Evaluating the Usability, Durability, and Effectiveness of Permethrin-Treated Uniforms and Metofluthrin Spatial Repellent in Preventing Mosquito Bites in the Laos Military

Abstract

While vector control methods have successfully reduced malaria rates worldwide, such methods are not always suitable for military use. We evaluated the usability, durability, and effectiveness of permethrin-treated uniforms and metofluthrin spatial repellent in preventing mosquito bites among soldiers in the Laos People’s Army that were deployed on a 12-week field exercise. The study enrolled 173 subjects into four different groups: (1) metofluthrin-only, (2) permethrin-treated uniforms, (3) metofluthrin with permethrin-treated uniforms, and (4) a control group. We measured efficacy through self-reported survey responses and a serological test for antibodies to Anopheles salivary antigens and assessed the durability of permethrin treatment over the 12-week exercise. We found that soldiers given metofluthrin and permethrin-treated uniforms were 72% and 46% more likely to report decreased mosquito bites compared to those in the control group and that soldiers with permethrin-treated uniforms had significantly lower (p < 0.05) antibody levels to the Anopheles SG6 salivary antigen. Mass spectrometry analysis revealed that treated uniforms still contained a significant permethrin concentration that showed 50 to 100% mosquito mortality. Overall, our findings show that both metofluthrin and permethrin-treated uniforms were well-tolerated and led to significantly fewer reported mosquito bites, and that permethrin, in particular, was found to be durable throughout the 12-week field exercise and effective in reducing mosquito bite exposure, underscoring its value in military applications.