N Engl J Med

Baby wraps treated with insecticide cut malaria cases by 66%

September 30, 2025

Permethrin-treated wraps offer a culturally integrated, low-cost adjunct to bed nets for malaria prevention in infants. This strategy could be especially valuable in high-transmission settings where infants are at elevated risk and traditional carrying practices are common.

Study details: This double-blind, randomized, placebo-controlled trial (NCT05391230) enrolled 400 mother-child pairs in Uganda. Children aged 6 to 18 months were assigned to either permethrin-treated or sham-treated cloth wraps, used for infant carrying. All participants received pyrethroid-only bed nets. Wraps were retreated every 4 weeks, and children were monitored biweekly for 24 weeks. Primary outcome was clinical malaria, defined by fever and a positive rapid diagnostic test.

Results: Clinical malaria incidence was significantly lower in the intervention group (0.73 vs. 2.14 cases per 100 person-weeks; incidence rate ratio [IRR] 0.34; 95% confidence interval [CI], 0.23–0.51; P<0.001). Rash occurred slightly more often in the intervention group (8.5% vs. 6.0%), but no serious adverse events were reported. Follow-up was nearly complete, with 99.9% of scheduled visits attended.

Source:

Boyce RM, et al. (2025, September 24). N Engl J Med. Permethrin-Treated Baby Wraps for the Prevention of Malaria. https://pubmed.ncbi.nlm.nih.gov/40991921/