Efficacy of Permethrin-Impregnated Uniforms in the Prevention of Cutaneous Leishmania-sis in Iranian Soldiers

Background: One approach for prevention of cutaneous leishmaniasis is creation of a barrier between the insect vector (phlebotomus) and the host.  Many, but not all, researchers claim that permethrin-impregnated uniforms are effective for prevention of cutaneous leishmaniasis.  We determined the efficacy of permethrin-impregnated uniforms for prevention of cutaneous leishmaniasis among Iranian soldiers. Methods: 324 soldiers were randomized into two equal groups.  272 soldiers completed the study.  In Group A, 134 soldiers were issued permethrin impregnated uniforms.  In Group B, 138 soldiers were issued uniforms washed in water.  The soldiers wore uniforms day and night for 3 months, and were observed for an additional 6 months.  All of the soldiers remained during this 3 months in the leishmaniasis-endemic area of Isfahan. Results: 9 (6.5%) of 138 soldiers wearing control uniforms and 6 (4.4%) of 134 soldiers wearing permethrin-impregnated uniforms acquired cutaneous leishmaniasis.  The difference between the two groups was not statistically significant. Conclusion: Permethrin-impregnated uniforms may not be effective in prevention of cutaneous leishmaniasis.