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Long-lasting permethrin-impregnated clothing: protective efficacy against malaria in hyperendemic foci, and laundering, wearing, and weathering effects on residual bioactivity after worst-case use in the rain forests of French Guiana.

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An Erratum to this article was published on 23 May 2017

Abstract

Personal protective measures against hematophagous vectors constitute the first line of defense against arthropod-borne diseases. However, guidelines for the standardized testing and licensing of insecticide-treated clothing are still lacking. The aim of this study was to analyze the preventive effect of long-lasting polymer-coated permethrin-impregnated clothing (PTBDU) against malaria after exposure to high-level disease transmission sites as well as the corresponding loss of permethrin and bioactivity during worst-case field use. Between August 2011 and June 2012, 25 personnel wearing PTBDUs and exposed for 9.5 person-months in hyperendemic malaria foci in the rain forest of French Guiana contracted no cases of malaria, whereas 125 persons wearing untreated uniforms only, exposed for 30.5 person-months, contracted 11 cases of malaria, indicating that PTBDU use significantly (p = 0.0139) protected against malaria infection. In the field, PTBDUs were laundered between 1 and 218 times (mean 25.2 ± 44.8). After field use, the mean remaining permethrin concentration in PTBDU fabric was 732.1 ± 321.1 min varying between 130 and 1270 mg/m2 (mean 743.9 ± 304.2 mg/m2) in blouses, and between 95 and 1290 mg/m2 (mean 720.2 ± 336.9 mg/m2) in trousers. Corresponding bioactivity, measured according to internal licensing conditions as KD99 times against Aedes aegypti mosquitoes, varied between 27.5 and 142.5 min (mean 47.7 ± 22.1 min) for blouses, and between 25.0 and 360 min (mean 60.2 ± 66.1 min) for trousers. We strongly recommend the use of long-lasting permethrin-impregnated clothing for the prevention of mosquito-borne diseases, including chikungunya, dengue, and zika fevers, which are currently resurging globally.

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Acknowledgements

The authors thank Ms. Anke Crecelius and Mr. Bernd Bocklet for the laboratory support. Thanks also to the military personnel involved who assisted in data collection. Dr. Richard G. Robbins, Walter Reed Biosystematics Unit, Department of Entomology, Smithsonian Institution, Washington, DC, helpfully reviewed and commented on an earlier version of our manuscript. This publication represents the thesis of Mr. Bruno Most.

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Authors and Affiliations

  1. Director Department A, Bundeswehr Medical Office, Koblenz, Germany

    Bruno Most

  2. French Armed Forces Center for Epidemiology and Public Health (CESPA), Camp Militaire de Sainte Marthe, Marseille, France

    Vincent Pommier de Santi & Frédéric Pagès

  3. Regional Office of the French Institute for Public Health Surveillance (Cire OI, Institut de Veille Sanitaire), Saint-Denis, Réunion, France

    Frédéric Pagès

  4. Institut de Recherche Biomédicale des Armées, Cedex, Brétigny sur Orge, France

    Marie Mura

  5. Bundeswehr Research Institute for Materials, Fuels, and Lubricants, Erding, Germany

    Waltraud M. Uedelhoven

  6. Department of Medical Entomology/Zoology, Central Institute of the Bundeswehr Medical Service, PO Box 7340, 56065, Koblenz, Germany

    Michael K. Faulde

  7. Institute of Medical Microbiology, Immunology and Parasitology, University Clinics Bonn, 53105, Bonn, Germany

    Michael K. Faulde

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  1. Bruno Most
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  2. Vincent Pommier de Santi
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  3. Frédéric Pagès
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Correspondence to Michael K. Faulde.

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An erratum to this article is available at http://dx.doi.org/10.1007/s00436-017-5513-z.

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Most, B., de Santi, V.P., Pagès, F. et al. Long-lasting permethrin-impregnated clothing: protective efficacy against malaria in hyperendemic foci, and laundering, wearing, and weathering effects on residual bioactivity after worst-case use in the rain forests of French Guiana.. Parasitol Res 116, 677–684 (2017). https://doi.org/10.1007/s00436-016-5333-6

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