Evaluation Of Topical Mosquito Repellents And Interpretation Of Efficacy Data: A Systematic Literature Review
  Key Words  
  Travel medicine, European Union biocides regulation, Culicidae.
  Barbara Colucci And Pie Müller
  Under the European Union Biocidal Products Regulation repellents are classified as biocides, and are subject to efficacy studies. To facilitate testing of repellents for product registration the EU has provided technical guidelines. The guidelines leave uncertainties as to how efficacy should be examined and how data may be evaluated in terms of label claim. The question is how do laboratory arm-in-cage bioassays relate to real conditions? We conducted a systematic literature review to examine published laboratory and field repellent studies that measured protection time against biting mosquitoes in humans with one of the four active ingredients: DEET, icaridin, citriodiol/PMD or EBAAP. Out of 871 publications identified with the search term mosquito repellents only nine studies met inclusion criteria. The data were insufficient to make a quantitative comparison between laboratory and field studies, which indicates the need for studies to support authorities in making evidence-based decisions on label claims for product registration.