Protection of dogs from bites of phlebotomine sandflies by deltamethrin collars for control of canine leishmaniasis

Abstract. Dog collars made of PVC plastic impregnated with the pyrethroid insecticide deltamethrin at 40 mg/g were investigated for their protective efficacy against phlebotomine sandflies. Collared dogs were kept separately (two untreated control dogs lived together) in outdoor enclosures, each with a kennel, in the Cevennes, southern France. To measure sandfly mortality and anti-feeding effects due to the deltamethrin-impregnated collars worn continuously by the dogs for up to 8 months, each dog was periodically sedated and exposed for 2h to 150–200 laboratory-reared Phlebotomus perniciosus females (plus c. 25 males) inside a net (1.2m square, 1.8 m high) indoors. After dogs were removed from the nets, allowed to recover and returned to their kennels, any dead sandflies were collected from inside the net and counted. Surviving flies were kept overnight, then scored according to whether they were still alive or dead, unfed or blood-fed. From tests 2, 3, 4, 13, 20, 26 and 34 weeks after the dogs began wearing collars, the overall numbers of blood-fed female sandflies recaptured were 75 from two dogs with collars, compared with 1911 from two collarless dogs. Thus, for every 100 flies which fed on collarless dogs, only 4 fed on collared dogs, i.e. the collars protected dogs from 96% of the bites and this activity was maintained for up to 34 weeks. During the same period, the percentage of recaptured female sandflies that had fed on collared dogs was 0–12% compared to 55–95% on collarless dogs. Immediately after dogs were taken out of the nets, 21–60% of flies confined with the collared dogs were found dead, compared to 0–12% with the controls. It is concluded that, at least in the Mediterranean subregion, this insecticidal collar would protect a dog from the majority of sandfly bites and retain a killing effect for a complete sandfly season. Moreover, it seems likely that the use of collars on all dogs in a focus of Leishmania infantum would reduce contact between sandfly vectors and canine reservoir hosts sufficiently to diminish the risk of infection for humans as well as dogs.     

Phlebotomine sandfly ecology on the Indian subcontinent: does village vegetation play a role in sandfly distribution in Bihar,India?

Visceral leishmaniasis (VL) is a disease that results in approximately 50 000 human deaths annually. It is transmitted through the bites of phlebotomine sandflies and around two‐thirds of cases occur on the Indian subcontinent. Indoor residual spraying (IRS), the efficacy of which depends upon sandfly adults resting indoors, is the only sandfly control method used in India. Recently, in Bihar, India, considerable sandfly numbers have been recorded outdoors in village vegetation, which suggests that IRS may control only a portion of the population. The purpose of this study was to revisit previously published results that suggested some sandflies to be arboreal and to rest on outlying plants by using Centers for Disease Control light traps to capture sandflies in vegetation, including banana plants and palmyra palm trees, in two previously sampled VL‐endemic Bihari villages. Over 3500 sandflies were trapped in vegetation over 12 weeks. The results showed the mean number of sandflies collected per trap night were significantly higher in banana trees than in other vegetation (P = 0.0141) and in female rather than male palmyra palm trees (P = 0.0002). The results raise questions regarding sandfly dispersal, oviposition and feeding behaviours, and suggest a need to refine current control practices in India and to take into account an evolving understanding of sandfly ecology.     

Studies on the behaviour and control of phlebotomine sandflies using experimental houses

Programmes for the control of phlebotomine sandflies (Diptera: Psychodidae), the vectors of leishmaniases, mainly target adults because larval breeding sites are generally unknown or inaccessible. To determine how blood‐questing sandfly females enter homes and to develop means for their control, an experimental house (EH) was constructed in a village endemic for cutaneous leishmaniasis. Initially, carbon dioxide (CO₂)‐baited suction traps were installed inside the EH to attract and capture sandflies. For other experiments, the windows of the EH were fitted with CO₂‐baited window entrance traps (WETs) that allow each window to be considered as a separate unit. The majority of captures inside the EH and in WETs consisted of Phlebotomus sergenti, a species that enters inhabited houses relatively infrequently. Analyses of collections in WETs and in sticky traps on external walls showed that sandflies entered windows having landed previously on the wall below or either side of the window. Shelves constructed below windows significantly reduced the numbers of sandflies that entered both the EH and inhabited houses. The lining of internal walls with insecticide‐impregnated fabric significantly increased mortality rates of sandflies captured inside the EH. To reduce the biting burden imposed by phlebotomine sandflies, several control measures must be integrated and sustained.     

