The influence of permethrin-impregnated bednets and mass drug administration on the incidence of Plasmodium falciparum malaria in children in Sabah, Malaysia

A small-scale trial was carried out in the Upper Kinabatangan district of Sabah, Malaysia, to determine the effect of using permethrin-impregnated bednets on malaria transmission. A total of 306 nylon bednets with cotton borders, impregnated at a dose estimated to have been 0.062 g permethrin/m2 of nylon netting, were distributed to 139 households in five villages. At the time of distributing bednets, mass drug administration with Fansidar plus primaquine was also administered to the human population to clear all parasitaemias due to Plasmodium falciparum Welch. In another village, for comparison, mass drug administration was the only intervention. After intervention measures in December 1984 and January 1985, the parasite rates in children declined in all villages during the first month, significantly more in the villages with impregnated bednets than in the control, thus proving that the nets had an impact on malaria. However, after about 2 months, parasite rates started to increase again. After 4-6 months, parasite rates in the villages with bednets approached the rate in the control village without nets. The increase in parasite rates was paralleled by a significant deterioration in the quality, physical condition and the degree of non-utilization of bednets. Entomological evaluation proved the efficacy of permethrin-impregnated nets for controlling Anopheles balabacensis Baisas and other anophelines. Bioassays (1 h exposure) of permethrin-impregnated bednets gave 100% mortality initially and 44-61% mortality after 85-106 days. Mosquito collections in treated bednets were significantly reduced for at least 217 days. The project failed to achieve prolonged suppression of malaria transmission for a combination of entomological, sociological and practical reasons which are discussed in relation to the objectives and implementation of future bednet studies.     

A longitudinal entomologic survey on the transmission of malaria in Ouagadougou (Burkina Faso)

A longitudinal entomological malaria survey was carried out in five zones of the town of Ouagadougou, Burkina Faso, and in three neighbouring villages. The main vector is Anopheles gambiae s.l. with An. funestus having a role in some localities during the dry season. Pyrethrum spray catches were carried out once or twice per month to determine variations in vector density. Inoculation rates were estimated from the number of blood-fed vectors per man and from the sporozoite rates. Larval sampling was routinely carried out all over the urban area in order to map the larval breeding sites. Widely different degrees of malaria transmission were documented in the urban area mainly related to the spatial and temporal distribution of An. gambiae larval breeding sites. Higher inoculation rates, depending both on higher vector densities and sporozoite rates, were documented in the villages.     

Field trial of the effectiveness of indoor-spraying with pirimiphos-methyl emulsion for malaria control in a tribal area of Phulbani district, Orissa State, India

A field trial of malaria vector control was conducted in Phulbani district, Orissa, during 1984 and 1985. Indoor-spraying of pirimiphos-methyl emulsion formulation was undertaken at an application rate of 2 g/m2 in two sections (population 14,692) of Nuagaon Primary Health Centre. Houses in two adjacent sections (population 21,450) were sprayed with DDT a water dispersible powder (wdp) formulation at 1 g/m2 for comparison purposes. Operational problems in this area come from the tendency of tribal people to re-plaster over wdp applications. Pre-spray malariological indices in the trial area were 38% slide positivity rate, 37% slide falciparum rate and 12.1% annual parasite incidence. Densities of Anopheles annularis Van der Wulp, An. culicifacies Giles, An. fluviatilis Theobald and other potential malaria vectors were reduced in the pirimiphos-methyl trial area 2-35-fold more than in the area sprayed with DDT. Malariological indices were reduced by 65-68% in the pirimiphos-methyl sprayed area compared with only 26-35% reduction in the DDT sprayed area. Spraymen and villagers experienced no adverse side-effects from residual house-spraying with pirimiphos-methyl emulsion and it is concluded that this organophosphate product has advantages for malaria vector control, especially in operationally difficult situations.     

