Electronic mosquito repellents (EMRs) are marketed to prevent mosquitoes biting and to prevent malaria. The objective of the study was to assess whether EMRs prevent mosquito bites, and to assess any evidence of an effect on malaria infection. In August 2006, The authors searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL, MEDLINE, EMBASE, LILACS, Cambridge Scientific Abstracts, and the Science Citation Index. They also checked conference proceedings, contacted international specialist centres and EMR manufacturers, and checked reference lists.   Selection criteria were field entomological studies, which controlled for geographic site, time, and attractiveness of human participants, of EMRs for preventing mosquito bites; and randomized and quasi-randomized controlled trials of EMRs to prevent malaria infection.  Two authors assessed trial quality, and extracted and analysed the data. MAIN  Ten field entomological studies met the inclusion criteria. All 10 studies found that there was no difference in the number of mosquitoes caught from the bare body parts of the human participants with or without an EMR. No randomized or quasi-randomized controlled trials on the efficacy of EMR on malaria infection were found. Field entomological studies confirm that EMRs have no effect on preventing mosquito bites. Therefore there is no justification for marketing them to prevent malaria infection.

Quinine and the artemisinin-derivative drugs artesunate and artemether are effective treatments for severe falciparum malaria. Trials comparing artemether with quinine have not demonstrated convincing evidence of a mortality advantage for artemether. The South East Asian Quinine Artesunate Malaria Trial (SEAQUAMAT), a multicenter, randomized, open-label trial in 1461 adults with severe malaria in Asia compared artesunate with quinine. Mortality was 15% in the artesunate group and 22% in the quinine group, a reduction of 34.7% (95% confidence interval: 18.5-47.6%) in the artesunate group, with almost all the benefit reported in those with high parasite counts. Artesunate should constitute first-line treatment for severe malaria in Asia. These results can probably be generalized to the treatment of severe malaria in adults from all areas, especially in those with hyperparasitemia. However, it is unclear whether these results can be generalized to children in Africa, who constitute the majority of those who die from severe malaria worldwide.