OBJECTIVE: To determine the risk of external urogenital birth
defects (UGBDs) in newborn boys from a malarial area
currently sprayed with technical DDT, 1,1,1-trichloro-2,2-
bis(4-chlorophenyl) ethane (DDT), as increased fetal
oestrogenic or anti-androgenic exposure might be involved
in the pathogenesis of increased prevalence of human male
reproductive tract anomalies, and DDT and metabolites
interact with both these receptors.
SUBJECTS AND METHODS: We examined 3310 newborn baby
boys and recorded external UGBDs.
RESULTS: Of the newborn boys 10.8% (357) had UGBDs; a
multivariate logistic model showed that mothers who lived
in villages sprayed with DDT between 1995 and 2003 had a
significantly greater chance (33%) of having a baby with a
UGBD than mothers whose homes were not sprayed (odds
ratio 1.33, 95% confidence interval 1.04–1.72). Being a
homemaker instead of being employed further significantly
increased the risk of having a baby with a UGBD by 41%
(odds ratio 1.41, 1.13–1.77).
CONCLUSIONS: Maternal exposure to DDT by living in a DDTsprayed
village was associated to having male offspring with
one or more UGBDs. Monitoring the impact of indoor
residual spraying on human and environmental health is
imperative if DDT is being used, especially as climate
change raises concerns about the global spread of malaria.
Integrating adequate indoor residual spraying measures by
malarial vector control programmes, and increased public
awareness to limit personal exposure, are crucial
components that need to be addressed.