Evaluation of the efficacy of Olyset® Plus in a village‐based cohort study in the Cukurova Plain,Turkey, in an area of hyperendemic cutaneous leishmaniasis

The aim of this study was to measure the protective efficacy of Olyset® Plus, a new long‐lasting factory‐treated insecticidal net (LLIN) incorporated with 2% permethrin and 1% of the synergist piperonyl butoxide (PBO), against cutaneous leishmaniasis (CL) transmission under field conditions. A village‐scale trial, promoting the use of LLIN by the local inhabitants of the study area was conducted as a pilot study in a new hyperendemic focus of CL caused by a Leishmania infantum/L. donovani hybrid parasite transmitted by proven vector species Phlebotomus tobbi in Cukurova Plain, Adana, Turkey, between May, 2013 and May, 2014. The study area comprised eight villages; two of them were selected as an intervention village with Olyset® Plus net (Kizillar) and a control village without net application (Malihidirli). Six villages with surrounding allopatric barriers were utilized as a buffer zone cluster between intervention and control villages. Monthly entomological surveys were performed in the intervention and control villages and Damyeri, representing the other six villages, to collect adults of Phlebotomus tobbi. Results showed a significant reduction in cutaneous leishmaniasis incidence in the intervention village from 4.78% to 0.37%. The protective efficacy rate of LLIN was 92.2%. In contrast, incidence rates increased in the control village from 3.67% to 4.69%. We also evaluated residual insecticide levels of used nets after six and 12 months of usage. It was determined that the nets had retained full insecticidal strength. These results highlight the value of real‐world data on bed net effectiveness and longevity to guide decisions regarding sand fly control strategies. To the best of our knowledge, this is the first field study to evaluate Olyset® Plus efficacy in a hyperendemic cutaneous leishmaniasis area.     

Vector bionomics and malaria transmission in the Upper Orinoco River, Southern Venezuela

A longitudinal epidemiological and entomological study was carried out in Ocamo, Upper Orinoco River, between January 1994 and February 1995 to understand the dynamics of malaria transmission in this area. Malaria transmission occurs throughout the year with a peak in June at the beginning of the rainy season. The Annual Parasite Index was 1,279 per 1,000 populations at risk. Plasmodium falciparum infections accounted for 64% of all infections, P. vivax for 28%, and P. malariae for 4%. Mixed P. falciparum/P. vivax infections were diagnosed in 15 people representing 4% of total cases. Children under 10 years accounted for 58% of the cases; the risk for malaria in this age group was 77% higher than for those in the greater than 50 years age group. Anopheles darlingi was the predominant anopheline species landing on humans indoors with a biting peak between midnight and dawn. A significant positive correlation was found between malaria monthly incidence and mean number of An. darlingi caught. There was not a significant relationship between mean number of An. darlingi and rainfall or between incidence and rainfall. A total of 7295 anophelines were assayed by ELISA for detection of Plasmodium circumsporozoite (CS) protein. Only An. darlingi (55) was positive for CS proteins of P. falciparum (0.42%), P. malariae (0.25%), and P. vivax-247 (0.1%). The overall estimated entomological inoculation rate was 129 positive bites/person/year. The present study was the first longitudinal entomological and epidemiological study conducted in this area and set up the basic ground for subsequent intervention with insecticide-treated nets.     

Village-scale evaluation of mosquito nets treated with a tablet formulation of deltamethrin against malaria vectors

A field trial was carried out in the Sundargarh district of Orissa, India on the efficacy of mosquito nets treated with a tablet formulation of deltamethrin (K-O TAB) against malaria vectors. Treated nets were used in one village, and in the two control villages, one used untreated nets and the other used indoor spraying with DDT, without nets. In this area the primary malaria vectors are Anopheles culicifacies Giles sensu lato (Diptera: Culicidae) and An. fluviatilis James s.l., which are both endophagic and endophilic, and fully susceptible to deltamethrin. Treatment of a 10-m(2) mosquito net with one of the tablets gave a deltamethrin deposit of 25 mg/m(2). Bioassays repeated on domestically used nets over 7 months showed persistence of almost 100% mortality of An. fluviatilis, whereas An. culicifacies showed a decline from 100% to 71% mortality over this period, after which the nets were re-treated and bioassays were not continued. The sum of collections of mosquitoes resting in village houses and those in exit traps and dead on floor sheets showed a reduction in the numbers of the two vector species due to the treated nets, compared with untreated or no nets, but no reduction in other anophelines or Culex species. Large proportions of the collections of the vector and non-vector anophelines were dead on the floor sheets, but among Culex, mortality was delayed. Treated and untreated nets reduced the proportion of anophelines that had blood-fed; the treated nets did so more effectively than the untreated in the case of An. culicifacies and of Culex mosquitoes. In rooms with treated nets a larger proportion of the total collections [dead + live] were in the exit traps, which can be attributed to the excito-repellent effect of deltamethrin. It is easier to pack and handle tablets of insecticide than liquid concentrate and the use of one tablet per net may be preferable to making up a large volume of diluted insecticide and dipping many nets at a time.     

