A study conducted in Uganda has demonstrated that treating traditional cloth wraps, known as lesus, with the insect repellent permethrin can significantly reduce malaria rates in infants. Researchers found that babies carried in treated wraps were two-thirds less likely to develop malaria compared to those in untreated wraps.
Malaria remains a critical global health concern, causing over 600,000 deaths annually, with a majority being children under five years old in Africa.
The trial involved 400 mothers and their approximately six-month-old babies in Kasese, a rural, mountainous region of western Uganda. Half of the participants received permethrin-treated wraps, while the other half used standard, untreated wraps. The researchers monitored the babies for six months, re-treating the wraps monthly.
Results showed a substantial difference in malaria incidence. In the group using treated wraps, there were 0.73 cases per 100 babies each week, compared to 2.14 cases per 100 babies each week in the group using untreated wraps. One mother reported her child, carried in a treated wrap, experienced malaria for the first time without developing the disease.
Co-lead investigator Professor Edgar Mugema Mulogo of Mbarara University of Science and Technology, Uganda, stated the magnitude of the benefit was particularly outstanding. Dr. Ross Boyce, co-lead investigator from the University of North Carolina at Chapel Hill, expressed surprise at the efficacy and suggested re-running results for verification.
The intervention addresses a changing pattern in mosquito behavior. While bed nets effectively combat nocturnal biting, mosquitoes are increasingly biting during evenings and early mornings. Treated wraps offer protection during these periods when individuals are often outdoors.
Health officials in Uganda and leaders at the World Health Organization have expressed interest in the research. The findings build upon earlier research involving treated shawls in Afghan refugee camps that demonstrated similar success. There is potential for local production of impregnated wraps, and the intervention could provide crucial protection for babies whose maternal antibody protection is waning before vaccination.
Researchers note that permethrin has a good safety profile and has been applied to textiles for years. While babies in treated wraps were slightly more prone to rashes (8.5% vs. 6%), none were severe enough to cause withdrawal from the study. Further research is required to confirm the intervention's safety across various settings, though potential benefits are expected to outweigh risks. Additional studies, such as treating school uniforms, are being considered, but require funding.