title: Applicability of citronella oil (Cymbopogon winteratus) for the prevention of mosquito-borne diseases in the rural area of Tikapur, far-western Nepal.
abstract: BACKGROUND
  Mosquito-borne diseases are a serious global problem, particularly in tropical and sub-tropical countries such as Nepal. Citronella oil is a natural mosquito repellent as well as a local fragrance in Nepal, which is accessible at very low cost because citronella plants are widely cultivated in rural areas of the Terai belt in Nepal. This study was conducted using a real-life randomized controlled pilot trial to confirm the effectiveness and applicability of locally-produced citronella oil as a mosquito repellent for the prevention of mosquito-borne diseases in Nepal.
  
  
  METHODS
  A repellency activity test was performed with 100% citronella oil (Cymbopogon winteratus) from April to May 2013 in the Tikapur Municipality of the Kailali district, Nepal. The test was divided into two trials: an indoor exposure (IE) test (N=101) and an outdoor exposure (OE) test (N=140) from 5.00 pm to 7.00 pm. Each trial contained an experimental citronella oil-applied group and a non-applied (control) group. The outcome measures were the protective effect of citronella oil against mosquitoes, the number of mosquito bites, the repellency percentage, the smell satisfaction and the irritation level.
  
  
  RESULTS
  Experimental group had a significant protective effect against mosquito bites in IE (96.5%, n=57) and OE (95.7%, n=70) tests compared to the control group in IE (29.5%, n=44) and OE (28.6%, n=70) tests (experimental vs control groups, p<0.001). The repellency percentage for the OE test was 96.7%. In the smell satisfaction test (n=127), most of the participants responded with high satisfaction: 'good' (67.7%), 'very good' (16.5%), 'bad' (13.4%) and 'very bad' (2.4%). IE and OE tests showed similar satisfaction levels in each category. In the irritation level test (n=127), 87.4% and 12.6% responded with no irritation and slight irritation, respectively. There were no reports of moderate or severe irritation.
  
  
  CONCLUSIONS
  The topical application of citronella oil can be employed as an easily-available, affordable and effective alternative mosquito repellent to prevent mosquito-borne diseases in rural areas such as Tikapur, Nepal.
authors.affiliation: Department of Environmental Medical Biology, Wonju College of Medicine, Yonsei University, Ilsan-dong, Wonju, Gangwon-do, Republic of Korea. retsae14@gmail.com.
authors.forename: Ma Easter Joy
authors.initials: ME
authors.lastname: Sajo
authors.affiliation: Department of Environmental Medical Biology, Wonju College of Medicine, Yonsei University, Ilsan-dong, Wonju, Gangwon-do, Republic of Korea. sbsong@yonsei.ac.kr.
authors.forename: Soon-Bong
authors.initials: SB
authors.lastname: Song
authors.affiliation: Department of Environmental Medical Biology, Wonju College of Medicine, Yonsei University, Ilsan-dong, Wonju, Gangwon-do, Republic of Korea. johnybajgai@gmail.com.
authors.forename: Johny
authors.initials: J
authors.lastname: Bajgai
authors.affiliation: Institute for Poverty Alleviation and International Development, Yonsei University, Wonju, Gangwon-do, Republic of Korea. kyj9989@yonsei.ac.kr.
authors.forename: Young-Je
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Department of Global Public Administration, College of Government and Business, Yonsei University, Wonju, Gangwon-do, Republic of Korea. pankim@yonsei.ac.kr.
authors.forename: Pan-Suk
authors.initials: PS
authors.lastname: Kim
authors.affiliation: Department of Global Public Administration, College of Government and Business, Yonsei University, Wonju, Gangwon-do, Republic of Korea. dongwona@yonsei.ac.kr.
authors.forename: Dong-Won
authors.initials: DW
authors.lastname: Ahn
authors.affiliation: Tikapur Hospital, Tikapur Municipality, Kailali District, Nepal. khanalnk2008@yahoo.com.
authors.forename: Narendra
authors.initials: N
authors.lastname: Khanal
authors.affiliation: Department of Environmental Medical Biology, Wonju College of Medicine, Yonsei University, Wonju, Gangwon-do, Republic of Korea. medbio9@gmail.com.
authors.forename: Kyu-Jae
authors.initials: KJ
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D002648:Child; D009033:Culicidae / Q000187:drug effects*; D003906:Developing Countries; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D007299:Insect Bites and Stings / Q000150:complications / Q000517:prevention & control*; D007302:Insect Repellents / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009390:Nepal; D010938:Plant Oils / Q000627:therapeutic use*; D011322:Primary Prevention / Q000379:methods*; D011634:Public Health; D012016:Reference Values; D012424:Rural Population; D055815:Young Adult
chemical_list: D007302:Insect Repellents; D010938:Plant Oils; C076730:citronella oil
keywords: Asia; Community-Controlled Health Services; Complementary Medicine; Evidence-based Care; Health Scientist; Health Service reform; Primary Health Care; Public Health