Volume 91, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



A randomized, double-blinded, placebo-controlled study was conducted to examine the effect of spatial repellent (SR) in households at risk of malaria in Indonesia. Following presumptive radical cure for malaria in 180 adult men representing sentinels of new infection in four clusters within two villages, all households were given either metofluthrin or placebo mosquito coils. Weekly blood smear screening and human-landing mosquito catches were done throughout the 6 months intervention. Malaria infections occurred in 61 subjects living in placebo households and 31 subjects living in SR coil households, suggesting a 52% protective effect of SR. Likewise, anopheles indoor human landing rates were 32% lower in homes receiving SR coils. Differences in the malaria attack rate between SR- and placebo-treated homes was significant when not accounting for the effects of clustering. When the analysis was adjusted for intra-cluster correlation, the differences between SR- and placebo-treated homes were not statistically significant. The findings provide evidence of SR public health benefit and support a larger trial statistically powered to detect those effects.


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  1. World Health Organization. 2011. World Malaria Report. Geneva: WHO.
  2. Murray CJ, Rosenfeld LC, Lim SS, Andrews KG, Foreman KG, Haring D, Fullman N, Naghavi M, Lozano M, Lopez AD, , 2011. Global malaria mortality between 1980 and 2010: a systematic review. Lancet 379: 413431.[Crossref]
  3. Hill J, Rowland M, , 2006. Insecticide-treated nets. Adv Parasitol 61: 77128.[Crossref]
  4. Achee NL, Bangs MJ, Farlow R, Killeen GF, Lindsay S, Logan JG, Moore SJ, Rowland M, Sweeney K, Torr SJ, Zwiebel LJ, Grieco JP, , 2012. Spatial repellents: from discovery and development to evidence-based validation. Malar J 11: 164.[Crossref]
  5. World Health Organization, 2013. Guidelines for Efficacy Testing of Spatial Repellents. Geneva: WHO.
  6. Muirhead-Thomson RC, , 1953. Mosquito Behavior in Relation to Malaria Transmission and Control in the Tropics. London, UK: Edward Arnold and Company.
  7. Kawada H, Maekawa Y, Tsuda Y, Takagi M, , 2004. Laboratory and field evaluation of spatial repellency with metofluthrin-impregnated paper strip against mosquitoes in Lombok Island, Indonesia. J Am Mosq Control Assoc 20: 292298.
  8. Kawada H, Maekawa Y, Takagi M, , 2005. Field trial on the spatial repellency of metofluthrin-impregnated plastic strips for mosquitoes in shelters without walls (beruga) in Lombok, Indonesia. J Vector Ecol 30: 181185.
  9. Ujihara K, Mori T, Iwasaki T, Sugano M, Shono Y, Matsuo N, , 2004. Metofluthrin: a potent new synthetic pyrethroid with high vapor activity against mosquitoes. Biosci Biotechnol Biochem 68: 170174.[Crossref]
  10. Kawada H, Maekawa Y, Tsuda Y, Takagi M, , 2004. Trial of spatial repellency of metofluthrin-impregnated paper strip against Anopheles and Culex in shelters without walls in Lombok, Indonesia. J Am Mosq Control Assoc 20: 434437. Erratum in J Am Mosq Control Assoc 21: 105.
  11. Kennedy JS, , 1947. The excitant and repellent effects on mosquito of sublethal contact with DDT. Bull Entomol Res 37: 593607.[Crossref]
  12. De Zulueta J, Cullen JR, , 1963. Deterrent effect of insecticides on malaria vectors. Nature 200: 860861.[Crossref]
  13. White GW, Debboun M, Frances SP, Strickman D, , 2007. Terminology of insect repellents. , eds. Insect Repellents. Boca Rotan, FL: CRC Press, 3146.
  14. Grieco JP, Achee NL, Andre RG, Roberts DR, , 2000. A comparison study of house entering and exiting behavior of Anopheles vestitipennis using experimental hut sprayed with DDT or deltramethrin in the southern district of Toledo, Belize, CA. J Vector Ecol 25: 6273.
