Study summary
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 V, Durnez L, Heng S, et al.
Read the original paper- Study type
- Rct
- Year
- 2016
- Species tested
- Human malaria (Plasmodium, Cambodia)
- Published in
- The Lancet Infectious Diseases 16(10):1169-1177
- Evidence strength
- Definitive evidence
How it was tested
98 village clusters were randomized to nets plus promoted daily picaridin use versus nets alone, with malaria measured by PCR prevalence surveys across two transmission seasons.
Summary
A large cluster-randomized trial in rural Cambodia testing whether adding a mass-distributed picaridin repellent on top of insecticidal bed nets would cut malaria further. It did not.
Key findings
Adding picaridin produced no significant reduction in malaria in either year, with prevalence essentially unchanged (2012 odds ratio 1.01, 2013 odds ratio 1.31, both non-significant). The authors attribute the null result mainly to poor day-to-day compliance with using the repellent, plus outdoor and early-evening biting that personal protection struggles to cover. It is a useful reminder that a repellent that works on skin only helps if people actually use it consistently.
Limitations
Real-world compliance with daily repellent use was low, the local mosquitoes bite outdoors and early, and the outcome was parasite prevalence rather than clinical illness.