title: Theoretical impact of insecticide-impregnated school uniforms on dengue incidence in Thai children.
abstract: BACKGROUND
  Children carry the main burden of morbidity and mortality caused by dengue. Children spend a considerable amount of their day at school; hence strategies that reduce human-mosquito contact to protect against the day-biting habits of Aedes mosquitoes at schools, such as insecticide-impregnated uniforms, could be an effective prevention strategy.
  
  
  METHODS
  We used mathematical models to calculate the risk of dengue infection based on force of infection taking into account the estimated proportion of mosquito bites that occur in school and the proportion of school time that children wear the impregnated uniforms.
  
  
  RESULTS
  The use of insecticide-impregnated uniforms has efficacy varying from around 6% in the most pessimistic estimations, to 55% in the most optimistic scenarios simulated.
  
  
  CONCLUSIONS
  Reducing contact between mosquito bites and human hosts via insecticide-treated uniforms during school time is theoretically effective in reducing dengue incidence and may be a valuable additional tool for dengue control in school-aged children. The efficacy of this strategy, however, is dependent on the compliance of the target population in terms of proper and consistent wearing of uniforms and, perhaps more importantly, the proportion of bites inflicted by the Aedes population during school time.
authors.affiliation: School of Medicine, University of São Paulo, São Paulo, Brazil.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Massad
authors.forename: Marcos
authors.initials: M
authors.lastname: Amaku
authors.forename: Francisco Antonio Bezerra
authors.initials: FA
authors.lastname: Coutinho
authors.forename: Pattamaporn
authors.initials: P
authors.lastname: Kittayapong
authors.forename: Annelies
authors.initials: A
authors.lastname: Wilder-Smith
mesh_terms: D000330:Aedes; D000818:Animals; D003020:Clothing; D003715:Dengue / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D007299:Insect Bites and Stings / Q000517:prevention & control*; D007303:Insect Vectors; D007306:Insecticides / Q000008:administration & dosage* / Q000494:pharmacology*; D008962:Models, Theoretical; D011481:Protective Clothing; D013785:Thailand / Q000453:epidemiology
chemical_list: D007306:Insecticides
keywords: Thailand; dengue; force of infection; impregnated clothes; insecticide-treated uniforms; mathematical models; school children
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