Open Access Open Badges Study protocol

The impact of insecticide-treated school uniforms on dengue infections in school-aged children: study protocol for a randomised controlled trial in Thailand

Annelies Wilder-Smith12, Peter Byass1, Phanthip Olanratmanee3, Pongsri Maskhao4, Luechai Sringernyuang5, James G Logan6, Steve W Lindsay6, Sarah Banks6, Duane Gubler7, Valérie R Louis2, Yesim Tozan28 and Pattamaporn Kittayapong3*

Author Affiliations

1 Centre for Global Health Research, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden

2 Institute of Public Health, Heidelberg University Medical School, Heidelberg, Germany

3 Center of Excellence for Vectors and Vector-Borne Diseases, Faculty of Science, Mahidol University at Salaya, Nakhon Phatom, Thailand

4 Faculty of Humanities and Social Sciences, Rajabhat Rajanagarindra University, Chachoengsao, Thailand

5 Faculty of Social Sciences and Humanities, Mahidol University at Salaya, Nakhon Pathom, Thailand

6 Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK

7 Emerging Infectious Diseases Program, Duke-NUS, Singapore, Singapore

8 Department of International Health, Boston University School of Public Health, Boston, MA, USA

For all author emails, please log on.

Trials 2012, 13:212  doi:10.1186/1745-6215-13-212

Published: 15 November 2012



There is an urgent need to protect children against dengue since this age group is particularly sensitive to the disease. Since dengue vectors are active mainly during the day, a potential target for control should be schools where children spend a considerable amount of their day. School uniforms are the cultural norm in most developing countries, worn throughout the day. We hypothesise that insecticide-treated school uniforms will reduce the incidence of dengue infection in school-aged children. Our objective is to determine the impact of impregnated school uniforms on dengue incidence.


A randomised controlled trial will be conducted in eastern Thailand in a group of schools with approximately 2,000 students aged 7–18 years. Pre-fabricated school uniforms will be commercially treated to ensure consistent, high-quality insecticide impregnation with permethrin. A double-blind, randomised, crossover trial at the school level will cover two dengue transmission seasons.


Practical issues and plans concerning intervention implementation, evaluation, analysing and interpreting the data, and possible policy implications arising from the trial are discussed.

Trial registration Registration number: NCT01563640

Dengue; Insecticide-treated clothes; School children; School uniforms; Randomised control trial; Cost effectiveness