Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
Parasit Vectors. 2014 Mar 28;7:132. doi: 10.1186/1756-3305-7-132.
A mosquito repellent has the potential to prevent malaria infection, but there has been few studies demonstrating the effectiveness of combining this strategy with the highly effective long-lasting insecticidal nets (LLINs). This study aimed to determine the effect of combining community-based mosquito repellent with LLINs in the reduction of malaria.
A community-based clustered-randomised trial was conducted in 16 rural villages with 1,235 households in southern Ethiopia between September and December of 2008. The villages were randomly assigned to intervention (mosquito repellent and LLINs, eight villages) and control (LLINs alone, eight villages) groups. Households in the intervention villages received mosquito repellent (i.e., Buzz-Off petroleum jelly, essential oil blend) applied every evening. The baseline survey was followed by two follow-up surveys, at one month interval. The primary outcome was detection of Plasmodium falciparum, Plasmodium vivax, or both parasites, through microscopic examination of blood slides. Analysis was by intention to treat. Baseline imbalances and clustering at individual, household and village levels were adjusted using a generalized linear mixed model.
3,078 individuals in intervention and 3,004 in control group were enrolled into the study. Compared with the control arm, the combined use of mosquito repellent and LLINs significantly reduced malaria infection of all types over time [adjusted Odds Ratio (aOR) = 0.66; 95% CI = 0.45-0.97]. Similarly, a substantial reduction in P. falciparum malaria infection during the follow-up surveys was observed in the intervention group (aOR = 0.53, 95% CI = 0.31-0.89). The protective efficacy of using mosquito repellent and LLINs against malaria infection of both P. falciparum/P. vivax and P. falciparum was 34% and 47%, respectively.
Daily application of mosquito repellent during the evening followed by the use of LLINs during bedtime at community level has significantly reduced malaria infection. The finding has strong implication particularly in areas where malaria vectors feed mainly in the evening before bedtime.
ClinicalTrials.gov identifier: NCT01160809.
驱蚊剂具有预防疟疾感染的潜力，但很少有研究证明将这种策略与高效长效驱虫蚊帐（LLINs）结合使用的有效性。本研究旨在确定在减少疟疾方面，社区为基础的驱蚊剂与 LLINs 联合使用的效果。
2008 年 9 月至 12 月，在埃塞俄比亚南部的 16 个农村村庄（共有 1235 户家庭）进行了一项社区为基础的聚类随机试验。这些村庄被随机分配到干预（驱蚊剂和 LLINs，8 个村庄）和对照（仅 LLINs，8 个村庄）组。干预村的家庭每晚都会使用驱蚊剂（即 Buzz-Off 凡士林，精油混合物）。基线调查后进行了两次随访调查，间隔一个月。主要结局是通过显微镜检查血片来检测疟原虫、间日疟原虫或两者寄生虫。分析采用意向治疗。使用广义线性混合模型调整个体、家庭和村庄各级的基线不平衡和聚类。
共有 3078 名干预组和 3004 名对照组的个人被纳入研究。与对照组相比，驱蚊剂和 LLINs 的联合使用显著降低了所有类型疟疾的感染率[调整后的优势比（aOR）=0.66；95%置信区间（CI）=0.45-0.97]。同样，在干预组中，在随访调查期间，间日疟原虫疟疾感染也显著减少（aOR=0.53，95%CI=0.31-0.89）。使用驱蚊剂和 LLINs 预防疟原虫/间日疟原虫和疟原虫感染的保护效力分别为 34%和 47%。
在社区层面上，每晚使用驱蚊剂，睡前使用 LLINs，可以显著降低疟疾感染。这一发现具有重要意义，特别是在疟疾传播媒介主要在傍晚睡前觅食的地区。
ClinicalTrials.gov 标识符：NCT01160809。