Movement of Anopheles gambiae s.l. malaria vectors between villages in The Gambia

ovement of mosquitoes belonging to the Anopheles gambiae complex (mixed wild populations of An.arabiensis, An.gambiae and An.melas ) between three neighbouring rural villages in The Gambia was investigated by mark-release-recapture. A total of 12,872 mosquitoes were collected in bednets, marked with a magenta fluorescent powder and released over a 15-day period in one of the villages. A further 15,507 mosquitoes were collected in exit traps, marked with a yellow powder and released over the same period. Mosquitoes were captured daily in all three villages using pyrethrum spray catches, as well as bednet and exit trap catches. The catching period extended for 6 days after the last day of release.
Of the mosquitoes released, 372 (1.3%) were recaptured 2–21 days later. Of these recaptures, 272 were caught in the release village, and 98 were caught in other villages situated 1–1.4 km away. The 'movement index' between villages was calculated as 17.2% (12.2–22.4% confidence limits) for mosquitoes released after feeding and 20.1% (14.7–25.3%) for those released unfed.
These results suggest that movement of mosquitoes between neighbouring villages in The Gambia seriously affects the entomological evaluation of pyrethroid-impregnated bednet programmes in areas where treated and untreated villages are interspersed.     

Urbanization, malaria transmission and disease burden in Africa

Many attempts have been made to quantify Africa's malaria burden but none has addressed how urbanization will affect disease transmission and outcome, and therefore mortality and morbidity estimates. In 2003, 39% of Africa's 850 million people lived in urban settings; by 2030, 54% of Africans are expected to do so. We present the results of a series of entomological, parasitological and behavioural meta-analyses of studies that have investigated the effect of urbanization on malaria in Africa. We describe the effect of urbanization on both the impact of malaria transmission and the concomitant improvements in access to preventative and curative measures. Using these data, we have recalculated estimates of populations at risk of malaria and the resulting mortality. We find there were 1,068,505 malaria deaths in Africa in 2000 - a modest 6.7% reduction over previous iterations. The public-health implications of these findings and revised estimates are discussed.     

Death in the West — A Regional Analysis of the Youthful Suicide Rate

A remarkable increase of youthful suicides over the past few years has caused the death rate for 15- to 24-year-old adolescents and young adults to rise while there has been a reduction in mortality for all other age groups.To analyze the geographic pattern of this youthful suicide epidemic, a national interstate analysis was done for the years 1964 through 1978. Results indicate a broad regional effect with high ratings of youthful suicide concentrated in the western United States, especially among states of the intermountain region.Statistical analysis shows a strong inverse relationship between youthful suicide and population density. Previous research in this area has usually related high population density (overcrowding) to social and behavioral pathology. The present research indicates, however, that low population density (undercrowding) can also have adverse effects. These undercrowding effects may occur because of social isolation, limited social services and loneliness.     

Entomological outcomes of cluster-randomised,community-driven dengue vector-suppression interventions in Kampong Cham province,Cambodia

Cambodia has one of the highest dengue infection rates in Southeast Asia. Here we report quantitative entomological results of a large-scale cluster-randomised trial assessing the impact on vector populations of a package of vector control interventions including larvivorous guppy fish in household water containers, mosquito trapping with gravid-ovitraps, solid waste management, breeding-container coverage through community education and engagement for behavioural change, particularly through the participation of school children. These activities resulted in major reductions in Container Index, House Index, Breteau Index, Pupal Index and Adult Index (all p-values 0.002 or lower) in the Intervention Arm compared with the Control Arm in a series of household surveys conducted over a follow-up period of more than one year, although the project was not able to measure the longer-term sustainability of the interventions. Despite comparative reductions in Adult Index between the study arms, the Adult Index was higher in the Intervention Arm in the final household survey than in the first household survey. This package of biophysical and community engagement interventions was highly effective in reducing entomological indices for dengue compared with the control group, but caution is required in extrapolating the reduction in household Adult Index to a reduction in the overall population of adult Aedes mosquitoes, and in interpreting the relationship between a reduction in entomological indices and a reduction in the number of dengue cases. The package of interventions should be trialled in other locations.     

