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Do topical repellents divert mosquitoes within a community? Health equity implications of topical repellents as a mosquito bite prevention tool.
PLoS One. 2013; 8(12):e84875.Plos

Abstract

OBJECTIVES

Repellents do not kill mosquitoes--they simply reduce human-vector contact. Thus it is possible that individuals who do not use repellents but dwell close to repellent users experience more bites than otherwise. The objective of this study was to measure if diversion occurs from households that use repellents to those that do not use repellents.

METHODS

The study was performed in three Tanzanian villages using 15%-DEET and placebo lotions. All households were given LLINs. Three coverage scenarios were investigated: complete coverage (all households were given 15%-DEET), incomplete coverage (80% of households were given 15%-DEET and 20% placebo) and no coverage (all households were given placebo). A crossover study design was used and coverage scenarios were rotated weekly over a period of ten weeks. The placebo lotion was randomly allocated to households in the incomplete coverage scenario. The level of compliance was reported to be close to 100%. Mosquito densities were measured through aspiration of resting mosquitoes. Data were analysed using negative binomial regression models.

FINDINGS

Repellent-users had consistently fewer mosquitoes in their dwellings. In villages where everybody had been given 15%-DEET, resting mosquito densities were fewer than half that of households in the no coverage scenario (Incidence Rate Ratio [IRR]=0.39 (95% confidence interval [CI]: 0.25-0.60); p<0.001). Placebo-users living in a village where 80% of the households used 15%-DEET were likely to have over four-times more mosquitoes (IRR=4.17; 95% CI: 3.08-5.65; p<0.001) resting in their dwellings in comparison to households in a village where nobody uses repellent.

CONCLUSIONS

There is evidence that high coverage of repellent use could significantly reduce man-vector contact but with incomplete coverage evidence suggests that mosquitoes are diverted from households that use repellent to those that do not. Therefore, if repellents are to be considered for vector control, strategies to maximise coverage are required.

Authors+Show Affiliations

Swiss Tropical & Public Health Institute, Department of Epidemiology & Public Health, Basel, Switzerland ; University of Basel, Basel, Switzerland ; Ifakara Health Institute, Environmental Health and Ecological Sciences Thematic Group, Bagamoyo, Pwani Region, United Republic of Tanzania.Ifakara Health Institute, Environmental Health and Ecological Sciences Thematic Group, Bagamoyo, Pwani Region, United Republic of Tanzania ; London School of Hygiene & Tropical Medicine, Department of Disease Control, London, England, United Kingdom.Ifakara Health Institute, Environmental Health and Ecological Sciences Thematic Group, Bagamoyo, Pwani Region, United Republic of Tanzania.Ifakara Health Institute, Environmental Health and Ecological Sciences Thematic Group, Bagamoyo, Pwani Region, United Republic of Tanzania.Duke University, Department of Biostatistics and Bioinformatics, Durham, North Carolina, United States of America ; Duke University, Duke Global Health Institute, Durham, North Carolina, United States of America.Swiss Tropical & Public Health Institute, Department of Epidemiology & Public Health, Basel, Switzerland ; University of Basel, Basel, Switzerland ; Ifakara Health Institute, Environmental Health and Ecological Sciences Thematic Group, Bagamoyo, Pwani Region, United Republic of Tanzania.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24376852

Citation

Maia, Marta Ferreira, et al. "Do Topical Repellents Divert Mosquitoes Within a Community? Health Equity Implications of Topical Repellents as a Mosquito Bite Prevention Tool." PloS One, vol. 8, no. 12, 2013, pp. e84875.
Maia MF, Onyango SP, Thele M, et al. Do topical repellents divert mosquitoes within a community? Health equity implications of topical repellents as a mosquito bite prevention tool. PLoS One. 2013;8(12):e84875.
Maia, M. F., Onyango, S. P., Thele, M., Simfukwe, E. T., Turner, E. L., & Moore, S. J. (2013). Do topical repellents divert mosquitoes within a community? Health equity implications of topical repellents as a mosquito bite prevention tool. PloS One, 8(12), e84875. https://doi.org/10.1371/journal.pone.0084875
Maia MF, et al. Do Topical Repellents Divert Mosquitoes Within a Community? Health Equity Implications of Topical Repellents as a Mosquito Bite Prevention Tool. PLoS One. 2013;8(12):e84875. PubMed PMID: 24376852.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Do topical repellents divert mosquitoes within a community? Health equity implications of topical repellents as a mosquito bite prevention tool. AU - Maia,Marta Ferreira, AU - Onyango,Sangoro Peter, AU - Thele,Max, AU - Simfukwe,Emmanuel Titus, AU - Turner,Elizabeth Louise, AU - Moore,Sarah Jane, Y1 - 2013/12/20/ PY - 2013/08/14/received PY - 2013/11/20/accepted PY - 2013/12/31/entrez PY - 2014/1/1/pubmed PY - 2014/10/14/medline SP - e84875 EP - e84875 JF - PloS one JO - PLoS One VL - 8 IS - 12 N2 - OBJECTIVES: Repellents do not kill mosquitoes--they simply reduce human-vector contact. Thus it is possible that individuals who do not use repellents but dwell close to repellent users experience more bites than otherwise. The objective of this study was to measure if diversion occurs from households that use repellents to those that do not use repellents. METHODS: The study was performed in three Tanzanian villages using 15%-DEET and placebo lotions. All households were given LLINs. Three coverage scenarios were investigated: complete coverage (all households were given 15%-DEET), incomplete coverage (80% of households were given 15%-DEET and 20% placebo) and no coverage (all households were given placebo). A crossover study design was used and coverage scenarios were rotated weekly over a period of ten weeks. The placebo lotion was randomly allocated to households in the incomplete coverage scenario. The level of compliance was reported to be close to 100%. Mosquito densities were measured through aspiration of resting mosquitoes. Data were analysed using negative binomial regression models. FINDINGS: Repellent-users had consistently fewer mosquitoes in their dwellings. In villages where everybody had been given 15%-DEET, resting mosquito densities were fewer than half that of households in the no coverage scenario (Incidence Rate Ratio [IRR]=0.39 (95% confidence interval [CI]: 0.25-0.60); p<0.001). Placebo-users living in a village where 80% of the households used 15%-DEET were likely to have over four-times more mosquitoes (IRR=4.17; 95% CI: 3.08-5.65; p<0.001) resting in their dwellings in comparison to households in a village where nobody uses repellent. CONCLUSIONS: There is evidence that high coverage of repellent use could significantly reduce man-vector contact but with incomplete coverage evidence suggests that mosquitoes are diverted from households that use repellent to those that do not. Therefore, if repellents are to be considered for vector control, strategies to maximise coverage are required. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/24376852/Do_topical_repellents_divert_mosquitoes_within_a_community_Health_equity_implications_of_topical_repellents_as_a_mosquito_bite_prevention_tool_ L2 - https://dx.plos.org/10.1371/journal.pone.0084875 DB - PRIME DP - Unbound Medicine ER -