Volume 93, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Outdoor exposure to mosquitoes is a risk factor for many diseases, including malaria and dengue. We have previously shown that long-lasting permethrin-impregnated clothing protects against tick and chigger bites in a double-blind randomized controlled trial in North Carolina outdoor workers. Here, we evaluated whether this clothing is protective against mosquito bites by measuring changes in antibody titers to mosquito salivary gland extracts. On average, there was a 10-fold increase in titer during the spring and summer when mosquito exposure was likely to be the highest. During the first year of the study, the increase in titer in subjects wearing treated uniforms was 2- to 2.5-fold lower than that of control subjects. This finding suggests that long-lasting permethrin-impregnated clothing provided protection against mosquito bites.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Lengeler C, , 2004. Insecticide-treated bed nets and curtains for preventing malaria. Cochrane Database Syst Rev CD000363. [Google Scholar]
  2. Monroe A, Asamoah O, Lam Y, Koenker H, Psychas P, Lynch M, Ricotta E, Hornston S, Berman A, Harvey SA, , 2015. Outdoor-sleeping and other night-time activities in northern Ghana: implications for residual transmission and malaria prevention. Malar J 14: 35. [Google Scholar]
  3. Sangoro O, Kelly AH, Mtali S, Moore SJ, , 2014. Feasibility of repellent use in a context of increasing outdoor transmission: a qualitative study in rural Tanzania. Malar J 13: 347. [Google Scholar]
  4. Leme TS, Papini S, Vieira E, Luchini LC, , 2014. Evaluation of personal protective equipment used by malathion sprayers in dengue control in Sao Paulo, Brazil. Cad Saude Publica 30: 567576. [Google Scholar]
  5. Banks SD, Murray N, Wilder-Smith A, Logan JG, , 2014. Insecticide-treated clothes for the control of vector-borne diseases: a review on effectiveness and safety. Med Vet Entomol 28 (Suppl 1): 1425. [Google Scholar]
  6. Faulde MK, Rutenfranz M, Keth A, Hepke J, Rogge M, Gorner A, , 2015. Pilot study assessing the effectiveness of factory-treated, long-lasting permethrin-impregnated clothing for the prevention of tick bites during occupational tick exposure in highly infested military training areas, Germany. Parasitol Res 114: 671678. [Google Scholar]
  7. Schofield S, Crane F, Tepper M, , 2012. Good interventions that few use: uptake of insect bite precautions in a group of Canadian Forces personnel deployed to Kabul, Afghanistan. Mil Med 177: 209215. [Google Scholar]
  8. Kitau J, Oxborough R, Kaye A, Chen-Hussey V, Isaacs E, Matowo J, Kaur H, Magesa SM, Mosha F, Rowland M, Logan J, , 2014. Laboratory and experimental hut evaluation of a long-lasting insecticide treated blanket for protection against mosquitoes. Parasit Vectors 7: 129. [Google Scholar]
  9. Gimnig JE, Lindblade KA, Mount DL, Atieli FK, Crawford S, Wolkon A, Hawley WA, Dotson EM, , 2005. Laboratory wash resistance of long-lasting insecticidal nets. Trop Med Int Health 10: 10221029. [Google Scholar]
  10. Rowland M, Durrani N, Hewitt S, Mohammed N, Bouma M, Carneiro I, Rozendaal J, Schapira A, , 1999. Permethrin-treated chaddars and top-sheets: appropriate technology for protection against malaria in Afghanistan and other complex emergencies. Trans R Soc Trop Med Hyg 93: 465472. [Google Scholar]