Further observations on chemoprophylaxis and prevalence of malaria using questionnaire data in urban and rural areas of Burkina Faso

A cross-sectional study of malaria prevalence (98.6% Plasmodium falciparum) was carried out in Ouagadougou (Burkina Faso) and in 3 neighbouring villages on 2117 children, zero to five years old. Data on antimalarial prophylaxis and treatment were obtained from the child's parent using an interviewer-administered questionnaire. Regular weekly chloroquine consumption lowered the parasite rate but a significant increase with respect to parasite density was recorded in protected children from the rural area. No significant differences related to previous antimalarial treatments were observed in parasite rate or density. Antimalarial treatments were less frequent in children under chemoprophylaxis. Information about dosage and date of therapy was not recalled by most of the interviewed parents. Problems and suggestions for questionnaire data are briefly discussed.     

Moderate transmission but high prevalence of malaria in Madagascar

Malaria transmission remains poorly documented in areas of low transmission. A study has been carried out over two consecutive years in Analamiranga, a village located at an altitude of 885m on the western edge of the Malagasy highlands, with the aim of generating and updating malariometric indexes for both mosquitoes and schoolchildren. In this village, no vector control measures were performed during the study period nor during previous decades. Mosquitoes were collected monthly when landing on human volunteers and in various resting-places. Blood samples were taken every 3 months from schoolchildren aged 6-12 years and microscopically examined. Of 7,480 mosquitoes collected on human subjects, 5,790 were anophelines. Ten anopheline species were represented and three of these, Anopheles funestus, Anopheles arabiensis and Anopheles mascarensis, accounted for 59.2% of the collection. Of these three species 4,640 were also collected in resting places. The proportion of mosquitoes fed on bovids was high; conversely, the anthropophilic rate (mosquitoes fed on human beings) was especially low: 31%, 7% and 1%, respectively, for A. funestus, A. arabiensis and A. mascarensis. The only confirmed malaria vector was A. funestus with a low sporozoite index (of 6,830 A. funestus, five were positive for Plasmodium falciparum and four for Plasmodium vivax). The annual entomological inoculation rate (number of bites of infected anophelines per adult person) was estimated at 2.49 with low variation over the 2 years. Overall, 909 thick blood smears were tested from blood samples taken from schoolchildren with 30.3% being malaria-positive. The four Plasmodium species infecting human subjects were detected in the following proportions: P. falciparum 78.9%, P. vivax 19.4%, Plasmodium malariae 1.0% and Plasmodium ovale 0.7%. The proportions of children who were infected with any Plasmodium ranged from 10.7% in February to 51.0% in September. Parasitemic children with fever (axillary temperature >37.5 degrees C) accounted for 16.4% of the children sampled. This study demonstrates that there are substantial parasitological consequences of even a relatively low entomological transmission and also recommends including exterior resting-places of mosquitoes in future spraying campaigns in the highlands of Madagascar.     

A weather-driven model of malaria transmission

The classic formulae in malaria epidemiology are reviewed that relate entomological parameters to malaria transmission, including mosquito survivorship and age-at-infection, the stability index (S), the human blood index (HBI), proportion of infected mosquitoes, the sporozoite rate, the entomological inoculation rate (EIR), vectorial capacity (C) and the basic reproductive number (R ₀). The synthesis emphasizes the relationships among classic formulae and reformulates a simple dynamic model for the proportion of infected humans. The classic formulae are related to formulae from cyclical feeding models, and some inconsistencies are noted. The classic formulae are used to to illustrate how malaria control reduces malaria transmission and show that increased mosquito mortality has an effect even larger than was proposed by Macdonald in the 1950's.     

