近日，美国北卡罗来纳大学教堂山分校Ross M. Boyce团队研究了氯菊酯处理的婴儿裹布预防疟疾的效果。2025年9月24日出版的《新英格兰医学杂志》发表了这项成果。

疟疾仍然是撒哈拉以南非洲儿童死亡的一个主要原因。研究组利用母亲用布包着孩子背在背上的传统做法，评估在布包上涂抹驱虫剂是否可以提供一层防止疟疾的保护。

在乌干达进行的一项双盲、随机、安慰剂对照试验中，研究组招募了带着6至18个月大孩子的成年妇女。母子按1:1的比例随机分配使用氯菊酯处理过的包装（干预组）或假药处理过的包装（对照组）。每4周进行一次复膜处理。所有的参与者都得到了一个新的、只含拟除虫菊酯类杀虫剂的长效蚊帐。参与者在24周内每2周访问一次试验诊所，并在儿童出现发热性疾病的情况下进行计划外访问。主要结果是儿童出现临床疟疾，定义为发热和疟疾快速诊断试验阳性。

从2022年6月到2024年4月，研究组共筛选了419对母婴，其中400对进行了随机化；200对被分配到干预组，200对被分配到对照组。诊所的出勤率很高（5200次计划就诊中有5194次（99.9%）参加了就诊），并且没有参与者失去随访。干预组临床疟疾发病率为每100人周0.73例（95%可信区间0.51 ~ 1.02），对照组为每100人周2.14例（95%可信区间1.73 ~ 2.62）（发病率比0.34；95%可信区间0.23 ~ 0.51;P<0.001）。干预组的皮疹发生率高于对照组（8.5%对6.0%）。

研究结果表明，在获得蚊帐的母婴对中，母亲使用氯菊酯处理过的婴儿包显著降低了儿童临床疟疾的发病率。

附：英文原文

Title: Permethrin-Treated Baby Wraps for the Prevention of Malaria

Author: Ross M. Boyce, Bonnie E. Shook-Sa, Ronnie Ndizeye, Emmanuel Baguma, Dana Giandomenico, Caitlin A. Cassidy, Solomon Eshun, Mark J. Siedner, Sarah G. Staedke, Moses Ntaro, Jonathan J. Juliano, Raquel Reyes, Edgar M. Mulogo

Issue&Volume: 2025-09-24

Abstract:

BACKGROUND

Malaria remains a major cause of childhood death in sub-Saharan Africa. We leveraged the traditional practice of mothers carrying children on their backs in cloth wraps to assess whether treating the wraps with an insect repellent might provide a layer of protection against malaria.

METHODS

In a double-blind, randomized, placebo-controlled trial conducted in Uganda, we enrolled adult women with a child who was 6 to 18 months of age. The mother–child pairs were randomly assigned in a 1:1 ratio to use permethrin-treated wraps (intervention group) or sham-treated wraps (control group). The wraps underwent retreatment every 4 weeks. All the participants received a new, pyrethroid-only long-lasting insecticide-treated bed net. The participants visited the trial clinics every 2 weeks for 24 weeks and made unscheduled visits in the case of febrile illness in the children. The primary outcome was clinical malaria in the children, as defined by fever and a positive malaria rapid diagnostic test.

RESULTS

From June 2022 through April 2024, a total of 419 mother–child pairs were screened, and 400 underwent randomization; 200 pairs were assigned to the intervention group and 200 to the control group. Clinic attendance was high (5194 of 5200 planned visits [99.9%] were attended), and no participants were lost to follow-up. The incidence rate of clinical malaria was 0.73 cases per 100 person-weeks (95% confidence interval [CI], 0.51 to 1.02) in the intervention group and 2.14 cases per 100 person-weeks (95% CI, 1.73 to 2.62) in the control group (incidence rate ratio, 0.34; 95% CI, 0.23 to 0.51; P<0.001). Rash was reported more often in the intervention group than in the control group (8.5% vs. 6.0% of participants).

CONCLUSIONS

Among mother–child pairs who had access to bed nets, maternal use of permethrin-treated baby wraps significantly reduced the incidence of clinical malaria in the children.

DOI: 10.1056/NEJMoa2501628

Source: https://www.nejm.org/doi/full/10.1056/NEJMoa2501628