  15. Ogoma SB, Lweitoijera DW, Ngonyani H, Furer B, Russell TL, Mukabana TR, Killeen GF, Moore SJ, , 2010. Screening mosquito house entry points as a potential method for integrated control of endophagic filariasis, arbovirus and malaria vectors. PLoS Negl Dis 4: e773.[Crossref]
  16. Hill N, Lenglet A, Arnez AM, Carneiro I, , 2007. Plant-based insect repellent and insecticide treated nets to protect against malaria in areas of early evening biting vectors: double blind randomized placebo controlled trial in the Bolivian Amazon. BMJ 335: 1023.[Crossref]
  17. Syafruddin D, Krisin Asih P, Sekartuti Dewi RM, Coutrier F, Rozy IE, Susanti AI, Elyazar IR, Sutamihardja A, Rahmat A, Kinzer M, Rogers WO, , 2009. Seasonal prevalence of malaria in West Sumba District, Indonesia. Malar J 8: 8.[Crossref]
  18. Asih PB, Dewi RM, Tuti S, Sadikin M, Sumarto W, Sinaga B, van der Ven AJ, Sauerwein RW, Syafruddin D, , 2009. Efficacy of artemisinin-based combination therapy for uncomplicated falciparum malaria in West Sumba district, East Nusa Tenggara Province, Indonesia and the genotypic profiles of the parasite. Am J Trop Med Hyg 80: 914918.
  19. Elyazar IR, Hay SI, Baird JK, , 2011. Malaria distribution, prevalence, drug resistance and control in Indonesia. Adv Parasitol 74: 41174.[Crossref]
  20. Ling J, Baird JK, Fryauff DJ, Sismadi P, Bangs MJ, Lacy M, Barcus MJ, Gramzinski R, Maguire JD, Kumusumangsih M, Miller GB, Jones TR, Chulay JD, Hoffman SL, , 2002. Randomized, placebo-controlled trial of atovaquone/proguanil for the prevention of Plasmodium falciparum and Plasmodium vivax malaria among migrants to Papua, Indonesia. Clin Infect Dis 35: 825833.[Crossref]
  21. Bennett S, Parpia T, Hayes R, Cousens S, , 2002. Methods for the analysis of incidence rates in cluster randomized trials. Int J Epidemiol 31: 839846.[Crossref]
  22. Dean AG, Sullivan KM, Soe MM, , 2010. Open epi: Open source epidemiologic statistic for Public Health . Version 2.3.1. Available at: www.OpenEpi.com. Updated 2010. Accessed September 22, 2012.
  23. Brookmeyer R, Chen YQ, , 1998. Person-time analysis of paired community intervention trials when the number of communities is small. Stat Med 71: 21212132.[Crossref]
  24. Directorate General for Diseases Control and Environmental Health, 2011. Guide to Malaria Case Management (Pedoman Tatalaksana Malaria). Jakarta, Indonesia: Ministry of Health.
  25. Baird JK, Lacy MD, Basri H, Barcus MJ, Maguire JD, Bangs MJ, Gramzinski R, Sismadi P, Krisin Ling J, Wiady I, Kusumaningsih M, Jones TR, Fryauff DJ, Hoffman SL, , 2001. Randomized, parallel placebo-controlled trial of primaquine for malaria prophylaxis in Papua, Indonesia. Clin Infect Dis 33: 19901997.[Crossref]
  26. Baird JK, Hoffman SL, , 2004. Primaquine therapy for malaria. Clin Infect Dis 39: 13361345.[Crossref]
  27. Sutanto I, Tjahyono B, Barsi H, Taylor WB, Putti FA, Meilia RA, Setiabudy R, Nurleila S, Ekawaty LL, Elyazar I, Farrar J, Sudoyo H, Baird JK, , 2013. Randomized, open-label trial of primaquine against vivax malaria relapse in Indonesia. Antimicrob Agents Chemother 57: 11281135.[Crossref]
  28. World Health Organization, 2010. Basic Malaria Microscopy Part 1. Learner's Guide. Second edition. Geneva: WHO.
  29. O?Connors CT, Soepanto A, , 1979. Kunci kunci bergambar untuk Anopheles betina dari Indonesia. Translated and revised by Atmosoedjono S, Bangs, MJ, 1989. Illustrated key to the Anopheles of Indonesia. Jakarta, Indonesia: The Ministry of Health. 140.