Interrupting malaria transmission: quantifying the impact of interventions in regions of low to moderate transmission

Malaria has been eliminated from over 40 countries with an additional 39 currently planning for, or committed to, elimination. Information on the likely impact of available interventions, and the required time, is urgently needed to help plan resource allocation. Mathematical modelling has been used to investigate the impact of various interventions; the strength of the conclusions is boosted when several models with differing formulation produce similar data. Here we predict by using an individual-based stochastic simulation model of seasonal Plasmodium falciparum transmission that transmission can be interrupted and parasite reintroductions controlled in villages of 1,000 individuals where the entomological inoculation rate is <7 infectious bites per person per year using chemotherapy and bed net strategies. Above this transmission intensity bed nets and symptomatic treatment alone were not sufficient to interrupt transmission and control the importation of malaria for at least 150 days. Our model results suggest that 1) stochastic events impact the likelihood of successfully interrupting transmission with large variability in the times required, 2) the relative reduction in morbidity caused by the interventions were age-group specific, changing over time, and 3) the post-intervention changes in morbidity were larger than the corresponding impact on transmission. These results generally agree with the conclusions from previously published models. However the model also predicted changes in parasite population structure as a result of improved treatment of symptomatic individuals; the survival probability of introduced parasites reduced leading to an increase in the prevalence of sub-patent infections in semi-immune individuals. This novel finding requires further investigation in the field because, if confirmed, such a change would have a negative impact on attempts to eliminate the disease from areas of moderate transmission.     

Recruitment and year-to-year variability in a population of Macoma balthica (L.)

Because of methodological problems, macrobenthic studies usually neglect the juvenile stages of invertebrate communities, due to the fact that appearance of recruits in samples is only detected some weeks or even months after their true recruitment. During this period, the temporary meiobenthos undergoes high rates of mortality. From year to year, juvenile survival rate is thus responsible for temporal patterns observed in adult population densities.The results presented here relate to the population dynamics of the tellinid bivalve Macoma balthica (L.). A study of temporary meiobenthos was conducted over two consecutive years in an intertidal Macoma-community located at the mouth of the Gironde Estuary in southwest France. Sampling of juvenile stages required short intervals (2 weeks) between successive samplings and a fine sieving mesh size (63 µm). Other population parameters, such as temporal patterns in density, reproductive cycle, and individual growth, were recorded.Recruitment processes showed a year-to-year variability, with regard to settlement density, settlement period, and survival rate. In 1983, recruitment was moderate and protracted over several months. Only one main recruitment period was detected in 1984, resulting in a high juvenile density. In a previous study (1977), by contrast, recruitment was almost non-existent.This variability is discussed as a function of climatic and sedimentological conditions which prevailed in the estuary throughout the study period. However, none of these physical factors appeared to underlie the recruitment fluctuation in Macoma balthica. It is suggested that biological interactions are of prime importance in regulating population densities in this community.     

The rise and fall of the Aldabran giant tortoise population.

At the end of the 19th century, after prolonged and extensive harvesting, indigenous giant tortoises had been eliminated from all islands in the Indian Ocean, except Aldabra atoll, where only a few survived. With greatly reduced levels of exploitation during the 20th century, the population recovered to a revised estimated total of 129,000 in 1973-1974, when the first sample census was conducted. A repeat census in 1997 revealed a highly significant reduction in numbers over the past 24 years to an estimated total of 100,000. The great majority of tortoises are still found at relatively high density in south-eastern Grande Terre, where the number of animals has declined by more than one-third. In contrast, low-density subpopulations on Malabar and Picard have almost doubled in size, but they represent less than 5% of the total population. Corroborative evidence for the crash in the Grande Terre subpopulation comes from two independent observations: a significant increase in tortoise mortality; and a significant decline in tortoise counts on long-term population monitoring transects. These population changes are attributed to natural population regulatory mechanisms, exacerbated by low rainfall years in the period 1980-1997, including two consecutive years of below average rainfall in 1995-1996 and 1996-1997.     