  11. Kimani EW, Vulule JM, Kuria IW, Mugisha F, , 2006. Use of insecticide-treated clothes for personal protection against malaria: a community trial. Malar J 5: 63. [Google Scholar]
  12. Soto J, Medina F, Dember N, Berman J, , 1995. Efficacy of permethrin-impregnated uniforms in the prevention of malaria and leishmaniasis in Colombian soldiers. Clin Infect Dis 21: 599602. [Google Scholar]
  13. Eamsila C, Frances SP, Strickman D, , 1994. Evaluation of permethrin-treated military uniforms for personal protection against malaria in northeastern Thailand. J Am Mosq Control Assoc 10: 515521. [Google Scholar]
  14. Deparis X, Frere B, Lamizana M, N'Guessan R, Leroux F, Lefevre P, Finot L, Hougard JM, Carnevale P, Gillet P, Baudon D, , 2004. Efficacy of permethrin-treated uniforms in combination with DEET topical repellent for protection of French military troops in Cote d'Ivoire. J Med Entomol 41: 914921. [Google Scholar]
  15. Faulde MK, Uedelhoven WM, Malerius M, Robbins RG, , 2006. Factory-based permethrin impregnation of uniforms: residual activity against Aedes aegypti and Ixodes ricinus in battle dress uniforms worn under field conditions, and cross-contamination during the laundering and storage process. Mil Med 171: 472477. [Google Scholar]
  16. Gupta RK, Rutledge LC, Reifenrath WG, Gutierrez GA, Korte DW, Jr, 1989. Effects of weathering on fabrics treated with permethrin for protection against mosquitoes. J Am Mosq Control Assoc 5: 176179. [Google Scholar]
  17. Vaughn MF, Meshnick SR, , 2011. Pilot study assessing the effectiveness of long-lasting permethrin-impregnated clothing for the prevention of tick bites. Vector Borne Zoonotic Dis 11: 869875. [Google Scholar]
  18. Vaughn MF, Funkhouser SW, Lin FC, Fine J, Juliano JJ, Apperson CS, Meshnick SR, , 2014. Long-lasting permethrin impregnated uniforms: a randomized-controlled trial for tick bite prevention. Am J Prev Med 46: 473480. [Google Scholar]
  19. Ribeiro JM, Rossignol PA, Spielman A, , 1984. Role of mosquito saliva in blood vessel location. J Exp Biol 108: 17. [Google Scholar]
  20. Waitayakul A, Somsri S, Sattabongkot J, Looareesuwan S, Cui L, Udomsangpetch R, , 2006. Natural human humoral response to salivary gland proteins of Anopheles mosquitoes in Thailand. Acta Trop 98: 6673. [Google Scholar]
  21. Londono-Renteria BL, Eisele TP, Keating J, James MA, Wesson DM, , 2010. Antibody response against Anopheles albimanus (Diptera: Culicidae) salivary protein as a measure of mosquito bite exposure in Haiti. J Med Entomol 47: 11561163. [Google Scholar]
  22. Londono-Renteria B, Cardenas JC, Cardenas LD, Christofferson RC, Chisenhall DM, Wesson DM, McCracken MK, Carvajal D, Mores CN, , 2013. Use of anti-Aedes aegypti salivary extract antibody concentration to correlate risk of vector exposure and dengue transmission risk in Colombia. PLoS One 8: e81211. [Google Scholar]
  23. Doucoure S, Mouchet F, Cournil A, Le Goff G, Cornelie S, Roca Y, Giraldez MG, Simon ZB, Loayza R, Misse D, Flores JV, Walter A, Rogier C, Herve JP, Remoue F, , 2012. Human antibody response to Aedes aegypti saliva in an urban population in Bolivia: a new biomarker of exposure to dengue vector bites. Am J Trop Med Hyg 87: 504510. [Google Scholar]
  24. Drame PM, Poinsignon A, Besnard P, Le Mire J, Dos-Santos MA, Sow CS, Cornelie S, Foumane V, Toto JC, Sembene M, Boulanger D, Simondon F, Fortes F, Carnevale P, Remoue F, , 2010. Human antibody response to Anopheles gambiae saliva: an immuno-epidemiological biomarker to evaluate the efficacy of insecticide-treated nets in malaria vector control. Am J Trop Med Hyg 83: 115121. [Google Scholar]
