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By: Chris Dall, MA January 9, 2026

In many parts of sub-Saharan Africa, mothers carry their young children on their backs in colorful cotton wraps called lesu. Could treating these cloths with insecticide reduce malaria transmission?

A study published in the New England Journal of Medicine explored this question in rural western Uganda, where malaria is transmitted year-round. Researchers enrolled 400 mothers with children aged six to 18 months.

Using a blinded randomized placebo-controlled trial design, half received lesu treated with permethrin, a commonly-used insecticide. The other half received untreated cloths. All participants also received insecticide-treated bed nets.

Every two weeks for 24 weeks, the mothers and children visited local health centers to check for fever and undergo malaria testing. The results were striking: children carried in permethrin-treated lesu represented 66% fewer malaria cases – 0.73 cases per 100 people compared with 2.13 in the control group.

The findings suggest that insecticide-treated lesu – much like treated bed nets – could offer an effective new tool particuarly against outdoor biting for a highly vulnerable population - children under 5 years of age - in sub-Saharan Africa.

Insecticide-Treated Baby Wraps Cut Malaria Cases by Two-Thirds in Uganda.

A new study in rural western Uganda finds that treating baby-carrying cloths, or lesu, with an insecticide with modest repellent effect significantly reduces malaria infections in young children.

Source: John Hopkins School of Public Health, Podcast Malaria Minute

Source: John Hopkins School of Public Health, Podcast Malaria Minute

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