Deltamethrin-impregnated bednets reduce human landing rates of sandfly vector Lutzomyia longipalpis in Amazon households

The entomological efficacy of using 25% deltamethrin EC insecticide-treated bednets (ITNs) was evaluated against the sandfly Lutzomyia longipalpis Lutz and Neiva (Diptera: Psychodidae), the principal vector of zoonotic visceral leishmaniasis (ZVL) in Latin America. A crossover field study in Amazon Brazil (Marajó Island, Pará State) demonstrated that, compared with untreated nets, the insecticide increased the barrier effect of nets by 39% (95% confidence interval [CI] 34-44%), reduced human landing rates by 80% (95% CI 62-90%) and increased the 24-h mortality rate from 0% to 98% (95% CI 93-99%) inside ITNs. The presence of an ITN also reduced the human landing rate on unprotected persons outside the net in the same room by 56% (95% CI 52-59%), and increased 24-h mortality to 68% (95% CI 62-73%) compared to 0.4% (0.1-2.0%) in untreated houses. The reduction in human landing rates in ITN rooms was associated with a doubling in the proportion of sandflies alighting on walls compared with that in untreated rooms, which was attributed to insecticide-induced excito-repellency. There was no evidence that sandflies were diverted onto unprotected hosts. Human landing catches inside houses peaked between 19.00 hours and 23.00 hours and declined steadily to zero at 02.00 hours and thereafter. House-to-house questionnaires established that only 34% of households owned at least one net (median two, range 1-8), only 20% of the population slept under a net (33% of 0-5-year-old children), and the majority (73%) of the population slept in hammocks. Combined data pertaining to sleeping times for children and sandfly activity period indicate that > 50% of sandfly bites inside houses, and substantially more outside houses, were taken before a third of children were potentially protected by a net. This study demonstrates the clear entomological efficacy of ITNs against Lu. longipalpis in this endemic region. The effectiveness of ITNs at preventing ZVL infection and disease has still to be evaluated.     

Abundance and site fidelity of Indo‐Pacific Humpback dolphins in the Great Sandy Strait,Queensland, Australia

This study examined the population of Indo‐Pacific humpback dolphins, Sousa chinensis, inhabiting the Great Sandy Strait Marine Park, Queensland, Australia. A total of 106 dolphins were identified during 228 boat‐based surveys, completed between April 2004 and April 2007. Based on the distribution of resighted individuals and the pattern of associations, it was established that this population consists of two largely geographically distinct communities, referred to as the Northern Community (NC) and the Southern Community (SC). The only recorded interaction between the two groups was a single pod composed of one member of the NC and 11 dolphins from the SC. Abundance was estimated for the entire population and by geographical area using open population models. Estimates for the Great Sandy Strait indicate that about 150 dolphins (N_GSS= 148.4, SE = 8.3, 95% CI: 132.5–165.2) used this area during the study. The NC and SC total population sizes was estimated to be 76 (N_NGSS= 75.80, SE = 3.88, 95% CI = 71–86) and 75 (N_SGSS= 74.98, SE = 4.43, 95% CI: 66–83), respectively. Analysis of residence patterns indicates that a majority of the identified dolphins are long‐term residents.     

Longitudinal monitoring of anti‐saliva antibodies as markers of repellent efficacy against Phlebotomus perniciosus and Phlebotomus papatasi in dogs

A 2‐year longitudinal study of enzyme‐linked immunosorbent assay (ELISA) antibodies against Phlebotomus perniciosus and Phlebotomus papatasi (Diptera: Psychodidae) sandfly saliva was performed in 32 Beagle dogs treated preventively with an imidacloprid–permethrin topical insecticide in an endemic area in Spain. Dogs were grouped into three sandfly exposure groups according to the time of inclusion in the study. Assays analysed immunoglobulin G (IgG) against salivary gland homogenates (SGH) of both species and recombinant P. papatasi rSP32 and P. perniciosus rSP03B proteins in serum. The dogs were participating in a Leishmania infantum (Kinetoplastida: Trypanosomatidae) vaccine trial and were experimentally infected with the parasite in the second year. No dog acquired natural L. infantum infections during the first year, but most developed anti‐saliva antibodies, and median log‐transformed optical densities (LODs) were seasonal, mimicking those of local sandflies. This indicates that the repellent efficacy of the insecticide used is below 100%. Multi‐level modelling of LODs revealed variability among dogs, autocorrelation and differences according to the salivary antigen and the dog's age. However, dog seroprevalence, estimated using pre‐exposure LODs as cut‐offs, was relatively low. This, and the fact that dogs did not become naturally infected with L. infantum, would support the efficacy and usefulness of this imidacloprid–permethrin topical insecticide in canine leishmaniasis control.     

