1. High Efficacy
In a laboratory study employing multiple test subjects (Scott Carroll, Davis, California), NO MO (NO MAS) provided 9 hours of complete protection time (CPT) against Anopheles gambiae (a vector for malaria). In the same laboratory, NO MO also provided 9 hours CPT against Culex quinquefasciatus (a vector for lymphatic filariasis) and 8 hours CPT against Lutzomyia longipalpis (a vector for leishmaniasis). Read PDF
In a separate laboratory study against Aedes aegypti (a vector for dengue), with females pre-selected for avidity (Don Barnard, USDA-ARS Gainesville, Florida), NO MO provided more than 9 hours CPT at biting pressures higher than those found in nature (>25 landings in 10 seconds). Additional cage studies conducted at the Harvard Laboratory of Public Health Entomology (Tony Kiszewski) confirmed the superior repellency of this formulation against the malaria vectors, Anopheles albimanus and An. stephensi, in head-to-head comparisons with DEET. Read PDF
In Ghana, during a 16-day efficacy study (October, 2010), NO MO provided 90% protection for 9 hours against several important malaria vectors including Anopheles gambiae and An. funestus. Read PDF
2. Low Cost
Made with off-the-shelf materials that are available through commercial suppliers around the world, NO MO can be produced for the lowest cost, per unit of efficacy, of any repellent currently manufactured. In 2010, when all materials and manufacturing costs for the repellent were added to the cost of ocean and land freight, an average daily application of NO MO – delivered to a port of entry, at cost – was $0.05 US per person (e.g. Accra, Ghana).
Malaria in Peru
Malaria transmission in the Peruvian Amazon experienced a resurgence in the 90s - 158,000 cases in Loreto Region (1997)
- 25% of population
- 50X increase between 1992-97
- ~54,000 caused by P. falciparum
- Growing antimalarial drug resistance in Plasmoldium vivax and P. falciparum.
- Public Health System lacked effective malaria reduction tools
The Cost of Repelling Malaria
The annual cost of malaria treatment in Loreto, Peru, in 1998 (adjusted to 2007 dollars) was $180 per case. This included:
- Transportation to state clinics
- Lost income
- Cost to state of free treatment subsidy
The estimated annual cost of the NO MO repellent intervention was $10.00 per person.
Protective Coverage for a 7 month transmission season @ $0.05/day
Equaled 5.5% of malaria treatment costs in 2007
3. High User Acceptance
Human societies have a diverse “culture of smell”, the sensibility that causes people to accept or reject the many chemical signatures we call odors. In poor rural areas where vector-borne disease abounds, the aromatic oils of familiar plants are often more easily accepted in consumer products than the industrial/synthetic odors manufactured for that purpose abroad. For example, lemongrass (Cymbopogon citratus and C. flexuosus) has been widely cultivated as a medicinal plant by indigenous people in South Asia and the Americas, and the oil distilled from its leaves is still used in many local products (soaps, candles etc). It is also what distinguishes the fragrance of NO MO, and, perhaps because of this, it fits the olfactory culture of numerous villages in Peru & Ghana where it was studied. In contrast, the odor of DEET seems less attractive to many rural folk around the world.
In a four-month repellent study conducted in 2007 near Iquitos, Peru, more than 98% of 2200 people who used NO MO said they would continue using it voluntarily when the study ended. Reiterating this support, a fisherman from a village near the Amazon told a public health nurse with the study that he thought news of NO MO would spread along the river “by word of mouth”. When asked why he believed this, he replied “No one has seen a repellent here before, but when neighboring villagers (not in the study) saw its effect on the nuisance bugs that drive us crazy, they wanted to get some, too.”
This anecdote underscores a useful fact about anopheline behavior: generally, wherever these malaria vectors gather, there are also great numbers of nuisance mosquitoes in the airspace. In the Peruvian Amazon, these aggressive biters can outnumber malaria vectors by more than 20 to 1. In such circumstances, immediate relief from painful bites tends to galvanize user interest in the product, thus assuring high levels of user compliance and consequently reducing infections from malaria vectors later at night. Significantly, after applying NO MO to their arms, legs and necks for 120 days (264,000 user-days of data), Peruvian study subjects reported only two cases of mild dermatitis. This fortunate outcome added to the high level of user-acceptance measured in the study and suggests that NO MO is particularly well suited for mass distribution in public health interventions against vector-borne diseases.