Spatial repellents: The current roadmap to global recommendation of spatial repellents for public health use

Nicole L Achee; T Alex Perkins; Sean M Moore; Fang Liu; Issaka Sagara; Suzanne Van Hulle; Eric O Ochomo; John E Gimnig; Hasitha A Tissera; Steven A Harvey; April Monroe; Amy C Morrison; Thomas W Scott; Robert C Reiner Jr; John P Grieco

doi:10.1016/j.crpvbd.2022.100107

Spatial repellents: The current roadmap to global recommendation of spatial repellents for public health use

Curr Res Parasitol Vector Borne Dis. 2022 Dec 9:3:100107. doi: 10.1016/j.crpvbd.2022.100107. eCollection 2023.

Authors

Affiliations

¹ Department of Biological Sciences, Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, USA.
² Department of Applied and Computational Mathematics and Statistics, University of Notre Dame, Notre Dame, IN, USA.
³ Malaria Research and Training Center (MRTC), Faculty of Medicine, Dentistry and Pharmacy at the University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako, Mali.
⁴ Catholic Relief Services, Baltimore, MD, USA.
⁵ Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya.
⁶ Centers for Disease Control and Prevention, Division of Parasitic Diseases and Malaria, Atlanta, GA, USA.
⁷ Epidemiology Unit, Ministry of Health, Sri Lanka.
⁸ Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
⁹ Johns Hopkins Center for Communication Programs, Baltimore, MD, USA.
¹⁰ Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, CA, USA.
¹¹ Department of Entomology and Nematology, University of California, Davis, CA, USA.
¹² Department of Health Metrics Sciences, University of Washington, Seattle, WA, USA.

Abstract

Spatial repellent (SR) products are envisioned to complement existing vector control methods through the continual release of volatile active ingredients (AI) providing: (i) protection against day-time and early-evening biting; (ii) protection in enclosed/semi-enclosed and peri-domestic spaces; (iii) various formulations to fit context-specific applications; and (iv) increased coverage over traditional control methods. SR product AIs also have demonstrated effect against insecticide-resistant vectors linked to malaria and Aedes-borne virus (ABV) transmission. Over the past two decades, key stakeholders, including World Health Organization (WHO) representatives, have met to discuss the role of SRs in reducing arthropod-borne diseases based on existing evidence. A key focus has been to establish a critical development path for SRs, including scientific, regulatory and social parameters that would constitute an outline for a SR target product profile, i.e. optimum product characteristics. The principal gap is the lack of epidemiological data demonstrating SR public health impact across a range of different ecological and epidemiological settings, to inform a WHO policy recommendation. Here we describe in brief trials that are designed to fulfill evidence needs for WHO assessment and initial projections of SR cost-effectiveness against malaria and dengue.

Keywords: Clinical trials; Cost-effectiveness; Dengue; Malaria; Social science; Spatial repellents; WHO.