Regulation of damseifly populations: the effects of larval density on larval urvival, development rate and size in the field

SUMMARY. 1. The popuhttion density of Coenagrion pttella larvae was monitored in five populations, and of Ischntira elegans in two populations, between October 1982 and May 1983.
2. There was no measurable mortality of larvae over winter and no larval growth until April. Larvae in high density populations were smaller than those in low density populations and were more likely to have a semi- voltine life history.
3. The population density of C. ptiella was also monitored (more frequently) in two populations with differenl initial densities between July and November 1983. In the high density population there was a constant rate of larval mortality, while in the low density population there was no detectable larval mortality, indicating that larval mortality may be density dependent. Larvae in the high density population were again smaller, and more likely to be semi-voitine, than those in the low density population.
4. The role of density dependent larval growth, development and mortality in the regulation of damseifly populations is discussed.     

Effect of density on larval development and female productivity ofTisbe holothuriae (Copepoda,Harpacticoida) under laboratory conditions

The harpacticoid copepodTisbe holothuriae has been cultivated in the Helgoland laboratory for more than 20 years. The effects of density on the larval development and the female productivity were studied by comparing two culture systems: (1) enclosed system, and (2) running-water system. In both systems, a nutritious mixed diet ofDunaliella tertiolecta, Skeletonema costatum, and granulatedMytilus edulis was offered. Larval mortality, larval development and female productivity are found to be significantly dependent on both the population density and specificity of the culture system. Increasing density causes higher larval mortality, longer larval development time, and a reduction in female productivity. In comparison with the enclosed system, the running-water system shows decisive advantages: larval mortality is about 20% lower, the rate of larval development is about two days shorter, and there is a very high rate of nauplii production. The sex ratio exhibits high variations, but in general, there is no clear relationship between sex ratio and population density. Nevertheless, when reared in the running-water system, a relatively high percentage of females (>45%) was found at lower densities.     

Adult anopheline ecology and malaria transmission in irrigated areas of South Punjab, Pakistan

Surface irrigation in the Punjab province of Pakistan has been carried out on a large scale since the development of the Indus Basin Irrigation System in the late 19th century. The objective of our study was to understand how the population dynamics of adult anopheline mosquitoes (Diptera: Culicidae) could be related to malaria transmission in rural areas with intensive irrigation and a history of malaria epidemics. In this paper we present our observations from three villages located along an irrigation canal in South Punjab. The study was carried out from 1 April 1999 to 31 March 2000. Mosquitoes were collected from bedrooms using the pyrethroid spraycatch method and from vegetation and animal sheds using backpack aspirators. Overall, Anopheles subpictus Grassi sensu lato predominated (55.6%), followed by An. stephensi Liston s.l. (41.4%), An. culicifacies Giles s.l. (2.0%), An. pulcherrimus Theobald (1.0%) and An. peditaeniatus Leicester (0.1%). Most mosquitoes (98.8%) were collected from indoor resting-sites whereas collections from potential resting-sites outdoors accounted for only 1.2% of total anopheline densities, confirming the endophilic behaviour of anophelines in Pakistan. Anopheles stephensi, An. culicifacies and An. subpictus populations peaked in August, September and October, respectively. High temperatures and low rainfall negatively affected seasonal abundance in our area. There were interesting differences in anopheline fauna between villages, with An. culicifacies occurring almost exclusively in the village at the head of the irrigation canal, where waterlogged and irrigated fields prevailed. Monthly house-to-house fever surveys showed that malaria transmission remained low with an overall slide positivity rate of 2.4% and all cases were due to infection with Plasmodium vivax. The most plausible explanation for low transmission in our study area seems to be the low density of Pakistan's primary malaria vector, An. culicifacies. The role of other species such as An. stephensi is not clear. Our observations indicate that, in South Punjab, irrigation-related sites support the breeding of anopheline mosquitoes, including the vectors of malaria. As our study was carried out during a year with exceptionally hot and dry climatic conditions, densities and longevity of mosquitoes would probably be higher in other years and could result in more significant malaria transmission than we observed. To assess the overall importance of irrigation-related sites in the epidemiology of malaria in the Punjab, more studies are needed to compare irrigated and non-irrigated areas.