Effectiveness of citronella preparations in preventing mosquito bites: systematic review of controlled laboratory experimental studies.

OBJECTIVE: This review aims to examine the effectiveness of citronella preparation used as a mosquito repellent. METHODS: Multiple computerized databases such as MEDLINE, EMBASE, Cochrane CENTRAL, CINAHL, and AMED, were searched for controlled laboratory experiments that compared the effectiveness of citronella products to control in repelling Aedes, Anopheles and Culex mosquitoes using the cage or room methods. Outcomes measures were protection time and percentage repellency. The weighted mean difference and 95% confidence interval were calculated comparing the outcomes in the citronella and control groups. Meta-analysis was performed using the DerSimonian and Laird method under a random-effects model. RESULTS: Eleven studies met inclusion criteria. Based on a meta-analysis of studies using the cage method, protection time of the citronella oil for preventing Aedes mosquitoes was less than that in the DEET (N,N-diethyl-m-toluamide) group, with a difference in protection time of 253 min (95% confidence interval: 169-336). The combination of citronella oil and vanillin is likely to have a longer protection time compared with citronella oil alone. In studies using the room method, citronella oil and/or the combination of citronella oil and vanillin provided complete repellency at least 3 h. In Anopheles and Culex mosquitoes, a combination of citronella oil and vanillin product demonstrated a comparable protection time against DEET; however, it remained inconclusive due to a limited number of studies. CONCLUSIONS: Citronella products are less effective than DEET products in terms of duration of protection. Adding vanillin to citronella oil products could prolong the protection time.

Clinical evaluation of the addition of lyophilized, heat-killed Lactobacillus acidophilus LB to oral rehydration therapy in the treatment of acute diarrhea in children.

BACKGROUND: Addition of a medication to the World Health Organization protocol for treatment of acute diarrhea in children is controversial. In this trial, the clinical efficacy of a medication (Lactéol Fort sachets; Laboratoire du Lactéol du Docteur Boucard, Houdan France) containing lyophilized heat-killed Lactobacillus acidophilus LB was assessed as an adjunct to oral rehydration therapy. METHODS: Children aged 3 to 24 months with acute diarrhea and mild or moderate dehydration were enrolled in the study. Children received oral rehydration therapy for the first 4 hours. After this first rehydration phase, undiluted milk formula or breast milk was fed alternately with oral rehydration solution. Children were fed rice gruel as tolerated. They received either one sachet containing 10 billion of lyophilized heat-killed L. acidophilus LB or placebo at admission and at 12-hour intervals for five doses. RESULTS: Seventy-three children (37 L. acidophilus LB, 36 placebo) were enrolled, of whom 40 (17 L. acidophilus LB, 23 placebo) received an antibiotic before inclusion. Rotavirus was identified in approximately 50% of the children in each group. After 24 hours of treatment, the number of rotavirus-positive children with watery stools was significantly lower (p = 0.012) in the L. acidophilus LB group. Mean duration of diarrhea was decreased (p = 0.034) with L. acidophilus LB (43.4 hours) versus placebo (57.0 hours). This decreased duration was particularly marked in children with no antibiotic therapy before inclusion (31.1 hours): 42.9 hours for the L. acidophilus LB group versus 74.0 hours for the placebo group (p = 0.016). CONCLUSIONS: Addition of L. acidophilus LB to oral rehydration therapy was effective in the treatment of children with acute diarrhea by decreasing the duration of diarrhea.

Comparison of efficacy of peptilose-base ORS (ORALNU) and WHO-ORS.

We examined whether replacing glucose with Peptilose into standard ORS would be advantageous over WHO-ORS. A study was carried out on 134 diarrheal children with mild to moderate dehydration. They received either WHO-ORS or Peptilose-ORS by randomized selection. In only two cases in each group, diarrhea was caused by Vibrio cholerae non 0-1. Significant per cent weight gain was observed in patients with Peptilose-ORS compared to those treated with WHO-ORS (P = 0.046). The patients could voluntarily take a higher amount of Peptilose-ORS and had significantly less stool output in the combined mildly and moderately dehydrated patients. It is concluded that Peptilose-ORS is more advantageous and acceptable than the standard WHO glucose-ORS for treatment of non cholera and 2 cases of cholera dehydrating diarrhea in children.