  25. Poinsignon A, Samb B, Doucoure S, Drame PM, Sarr JB, Sow C, Cornelie S, Maiga S, Thiam C, Rogerie F, Guindo S, Hermann E, Simondon F, Dia I, Riveau G, Konate L, Remoue F, , 2010. First attempt to validate the gSG6-P1 salivary peptide as an immuno-epidemiological tool for evaluating human exposure to Anopheles funestus bites. Trop Med Int Health 15: 11981203. [Google Scholar]
  26. Ali ZM, Bakli M, Fontaine A, Bakkali N, Vu Hai V, Audebert S, Boublik Y, Pages F, Remoue F, Rogier C, Fraisier C, Almeras L, , 2012. Assessment of Anopheles salivary antigens as individual exposure biomarkers to species-specific malaria vector bites. Malar J 11: 439. [Google Scholar]
  27. Badu K, Siangla J, Larbi J, Lawson BW, Afrane Y, Ong'echa J, Remoue F, Zhou G, Githeko AK, Yan G, , 2012. Variation in exposure to Anopheles gambiae salivary gland peptide (gSG6-P1) across different malaria transmission settings in the western Kenya highlands. Malar J 11: 318. [Google Scholar]
  28. Doucoure S, Mouchet F, Cornelie S, DeHecq JS, Rutee AH, Roca Y, Walter A, Herve JP, Misse D, Favier F, Gasque P, Remoue F, , 2012. Evaluation of the human IgG antibody response to Aedes albopictus saliva as a new specific biomarker of exposure to vector bites. PLoS Negl Trop Dis 6: e1487. [Google Scholar]
  29. Rizzo C, Ronca R, Lombardo F, Mangano V, Sirima SB, Nebie I, Fiorentino G, Troye-Blomberg M, Modiano D, Arca B, , 2014. IgG1 and IgG4 antibody responses to the Anopheles gambiae salivary protein gSG6 in the sympatric ethnic groups Mossi and Fulani in a malaria hyperendemic area of Burkina Faso. PLoS One 9: e96130. [Google Scholar]
  30. Stone W, Bousema T, Jones S, Gesase S, Hashim R, Gosling R, Carneiro I, Chandramohan D, Theander T, Ronca R, Modiano D, Arca B, Drakeley C, , 2012. IgG responses to Anopheles gambiae salivary antigen gSG6 detect variation in exposure to malaria vectors and disease risk. PLoS One 7: e40170. [Google Scholar]
  31. Irby WS, Apperson CS, , 1992. Spatial and temporal distribution of resting female mosquitoes (Diptera: Culicidae) in the coastal plain of North Carolina. J Med Entomol 29: 150159. [Google Scholar]
  32. Richards SL, Ponnusamy L, Unnasch TR, Hassan HK, Apperson CS, , 2006. Host-feeding patterns of Aedes albopictus (Diptera: Culicidae) in relation to availability of human and domestic animals in suburban landscapes of central North Carolina. J Med Entomol 43: 543551. [Google Scholar]
  33. Graham K, Kayedi MH, Maxwell C, Kaur H, Rehman H, Malima R, Curtis CF, Lines JD, Rowland MW, , 2005. Multi-country field trials comparing wash-resistance of PermaNet and conventional insecticide-treated nets against anopheline and culicine mosquitoes. Med Vet Entomol 19: 7283. [Google Scholar]
  34. Murray N, Jansarikij S, Olanratmanee P, Maskhao P, Souares A, Wilder-Smith A, Kittayapong P, Louis VR, , 2014. Acceptability of impregnated school uniforms for dengue control in Thailand: a mixed methods approach. Glob Health Action 7: 24887. [Google Scholar]
  35. Tozan Y, Ratanawong P, Louis VR, Kittayapong P, Wilder-Smith A, , 2014. Use of insecticide-treated school uniforms for prevention of dengue in schoolchildren: a cost-effectiveness analysis. PLoS One 9: e108017. [Google Scholar]

Data & Media loading...

  • Received : 13 Feb 2015
  • Accepted : 24 May 2015
  • Published online : 07 Oct 2015

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error