Factors influencing the use of bed nets in Mbarara municipality of Uganda.
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In order to identify independent predictors for bed net use, respondents from 643 households selected randomly from 21 clusters were interviewed in Mbarara municipality, Uganda. Respondents answered questions about demographic characteristics, social economic conditions, causes and transmission of malaria, beliefs about severity and complications of malaria, malaria morbidity and health care-seeking behavior, perceived control of malaria prevention, beliefs about utility of bed nets, perceived susceptibility to malaria, and whether they use bed nets or not. Univariate and multivariate logistic regression analyses were used to identify predictors for bed net use. Fifty-five percent (356 of 643) of the households had bed net users. The independent factors that favored bed net use were as follows: 1) age < 30 years, 2) ownership of a television, 3) having mosquito nets in ventilators of the house, 4) being a skilled worker or a professional, or owning a major business, 5) living in a permanent house, 6) believing that bed nets prevent malaria, 7) believing that bed nets are worth their cost, 8) not believing that convulsions cannot be cured by modern medicine, and 9) believing that bed nets are not expensive. The strongest predictors of bed net use are living in a permanent house and agreeing that bed nets are worth their cost, with adjusted odds ratios of 4.29 (95% confidence interval, 2.76-6.71) and 3.93 (95% confidence interval, 2.5-26.13), respectively. These data suggest that in order to increase the use of bed nets, the price of bed nets needs to be reduced and educational messages that stress the favorable use of bed nets need to be increased. (+info)
Educational campaign versus malathion spraying for the control of Aedes aegypti in Colima, Mexico.
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OBJECTIVE: To evaluate the effect of an educational campaign for reducing the breeding places of Aedes aegypti, the principal vector of dengue; and to compare its effects with the ones obtained by spraying of malathion at ultralow volume. DESIGN: Randomised community trial. SETTING: Colima city, in the State of Colima, Mexico. PARTICIPANTS: Householders of 187 houses, randomly selected from the west sector of the city. DATA: In each house, an entomological survey was done, as well as one for knowledge, attitude and practices (KAP), before the intervention and six months after. The intervention consisted of educational campaign alone (47 houses); malathion spraying at ultra low volume alone (46 houses); both treatments simultaneously (49 houses) and no intervention, or control group (45 houses). MAIN RESULTS: The global average of the positive containers by house (C+/C) was reduced from 0.97 to 0.77. A two way analysis of variance showed that this reduction was more apparent in the houses that received educational campaign (F=8.4, p<0.005) with relation to the ones that received malathion spraying (F=0.38, p>0.5), while the combination of both treatments demonstrated a discrete negative interaction (F=6.52, p<0.05). These effects were independent of climatic changes and level of knowledge about dengue, as the KAP indicator did not show any significant changes in any group (F=1.14, p>0.1). CONCLUSION: The results indicated that the educational campaign reduced the A aegypti breeding places more effectively than the use of chemicals spraying, and that the combination of both treatments can reduce its efficiency, possibly because of the false expectancy of protection that spraying creates. The KAP surveys seemed to have very limited value in evaluating quantitatively the programmes of eradication of the dengue vector. (+info)
Dichlorodiphenyltrichloroethane (DDT): ubiquity, persistence, and risks.
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Due to uncontrolled use for several decades, dichlorodiphenyltrichloroethane (DDT), probably the best known and most useful insecticide in the world, has damaged wildlife and might have negative effects on human health. This review gives a brief history of the use of DDT in various countries and presents the results of epidemiologic and experimental studies of carcinogenesis. Even though its use has been prohibited in most countries for ecologic considerations, mainly because of its negative impact on wildlife, it is still used in some developing countries for essential public health purposes, and it is still produced for export in at least three countries. Due to its stability and its capacity to accumulate in adipose tissue, it is found in human tissues, and there is now not a single living organism on the planet that does not contain DDT. The possible contribution of DDT to increasing the risks for cancers at various sites and its possible role as an endocrine disruptor deserve further investigation. Although there is convincing experimental evidence for the carcinogenicity of DDT and of its main metabolites DDE and DDD, epidemiologic studies have provided contrasting or inconclusive, although prevailingly negative, results. The presence and persistence of DDT and its metabolites worldwide are still problems of great relevance to public health. Efficient pesticides that do not have the negative properties of DDT, together with the development of alternative methods to fight malaria, should be sought with the goal of completely banning DDT. (+info)
Resurgence in filarial transmission after withdrawal of mass drug administration and the relationship between antigenaemia and microfilaraemia--a longitudinal study.
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Seven village units endemic for filariasis were assigned randomly into three arms with different intervention strategies in the years 1995 and 1996. Villages in Group A received two annual mass drug administrations (MDAs) of diethylcarbamazine (DEC) plus ivermectin (IVR). Group B received the same MDAs in combination with vector control; in Group C only placebo was administered. Post-treatment evaluation in 1997 revealed marked reductions in microfilaraemia prevalences (MFP) and geometric mean intensities (GMI). Subsequently, vector control in Group B was continued by the community. Groups A and B received no MDAs between 1997 and 1999 and were re-evaluated in 1999. During this evaluation, antigenaemia prevalence (AGP) was estimated along with MFP, using immunochromatographic test (ICT) kits. The gains of the MDAs were sustained in Group B, while resurgences occurred in Group A, where annual transmission potential (ATP) rose from 21 to 631.6 and MFP doubled. Group C continued to have high ATPs (1057-1617), while Group B had very low ATPs (0-63). After Mulla's corrections, the reductions in MFP were 62.7 and 83.5% and for GMI 72.1 and 91.4% in Group A and B, respectively, compared with Group C. Vector control preserved the gains of MDAs and accounted for 55.8% and 67.1% reductions in MFP and GMI in Group B compared with Group A. The reductions in AGP were 29.4% in Group A and 39.2% in Group B against Group C. The differences between MFP and AGP were nearly uniform across all villages and there was a significant correlation (r=0.98) between the two variables. A similar significant relationship was observed between MFP and AGP values across age groups (r=0.95). Prediction of AGP values from MFP values was proposed with regression equations. We conclude that vector control would be useful as an adjuvant to chemotherapy to prevent resurgences. (+info)
Community factors associated with malaria prevention by mosquito nets: an exploratory study in rural Burkina Faso.