  30. Detinova TS, , 1962. Age-grouping methods in Diptera of medical important with special reference to some vectors of malaria. Geneva: World Health Organization. 216 pp.
  31. Burkot TR, Williams JL, Schneider I, , 1984. Identification of Plasmodium falciparum infected mosquitoes by double antibody enzyme-linked immunosorbent assay. Am J Trop Med Hyg 33: 783788.
  32. Singh B, Bobogare A, Cox-Singh J, Snounou G, Abdullah MS, Rahman HA, , 1999. A genus- and species-specific nested polymerase chain reaction malaria detection assay for epidemiologic studies. Am J Trop Med Hyg 60: 687692.
  33. Beier JC, Doolan DL, , 2002. Vector incrimination and entomological inoculation rates. , ed. Malaria Methods and Protocols. Totowa, NJ: Humana Press, 311.
  34. Vazquez-Prokopec GM, Galvin WA, Kelly R, Kitron U, , 2009. A new, cost-effective, battery-powered aspirator for adult mosquito collections. J Med Entomol 46: 12561259.[Crossref]
  35. Zimmerman RH, Galardo AK, Lounibos LP, Arruda M, Wirtz R, , 2006. Bloodmeal hosts of Anopheles species (Diptera: Culicidae) in a malaria-endemic area of the Brazilian Amazon. J Med Entomol 43: 947956.[Crossref]
  36. Donner A, Klar N, Zou G, , 2004. Methods for the statistical analysis of binary data in split-cluster designs. Biometrics 60: 919925.[Crossref]
  37. Dusfour I, Blondeau J, Harbach RE, Vythilingham I, Baimai V, Trung HD, Sochanta T, Bangs MJ, Manguin S, , 2007. Polymerase chain reaction identification of three members of the Anopheles sundaicus (Diptera: Culicidae) complex, malaria vectors in Southeast Asia. J Med Entomol 44: 723731.[Crossref]
  38. Grieco JP, Achee NL, Chareonviriyaphap T, Suwonkerd W, Chauhan K, Sardelis MR, Roberts DR, , 2007. A new classification system for the actions of IRS chemicals traditionally used for malaria control. PLoS ONE 2: e716.[Crossref]
  39. Said SH, Grieco JP, Achee NL, , 2009. Evaluation of contact irritant and spatial repellent behavioral responses of male Aedes aegypti to vector control compounds. J Mosq Contr Assoc 25: 436441.[Crossref]
  40. Hawley WA, Phillips-Howard PA, ter Kuile FO, Terlouw DJ, Vulule JM, Ombok M, Nahlen BL, Gimnig JE, Kariuki SK, Kolczak MS, Hightower AW, , 2003. Community-wide effects permethrin-treated bed nets on child mortality and malaria morbidity in western Kenya. Am J Trop Med Hyg 68: 121127.
  41. Phillips-Howard PA, ter Kuile FO, Nahlen BL, Alaii JA, Gimnig JE, Kolczak MS, Terlouw DJ, Kariuki SK, Shi YP, Kachur SP, Hightower AW, Vulule JM, Hawley WA, , 2003. The efficacy of permethrin-treated bed nets on child mortality and morbidity in western Kenya II. Study design and methods. Am J Trop Med Hyg 68: 1015.
  42. Lengeler C, , 2009. Insecticide treated bed net and curtain for preventing malaria (review). The Cochrane Library. Available at: http://www.thecochranelibrary.com/userfiles/ccoch/file/CD000363.pdf. Accessed September 25, 2014.
  43. Hill N, Zho HN, Wang P, Guo X, Carneiro I, Moore SJ, , 2014. A household randomized, controlled trial of the efficacy of 0.03% transfluthrin coils alone and in combination with long-lasting insecticidal nets on the incidence of Plasmodium falciparum and Plasmodium vivax malaria in Western Yunnan Province, China. Malar J 13: 208.[Crossref]
  44. Hemingway J, Beaty BJ, Rowland M, Scott TW, Sharp BL, , 2006. The innovative vector control consortium: improved control of mosquito-borne diseases. Trends Parasitol 22: 308312.[Crossref]

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  • Received : 13 Dec 2013
  • Accepted : 25 Aug 2014

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