Molecular surveillance of the antifolate-resistant mutation I164L in imported african isolates of Plasmodium falciparum in Europe: sentinel data from TropNetEurop

Background

Malaria control programmes utilising indoor residual spraying are only effective if a high coverage of targeted structures is achieved and an insecticide that is effective against the specific mosquito vector is correctly applied. Ongoing monitoring of spraying operations is essential to assure optimal programme performance and early corrective action, where indicated.

Methods

Successful development and application of a computerised spraying operations management system in Mpumalanga Province, South Africa during 1998 resulted in its adaptation and introduction in neighbouring Maputo Province, southern Mozambique during 2000. The structure and components of this computerised management system are described, and its' operational benefit in southern Mozambique, where community-based spray operators apply intradomiciliary insecticide, are reviewed.

Conclusions

The computerised management system allowed malaria programme management and field supervisors to monitor spraying coverage, insecticide consumption and application rates on an ongoing basis. The system supported a successful transition to community-based spraying, while assuring correct insecticide application and spraying completion according to schedule.     

Doctor-patient communications revisited

To test a new approach to detecting and managing hypertension, 34 family practices in southwestern Ontario that comprised 32 124 patients aged 20 to 65 years were randomly assigned in a 5-year study to either undertake a system of care in which a medical assistant oversaw screening and attended to education, compliance and follow-up (experimental group) or continue their usual practices (control group). The 17 physicians in the experimental practices (15 659 patients) were matched with the 17 in the control practices (16 465 patients) according to size of the community, sex, level of practice activity and length of time in practice. Hypertension was defined as at least two diastolic blood pressure readings over 90 mm Hg. More patients in the experimental group than in the control group were screened at least once (91% v. 80%); the former were more likely to have lower systolic blood pressure (p less than 0.02), to be compliant (p less than 0.05) and to be very satisfied with care (p less than 0.01). There were no significant differences between the two groups in the rates of illness and death due to cardiovascular disease for all patients or for hypertensive patients. The unassisted family physician can provide effective care for hypertensive patients. However, minor modifications in the physician''s practices can improve care.     

Conservation of Glycerolated Cultures of Ochromonas danica and O. malhamensis at −10 C

SYNOPSIS. Ochromonas danica in a complex natural growth medium dies at 6–10 C in 4 days; O. malhamensis in ∼2 days. O. danica grown in the medium supplemented with 4.0% glycerol survived at −10±2 C for 35 days, and with 8% glycerol 29 days. O. malhamensis lasted only to 5 days in these media supplemented with 4% glycerol. Ethylene glycol and dimethylsulfoxide were too toxic to be effective. Difficulties in freeze-preservation of certain other phagocytic cells, notably blood granulocytes having comparatively simple flexuous outer membranes, add interest to use of O. danica and O. malhamensis as test organisms for preservation methods, especially in the convenient, inexpensive -10 to -20 C range. Biphasic media with an overlay of distilled water serve for conservation at room temperature. Problems of mutational erosion of these photosynthetic phagotrophs are discussed.