Rowland Mark, Freeman Tim, Downey Gerald, Hadi Abdul, Saeed Mohammed
HealthNet International, University Town, Peshawar, Pakistan.
Trop Med Int Health. 2004 Mar;9(3):343-50. doi: 10.1046/j.1365-3156.2003.01183.x.
DEET (diethyl-3-methylbenzamide), the widely used mosquito repellent, has the potential to prevent malarial infection but hitherto there has been no study demonstrating this possibility during normal everyday use. Mosbar, a repellent soap containing DEET, was promoted through social marketing in villages in eastern Afghanistan. This was followed up with a case-control study of effectiveness against malarial infection conducted through local clinics. Mosbar was purchased by 43% of households. Reported use of insecticide-treated nets (ITNs) was 65% among the control group. There was a strong association between Mosbar use and ITN use, as 81% of Mosbar users also possessed ITN. The use of Mosbar was associated with a 45% reduction in the odds of malaria (95% CI: -11% to 72%, P=0.08) after adjusting for ITN and other unmatched factors. Ownership of ITNs was associated with a 46% reduction in the odds of malaria (95% CI: 12% to 67%, P=0.013) after adjusting for Mosbar and other unmatched factors. The greatest reduction in the odds of malaria was associated with combined use of Mosbar and ITN (69% reduction, 95% CI: 28% to 87%, P=0.007). The association between recalled use of Mosbar 10 days ago (nearer the time of infection) and reduction in malarial infections (adjusted odds ratio 0.08, 95% CI: 0.01-0.61, P=0.001) was significantly stronger than that shown by current use of Mosbar. Most purchasers of Mosbar were satisfied with the product (74%), although a minority said they preferred to use only ITN (8%). The local mosquito vectors, Anopheles stephensi and A. nigerrimus, started biting shortly after dusk and continued biting until early morning. It was shown that Mosbar prevented biting throughout this period. In regions where mosquito vectors bite during evening and night, repellents could have a useful supplementary role to ITN and their use should be more widely encouraged.
避蚊胺（二乙基-3-甲基苯甲酰胺）是一种广泛使用的驱蚊剂，有预防疟疾感染的潜力，但迄今为止尚无研究表明在日常正常使用中存在这种可能性。Mosbar是一种含避蚊胺的驱蚊皂，通过社会营销在阿富汗东部的村庄推广。随后通过当地诊所进行了一项关于其预防疟疾感染有效性的病例对照研究。43%的家庭购买了Mosbar。对照组中报告使用经杀虫剂处理蚊帐（ITN）的比例为65%。Mosbar的使用与ITN的使用之间存在很强的关联，因为81%的Mosbar使用者也拥有ITN。在对ITN和其他未匹配因素进行调整后，使用Mosbar与疟疾发病几率降低45%相关（95%置信区间：-11%至72%，P=0.08）。在对Mosbar和其他未匹配因素进行调整后，拥有ITN与疟疾发病几率降低46%相关（95%置信区间：12%至67%，P=0.013）。疟疾发病几率降低幅度最大的是Mosbar和ITN联合使用（降低69%，95%置信区间：28%至87%，P=0.007）。10天前（更接近感染时间）回忆使用Mosbar与疟疾感染减少之间的关联（调整后的优势比为0.08，95%置信区间：0.01 - 0.61，P=0.001）明显强于当前使用Mosbar所显示的关联。大多数Mosbar购买者对该产品满意（74%），尽管少数人表示他们更喜欢仅使用ITN（8%）。当地的蚊媒斯氏按蚊和黑足按蚊在黄昏后不久开始叮咬，并持续叮咬至清晨。结果表明，Mosbar在此期间可防止叮咬。在蚊媒在傍晚和夜间叮咬的地区，驱蚊剂对ITN可起到有益的补充作用，应更广泛地鼓励使用。