Sustained efficacy of the novel topical repellent TT‐4302 against mosquitoes and ticks

Mosquitoes and ticks are blood‐feeding pests of humans and animals that can vector many important aetiological agents of disease. Previous research demonstrated that TT‐4302 (Guardian^® Wilderness) containing 5% geraniol applied to human subjects gave 5–6 h of repellency against mosquitoes (depending on species) and was repellent to ticks in vitro. This study was conducted to obtain an independent third‐party evaluation of TT‐4302 against Stegomyia aegypti (= Aedes aegypti) (Diptera: Culicidae) mosquitoes and to test the efficacy of the product in the field against ticks. TT‐4302 provided an average of 6.5 h of repellency of ≥ 95% [Weibull mean protection time: 7.4 h, 95% confidence interval (CI) 5.8–11.3 h] for St. aegypti, whereas a 15% DEET formulation provided 4.7 h of repellency (Weibull mean protection time: 5.2 h, 95% CI 3.7–6.9 h). In tick field trials, the efficacy of TT‐4302 did not differ significantly from that of a 25% DEET formulation against Amblyomma americanum (Ixodida: Ixodidae). TT‐4302 was 81.3% repellent at 2.5 h after application, whereas DEET was 77.2% repellent at the same time‐point. Results at 3.5 h after application were 71.4% for TT‐4302 and 72.9% for DEET.     

Potential role of ATP‐binding cassette transporters against acaricides in the brown dog tick Rhipicephalus sanguineus sensu lato

ATP‐binding cassette (ABC) transporters have been shown to be involved in pesticide detoxification in arthropod vectors and are thought to contribute to the development of drug resistance. Little is currently known about the role they play in ticks, which are among the more important vectors of human and animal pathogens. Here, the role of ABC transporters in the transport of fipronil and ivermectin acaricides in the tick Rhipicephalus sanguineus (Ixodida: Ixodidae) was investigated. Larvae were treated with acaricide alone and acaricide in combination with a sub‐lethal dose of the ABC transporter inhibitor cyclosporine A. The LC₅₀ doses and 95% confidence intervals (CIs) estimated by mortality data using probit analysis were 67.930 p.p.m. (95% CI 53.780–90.861) for fipronil and 3741 p.p.m. (95% CI 2857–4647) for ivermectin. The pre‐exposure of larvae to a sub‐lethal dose of cyclosporine A reduced the LC₅₀ dose of fipronil to 4.808 p.p.m. (95% CI 0.715–9.527) and that of ivermectin to 167 p.p.m. (95% CI 15–449), which increased toxicity by about 14‐ and 22‐fold, respectively. The comparison of mortality data for each separate acaricide concentration showed the synergic effect of cyclosporine A to be reduced at higher concentrations of acaricide. These results show for the first time a strong association between ABC transporters and acaricide detoxification in R.sanguineus s.l.     

Seroprevalence and Potential Risk Factors for Helicobacter pylori Infection in Brazilian Children

Background: Helicobacter pylori infection has been proved to be of great relevance to public health in unindustrialized countries, especially in low socioeconomic groups. Poor hygiene, deficient sanitation, and crowded conditions have been reported as risk factors for this infection. In this work, we investigated whether social and demographic characteristics were associated with anti‐H. pylori IgG antibodies in 1104 children aged 4–11 years old from Salvador, a large city located in northeastern Brazil. Methods: Standardized questionnaires were used to obtain social, demographic, and environmental data for the studied population in two periods of time (from 1997 to 2003 and in 2005). Anti‐H. pylori IgG antibodies were assessed by indirect enzyme‐linked immunosorbent assay in 2005. Results: Anti‐H. pylori IgG antibody was present in 28.7% of the children. Among the studied variables, the following were positively associated with the presence of anti‐H. pylori antibodies in multivariable analyses: age above 8 years old (OR = 1.72, 95% CI = 1.23–2.40), a larger sibling number (OR = 1.66, 95% CI = 1.26–2.18), nursery attendance (OR = 1.49, 95% CI = 1.04–2.12), location of the house at an unpaved street (OR = 2.03, 95% CI = 1.44–2.87) and absence of a flush toilet (OR = 1.32, 95% CI = 1.00–1.74). Conclusion: Our data show that H. pylori infection in children from a major Brazilian city is associated with variables indicative of a crowded environment and deficient sanitation/habitation conditions, leading to the conclusion that improvements in hygiene and social conditions may protect children against this infection.     

