Mbarara, Uganda | THE INDEPENDENT | Dr. Moses Ntaro, a lecturer at Mbarara University of Science and Technology and co-author of a recent study that found treating traditional baby wraps with insect repellent can significantly reduce malaria infections in young children, says the research team is planning to expand the study to include a larger sample size and more diverse settings across Uganda.
The study, published in The New England Journal of Medicine in October last year, was conducted in Kasese District. Ntaro said malaria transmission in Kasese is moderate, and the next phase of research will examine areas with both high and low transmission rates. The team also plans to extend the study to refugee-hosting areas.
Ntaro said the idea for the research was inspired by a common cultural practice: the widespread use of wrappers, also known as Bitenge, by mothers to carry their babies on their backs in rural Uganda and across Africa. Because infants spend much of their time in close contact with their mothers during the day, researchers explored whether treating the wraps with insecticide could help protect them from mosquito bites.
The results were striking. The study found that children whose mothers used permethrin-treated wraps experienced nearly a 60 percent reduction in malaria infections compared to those using untreated wraps. Malaria remains a leading cause of illness and death in Uganda. In 2023 alone, the country recorded more than 16 million cases and 2,793 deaths, most of them among children under five.
Across sub-Saharan Africa, the disease was responsible for nearly 600,000 deaths in 2023, the majority occurring on the continent, according to the World Health Organization. Although insecticide-treated bed nets and indoor residual spraying have significantly reduced malaria cases over the past two decades, progress has slowed due to growing insecticide resistance and changes in mosquito behavior.
Increasingly, mosquitoes are biting outdoors or during the day, when bed nets offer little protection. The Ugandan trial involved 400 mother-and-child pairs. Half received wraps treated with permethrin—a common insect repellent also used in bed nets and military uniforms—while the other half received wraps soaked only in water. All participating households were provided with new insecticide-treated bed nets to ensure nighttime protection.
Over 24 weeks, children were monitored through regular clinic visits. It was during this 24-week study period that researchers observed a significant reduction in malaria infections among children whose mothers used treated wraps. Hospital admissions for malaria were also lower in the treated group, the researchers reported. There were no serious side effects.
A small number of children developed mild skin rashes, but none required medical attention. Ntaro emphasized that the treated wraps are intended to provide an additional layer of protection, not to replace existing malaria prevention strategies.
The approach is considered promising because it builds on an existing cultural practice, making it easier for communities to adopt without major changes in behavior.
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