies are necessary to optimize treatment techniques and substrates, establish safety profiles and determine epidemiological impact in different settings.

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“…However, the model emphasized the importance of achieving high rates of uptake. There are a number of factors that could influence the uptake of a repellent clothing intervention, including an absence of disease awareness, a lack of full appreciation of disease risk, or anxieties over the safety of the repellent active ingredient itself [32]. Although concern among FGD participants was generally high for dengue, it was far more variable for Zika.…”

Section: Discussionmentioning

confidence: 99%

An investigation into the knowledge, perceptions and role of personal protective technologies in Zika prevention in Colombia

et al. 2020

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Background Arboviruses transmitted by day-biting Aedes mosquitoes are a major public health concern. With the challenges inherent in arbovirus vaccine and therapeutics development, vector control and bite prevention strategies are among the limited options available for immediate intervention. Bite prevention through personal protective technologies (PPT), such as topical mosquito repellents or repellent-impregnated clothing, may help to decrease biting rates and, therefore, the risk of disease in groups most susceptible to adverse outcomes from Zika virus. However, achieving high uptake and compliance with PPT can be challenging. Methodology/Principal findings To gain an insight into the knowledge and concerns of pregnant women surrounding Zika and their opinions regarding PPT, particularly repellent clothing, a focus group study was carried out with pregnant women, women of reproductive age, and semi-structured interviews with their male partners in two cities in Colombia. The discussions revealed shortfalls in basic knowledge of Zika virus, with several pregnant participants reporting being unaware of the potential for Zika-related congenital malformations. Although participants generally considered Zika to be a significant personal threat, most rated it as less of a concern than dengue or diarrheal diseases. Overall, repellent clothing and other forms of PPT were viewed as effective, although some participants expressed concerns over the high costs of repellents, and safety fears of regular contact with repellent chemicals, which they perceived as potentially harmful. Plant-derived repellents were considered to be safer than synthetic

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Factors influencing the use of topical repellents: implications for the effectiveness of malaria elimination strategies

Cited by 78 publications

References 43 publications

Malaria epidemiology in central Myanmar: identification of a multi-species asymptomatic reservoir of infection

Malaria epidemiology in central Myanmar: identification of a multi-species asymptomatic reservoir of infection

Evaluation of personal protection afforded by repellent-treated sandals against mosquito bites in south-eastern Tanzania

An investigation into the knowledge, perceptions and role of personal protective technologies in Zika prevention in Colombia

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