Evaluation of a new antigen for diagnosis of Helicobacter pylori infection in stool of adult and children

Background: Nowadays, there is an increasing interest in noninvasive methods to diagnose Helicobacter pylori infection. Indeed, they can profitably replace endoscopy in predicting the diagnosis. The stool antigen test for H. pylori is a noninvasive immunoassay to diagnose active infection with this bacterium in human fecal samples. The aim of this study was detection of alkyl hydroperoxide reductase protein (AhpC) antigen by immunoblotting in stool samples for diagnosis of H. pylori. Materials and Methods: Chromosomal DNA from H. pylori was isolated. AhpC gene was amplified by PCR, These amplicons were cloned into pTZ57R/T cloning vector then subcloned into pQE30 expression vector and overexpressed using isopropyl‐beta‐D‐thiogalactopyranoside in E. coli M15. AhpC protein was purified by affinity chromatography. Rabbits were immunized with the purified AhpC protein for the production of antibodies. To determine the accuracy of the test for diagnosing H. pylori infection from stool, we evaluated 84 patients (6–81 years old) using Western blot analysis by rabbit anti‐AhpC antibody. Positive rapid urease test on biopsy samples was considered as the gold standard. Results: AhpC gene was overexpressed, and AhpC protein was purified. Rabbit anti‐AhpC antibody produced after immunization with the purified AhpC protein. By immunoblotting, we detected AhpC protein in the positive stool samples. The test showed a 83.3% sensitivity (95% CI: 69.8–92.5%) and a 91.7% specificity (95% CI: 77.5–98.2). Among the children, the sensitivity was 88.2% (95% CI: 63.6–98.5) and the specificity was 100% (95% CI: 69.2–100); in adults, the sensitivity and specificity were 80.6% (95% CI: 62.5–92.5) and 88.5% (95% CI: 69.8–97.6), respectively. Conclusions: Using of AhpC antigen for diagnosis of H. pylori infection is a useful noninvasive method, accurate in adolescents and children, and can be used for the development of a stool antigen detection kit for H. pylori.     

Effect of trapping method on species identification of phlebotomine sandflies by MALDI‐TOF MS protein profiling

Sandflies (Diptera: Psychodidae) (Newstead, 1911) are blood‐feeding insects that transmit human pathogens including Leishmania (Trypanosomatida: Trypanosomatidae) parasites, causative agents of the leishmaniases. To elucidate Leishmania transmission cycles, conclusive identification of vector species is essential. Molecular approaches including matrix‐assisted laser desorption ionization time‐of‐flight mass spectrometry (MALDI‐TOF MS) protein profiling have recently emerged to complement morphological identification. The aim of this study was to evaluate the effect of the trap type used to collect sandflies, specifically Centers for Disease Control (CDC) light or sticky traps, the two most commonly used in sandfly surveys, on subsequent MALDI‐TOF MS protein profiling. Specimens of five species (Phlebotomus ariasi, Phlebotomus papatasi, Phlebotomus perniciosus, Phlebotomus sergenti, Sergentomyia minuta) collected in periurban and agricultural habitats in southeast Spain were subjected to protein profiling. Acquired protein spectra were queried against an in‐house reference database and their quality assessed to evaluate the trap type effect. The results indicate that trap choice can substantially affect the quality of protein spectra in collected sandflies. Whereas specimens retrieved from light traps produced intense and reproducible spectra that allowed reliable species determination, profiles of specimens from sticky traps were compromised and often did not enable correct identification. Sticky traps should therefore not be used in surveys that deploy MALDI‐TOF MS protein profiling for species identification.     

The effectiveness of a pyriprole (125 mg/ml) and a metaflumizone (150 mg/ml) combined with amitraz (150 mg/ml) spot-on treatment in preventing Phlebotomus perniciosus from feeding on dogs

A controlled clinical trial was performed to assess the effectiveness of a pyriprole (125 mg/ml) and a metaflumizone (150 mg/ml) combined with amitraz (150 mg/ml) spot-on treatment (recommended dosage) in preventing adult female sandflies (Phlebotomus perniciosus) from feeding on dogs. Sandfly mortality was also assessed. Twelve beagle dogs were used in the study. Prior to treatment they were checked for their attractiveness to sandflies, ranked accordingly to generate partner triplets of equivalent sensitivity to sandflies: four control dogs, four treated with the pyriprole and four with the metaflumizone spot-on. The dogs were challenged with 50 unfed adult female sandflies (8-10 days old), in cages for one hour on Day 1 and Day 7. The sandflies were checked for blood feeding and mortality at one hour, 24 hours and 48 hours after exposure to the dogs. A very poor anti-feeding effect (near 7%) was seen on sandflies with the metaflumizone combined with amitraz and no antifeeding effect was seen with pyriprole. The sandfly mortality effect as a result of exposure to treated dogs was under 20% for the two spot-on. The two formulations could not be proposed in a leishmaniosis prevention program.     

Association of common polymorphisms in the IL2RA gene with type 1 diabetes: evidence of 32,646 individuals from 10 independent studies

Single nucleotide polymorphisms (SNPs) in the interleukin 2 receptor alpha (IL2RA) gene have been suggested to be associated with type 1 diabetes (T1D) susceptibility. However, the results from individual studies are inconsistent. To explore the association of IL2RA polymorphisms with T1D, including rs11594656, rs2104286, rs3118470, rs41295061 and rs706778, a meta‐analysis involving 10 independent studies with 19 outcomes was conducted: five studies with a total of 10,572 cases and 12,956 controls were analysed for rs11594656 with T1D risk, three studies with 7300 cases and 8331 controls for rs2104286, three studies with 3880 cases and 5409 controls for rs3118470, five studies with 11,253 cases and 13,834 controls for rs41295061 and three studies with 1896 cases and 1709 controls for rs706778 respectively. Using minor allelic comparison, the five investigated SNPs were all observed to have a significant association with T1D: For rs11594656, fixed effect model (FEM) odds ratio (OR) 0.87, 95% confidence interval (CI) 0.83, 0.91; rs2104286, FEM OR 0.81, 95% CI 0.77, 0.85; rs3118470, FEM OR 1.23, 95% CI 1.16, 1.31; rs41295061, random effect model (REM) OR 0.67, 95% CI 0.60, 0.76 and rs706778 FEM OR 1.20, 95% CI 1.08, 1.33. Similar results were obtained when all the included studies were calculated by a REM. Our meta‐analysis suggests that all five SNPs in the IL2RA gene are risk factors for T1D risk, and rs11594656, rs2104286 and rs41295061 are the most associated SNPs in the populations investigated. This conclusion warrants confirmation by further studies.     

Sugars in the alimentary canal of Lutzomyia youngi (Diptera: Phlebotominae)

Abstract. Gas chromatography (GC) analysis of 159 specimens (144 females and 15 males) of Lutzomyia youngi collected in Shannon traps in a coffee plantation in the Andean region of western Venezuela, where leishmaniasis is endemic, revealed the presence of fructose, sucrose, glucose and maltose in the gut and crop of the wild sandflies. The identification of the sugars was confirmed by comparing retention times with those observed for standard sugars and those obtained from sandflies experimentally fed on known sugar solutions. Although the sandflies in nature may ingest each of the four sugars, the results suggest that it is more probable there is an invertase enzyme (glycosidase?) in the gut or crop of the sandfly which hydrolyses ingested disaccharides (e.g. sucrose) to the constituent monosaccharides (i.e. fructose and glucose). Ecological and altitudinal distributions of sandfly species may be related to the availability of specific sugar sources, with epidemiological implications. Identification of the preferred sugar could make breeding easier and would facilitate further research on Leishmania–wector relationships.     

Assessing the importance of four sandfly species (Diptera: Psychodidae) as vectors of Leishmania mexicana in Campeche,Mexico

Localized cutaneous leishmaniasis represents a public health problem in many areas of Mexico, especially in the Yucatan Peninsula. An understanding of vector ecology and bionomics is of great importance in evaluations of the transmission dynamics of Leishmania parasites. A field study was conducted in the county of Calakmul, state of Campeche, during the period from November 2006 to March 2007. Phlebotomine sandfly vectors were sampled using Centers for Disease Control light traps, baited Disney traps and Shannon traps. A total of 3374 specimens were captured in the two villages of Once de Mayo (93.8%) and Arroyo Negro (6.1%). In Once de Mayo, the most abundant species were Psathyromyia shannoni, Lutzomyia cruciata, Bichromomyia olmeca olmeca and Psychodopygus panamensis (all: Diptera: Psychodidae). The Shannon trap was by far the most efficient method of collection. The infection rate, as determined by Leishmania mexicana‐specific polymerase chain reaction, was 0.3% in Once de Mayo and infected sandflies included Psy. panamensis, B. o. olmeca and Psa. shannoni. There were significant differences in human biting rates across sandfly species and month of sampling. Ecological niche modelling analyses showed an overall overlap of 39.1% for the four species in the whole state of Campeche. In addition, the finding of nine vector–reservoir pairs indicates a potential interaction. The roles of the various sandfly vectors in Calakmul are discussed.     

A New Long-Lasting Indoor Residual Formulation of the Organophosphate Insecticide Pirimiphos Methyl for Prolonged Control of Pyrethroid-Resistant Mosquitoes: An Experimental Hut Trial in Benin

Background

Indoor residual spraying (IRS) is widely used for malaria transmission control in sub-Saharan Africa. Resistance to pyrethroids in the mosquito Anopheles gambiae is a growing problem. There is an urgent need to develop long-lasting alternative insecticides to reduce selection pressure for pyrethroid resistance and to provide control with a single IRS application in countries with long transmission seasons.

Methods

Two capsule suspension formulations (CS) of the organophosphate pirimiphos methyl were evaluated as IRS treatments in experimental huts in an area of Benin where the mosquitoes Anopheles gambiae and Culex quinquefasciatus are resistant to pyrethroids but susceptible to organophosphates. The CS formulations were tested alongside an emulsifiable concentrate (EC) formulation of pirimiphos methyl and a CS formulation of the pyrethroid lambdacyhalothrin.

Results

The two CS formulations of pirimiphos methyl gave prolonged control of An. gambiae and Cx. quinquefasciatus. In cement huts application rates of 0.5 g/m² induced high mortality of An. gambiae for almost a year: overall mortality rates 87% (95% CI 82–91%) and 92% (95% CI 88–94%). In mud huts application rates of 1 g/m² induced high mortality of An. gambiae for 10 months: overall mortality rates 75% (95% CI 69–81%) and 76% (95% CI 68–83%). The EC formulation of pirimiphos methyl failed to control An. gambiae two months after spraying. The pyrethroid lambdacyhalothrin demonstrated prolonged residual activity in bioassay tests but failed to control pyrethroid resistant An. gambiae that entered the huts. Pirimiphos methyl CS was highly active against Culex quinquefasciatus and gave control for 10 months in cement huts and 6 months in mud huts.

Conclusion

Pirimiphos methyl CS (Actellic 300 CS) applied at 1 g/m² shows great promise for providing prolonged control of pyrethroid-resistant An gambiae and for delaying pyrethroid resistance. An alternative to DDT, giving year-round transmission control in sub-Saharan Africa is now a realistic prospect.     

Eradication of Helicobacter pylori infection reduces the incidence of peptic ulcer disease in patients using nonsteroidal anti-inflammatory drugs: a meta-analysis

Aim: To investigate the association between use of nonsteroidal anti‐inflammatory drugs (NSAID) and Helicobacter pylori infection, interactive effect of H. pylori infection and NSAID use on the development of peptic ulcer disease (PUD), and the effect of H. pylori eradication therapy on PUD development. Material and Methods: We performed a systematic literature search in EMBASE and PubMed for relevant articles published in English between January 1989 and August 2010, with the following MeSH and/or key words: non‐steroidal anti‐inflammatory drugs, or NSAIDs, Helicobacter pylori, or H. pylori, peptic ulcer disease or PUD, and randomized‐control study or clinical trial. The meta‐analysis was conducted using the Review Manager 4.2.2. Results: In the analysis of five studies, the pooled prevalence of H. pylori infection was 74.5% and 71.1% in NSAID users and non‐NSAID users, respectively, (OR = 0.65; 95% CI: 0.35–1.20, p = .170). In the analysis of nine studies, the pooled prevalence of PUD in NSAID users was 31.2% and 17.9% in the presence and absence of H. pylori infection, respectively, (OR = 3.08; 95% CI: 1.26–7.55, p = .010). Moreover, in the analysis of seven studies, PUD developed in 6.4% and 11.8% of NSAID users with and without eradication therapy, respectively (OR = 0.50; 95% CI: 0.36–0.74, p < .001). The preventive effect of the eradication therapy was further revealed in NSAID‐naive users (OR = 0.26; 95% CI: 0.14–0.49, p < .0001) and in the Asian population (OR = 0.30; 95% CI: 0.16–0.56, p < .001). Conclusion: NSAID use is not associated with H. pylori infection in patients with PUD. PUD is more common in H. pylori positive than in negative NSAID users. Moreover, H. pylori eradication therapy reduces PUD incidence in NSAID users, especially in naive users and in the Asian population.     

Air quality modeling for health risk assessment of ambient PM10, PM2.5 and SO2 in Iran

In this study, we have estimated the number of total mortality (T-mortality), cardiovascular morbidity (CV-mortality), respiratory mortality (R-mortality), hospital admissions due to cardiovascular diseases (HA-CVD), respiratory diseases (HA-RD), chronic obstructive pulmonary diseases (COPD) and acute myocardial infarction (AMI) due to exposure to particulate matter less than 10 µm (PM₁₀), 2.5 µm (PM_2.5) and sulfur dioxide (SO₂) in western Iran in 2016. The World Health Organization (WHO) method was used to assess the mortality and morbidity among the exposed people. The results showed that about 3.9% CM (95% CI: 2.9–7.8%), 3.9% HA-RD (95% CI: 2.4–7.8%) and 4.4% HA-CVD (95% CI: 3.0–6.8%) for ambient PM₁₀ and about 7.3% TM (95% CI: 4.2–9.7%), 12.1% CM (95% CI: 3.5–14.6%) and 3.0% RM (95% CI: 0–6.3%) for PM_2.5 are respectively attributed to concentrations exceeding 10 µg/m³. Furthermore, 3.2% HA-COPD (95% CI: 0–5.04%) and 4.2% AMI (95% CI: 1.6–4.3%) can be attributed to SO₂ concentrations greater than 10 µg/m³, respectively. To reduce the adverse health effect of PM, health advices provided by health authorities should be given to general population especially vulnerable people such as people with chronic lung and heart pathologies, elderly and children during the dusty days.     

Modifications of pyrethroid effects associated with kdr mutation in Anopheles gambiae

Effects of knockdown resistance (kdr) were investigated in three pyrethroid‐resistant (RR) strains of the Afrotropical mosquito Anopheles gambiae Giles (Diptera: Culicidae): Kou from Burkina Faso, Tola and Yao from Côte d'Ivoire; compared with a standard susceptible (SS) strain from Kisumu, Kenya. The kdr factor was incompletely recessive, conferring 43‐fold resistance ratio at LD₅₀ level and 29‐fold at LD₉₅ level, as determined by topical application tests with Kou strain. When adult mosquitoes were exposed to 0.25% permethrin‐impregnated papers, the 50% and 95% knockdown times (KdT) were 23 and 42 min for SS females, compared with 40 and 62 min for RS (F₁ Kou × Kisumu) females. On 1% permethrin the KdT₅₀ and KdT₉₅ were 11 and 21 min for SS compared with 18 and 33 min for RS females. Following 1 h exposure to permethrin (0.25% or 1%), no significant knockdown of Kou RR females occurred within 24 h. Permethrin irritancy to An. gambiae was assessed by comparing ‘time to first take‐off’ (TO) for females. The standard TO₅₀ and TO₉₅ values for Kisumu SS on untreated paper were 58 and 1044 s, respectively, vs. 3.7 and 16.5 s on 1% permethrin. For Kou RR females the comparable values were 27.3 s for TO₅₀ and 294 s for TO₉₅, with intermediate RS values of 10.1 s for TO₅₀ and 71.9 s for TO₉₅. Thus, TO values for RS were 2.7–4.4 times more than for SS, and those for RR were 7–18 times longer than for SS. Experiments with pyrethroid‐impregnated nets were designed to induce hungry female mosquitoes to pass through holes cut in the netting. Laboratory ‘tunnel tests’ used a bait guinea‐pig to attract mosquitoes through circular holes (5 × 1 cm) in a net screen. With untreated netting, 75–83% of laboratory‐reared females passed through the holes overnight, 63–69% blood‐fed successfully and 9–17% died, with no significant differences between SS and RR genotypes. When the netting was treated with permethrin 250 mg ai/m² the proportions that passed through the holes overnight were only 10% of SS vs. 40–46% of RR (Tola & Kou); mortality rates were 100% of SS compared with 59–82% of RR; bloodmeals were obtained by 9% of Kou RR and 17% of Tola RR, but none of the Kisumu SS females. When the net was treated with deltamethrin 25 mg ai/m² the proportions of An. gambiae that went through the holes and blood‐fed successfully were 3.9% of Kisumu SS and 3.5% of Yaokoffikro field population (94% R). Mortality rates were 97% of Kisumu SS vs. 47% of Yaokoffikro R. Evidently this deltamethrin treatment was sufficient to kill nearly all SS and half of the Yaokoffikro R An. gambiae population despite its high kdr frequency. Experimental huts at Yaokoffikro were used for overnight evaluation of bednets against An. gambiae females. The huts were sealed to prevent egress of mosquitoes released at 20.00 hours and collected at 05.00 hours. Each net was perforated with 225 square holes (2 × 2 cm). A man slept under the net as bait. With untreated nets, only 4–6% of mosquitoes died overnight and bloodmeals were taken by 17% of SS vs. 29% of Yaokoffikro R (P < 0.05). Nets treated with permethrin 500 mg/m² caused mortality rates of 95% Kisumu SS and 45% Yao R (P < 0.001) and blood‐feeding rates were reduced to 1.3% of SS vs. 8.1% of Yao R (P < 0.05). Nets treated with deltamethrin 25 mg/m² caused mortality rates of 91% Kisumu SS and 54% Yao R (P < 0.001) and reduced blood‐feeding rates to zero for SS vs. 2.5% for Yao R (P > 0.05). Pyrethroid‐impregnated bednets in experimental huts and ‘tunnel tests’ gave equivalent results, showing that nets impregnated with permethrin or deltamethrin provided good levels of protection against kdr homozygous strains of An. gambiae (Kou and Tola), and against the field population at Yaokoffikro with 94% kdr frequency. The explanation seems to be that (a) high proportions of kdr females are killed by prolonged contact with pyrethroids through diminished sensitivity to the usual irritant and repellent effects, and (b) relatively few kdr females take advantage of this prolonged contact to ingest a bloodmeal.     

Additive Interactions of Maternal Prepregnancy BMI and Breast‐feeding on Childhood Overweight

Objective: To examine the interactions of maternal prepregnancy BMI and breast‐feeding on the risk of overweight among children 2 to 14 years of age. Research Methods and Procedures: The 1996 National Longitudinal Survey of Youth, Child and Young Adult data in the United States were analyzed (n = 2636). The weighted sample represented 51.3% boys, 78.0% whites, 15.0% blacks, and 7.0% Hispanics. Childhood overweight was defined as BMI ≥95th percentile for age and sex. Maternal prepregnancy obesity was determined as BMI ≥30 kg/m². The duration of breast‐feeding was measured as the weeks of age from birth when breast‐feeding ended. Results: After adjusting for potential confounders, children whose mothers were obese before pregnancy were at a greater risk of becoming overweight [adjusted odds ratio (OR), 4.1; 95% confidence interval (CI), 2.6, 6.4] than children whose mothers had normal BMI (<25 kg/m²; p < 0.001 for linear trend). Breast‐feeding for ≥4 months was associated with a lower risk of childhood overweight (OR, 0.6; 95% CI, 0.4, 1.0; p = 0.06 for linear trend). The additive interaction between maternal prepregnancy obesity and lack of breast‐feeding was detected (p < 0.05), such that children whose mothers were obese and who were never breast‐fed had the greatest risk of becoming overweight (OR, 6.1; 95% CI, 2.9, 13.1). Discussion: The combination of maternal prepregnancy obesity and lack of breast‐feeding may be associated with a greater risk of childhood overweight. Special attention may be needed for children with obese mothers and lack of breast‐feeding in developing childhood obesity intervention programs.