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Malaria-related knowledge, attitudes and practices (KAP) were examined in a rural and partly urban multiethnic population of Kossi province in north-western Burkina Faso prior to the establishment of a local insecticide-treated bednet (ITN) programme. Various individual and group interviews were conducted, and a structured questionnaire was administered to a random sample of 210 heads of households in selected villages and the provincial capital of Nouna. Soumaya, the local illness concept closest to the biomedical term malaria, covers a broad range of recognized signs and symptoms. Aetiologically, soumaya is associated with mosquito bites but also with a number of other perceived causes. The disease entity is perceived as a major burden to the community and is usually treated by both traditional and western methods. Malaria preventive practices are restricted to limited chloroquine prophylaxis in pregnant women. Protective measures against mosquitoes are, however, widespread through the use of mosquito nets, mosquito coils, insecticide sprays and traditional repellents. Mosquito nets are mainly used during the rainy season and most of the existing nets are used by adults, particularly heads of households. Mosquito nets treated with insecticide (ITN) are known to the population through various information channels. People are willing to treat existing nets and to buy ITNs, but only if such services would be offered at reduced prices and in closer proximity to the households. These findings have practical implications for the design of ITN programmes in rural areas of sub-Saharan Africa (SSA). (+info)
Japanese viral encephalitis.
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One of the leading causes of acute encephalopathy in children in the tropics is Japanese encephalitis (JE). Transmitted by the culex mosquito, this neurotropic virus predominately affects the thalamus, anterior horns of the spinal cord, cerebral cortex, and cerebellum. It mainly affects children <15 years and is mostly asymptomatic. The occasional symptomatic child typically presents with a neurological syndrome characterised by altered sensorium, seizures, and features of intracranial hypertension. Aetiological diagnosis is based on virus isolation or demonstration of virus specific antigen or antibodies in the cerebrospinal fluid/blood. Though no antiviral drug is available against JE, effective supportive management can improve the outcome. Control of JE involves efficient vector control and appropriate use of vaccines. (+info)
Integrated approach to malaria control.
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Malaria draws global attention in a cyclic manner, with interest and associated financing waxing and waning according to political and humanitarian concerns. Currently we are on an upswing, which should be carefully developed. Malaria parasites have been eliminated from Europe and North America through the use of residual insecticides and manipulation of environmental and ecological characteristics; however, in many tropical and some temperate areas the incidence of disease is increasing dramatically. Much of this increase results from a breakdown of effective control methods developed and implemented in the 1960s, but it has also occurred because of a lack of trained scientists and control specialists who live and work in the areas of endemic infection. Add to this the widespread resistance to the most effective antimalarial drug, chloroquine, developing resistance to other first-line drugs such as sulfadoxine-pyrimethamine, and resistance of certain vector species of mosquito to some of the previously effective insecticides and we have a crisis situation. Vaccine research has proceeded for over 30 years, but as yet there is no effective product, although research continues in many promising areas. A global strategy for malaria control has been accepted, but there are critics who suggest that the single strategy cannot confront the wide range of conditions in which malaria exists and that reliance on chemotherapy without proper control of drug usage and diagnosis will select for drug resistant parasites, thus exacerbating the problem. An integrated approach to control using vector control strategies based on the biology of the mosquito, the epidemiology of the parasite, and human behavior patterns is needed to prevent continued upsurge in malaria in the endemic areas. (+info)
Late season commercial mosquito trap and host seeking activity evaluation against mosquitoes in a malarious area of the Republic of Korea.
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Field trials evaluating selected commercially available mosquito traps variously baited with light, carbon dioxide, and/or octenol were conducted from 18-27 September 2000 in a malarious area near Paekyeon-ri (Tongil-Chon) and Camp Greaves in Paju County, Kyonggi Province, Republic of Korea. The host-seeking activity for common mosquito species, including the primary vector of Japanese encephalitis, Culex tritaeniorhynchus Giles, was determined using hourly aspirator collections from a human and propane lantern-baited Shannon trap during hours when temperatures exceeded 15 degrees C. The total number of mosquitoes and number of each species captured during the test was compared using a block design. Significant differences were observed for the total number of mosquitoes collected, such that, the Mosquito MagnetTM with octenol > Shannon trap > ABC light trap with light and dry ice > Miniature Black Light trap (manufactured by John W. Hock) > or = New Jersey Trap > ABC light trap with light only. Significant differences in numbers collected among traps were noted for several species including: Aedes vexans (Meigen), Anopheles lesteri Baisas and Hu. An. sinensis Weidemann. An. sineroides Yamada, An. yatsushiroensis Miyazaki, Culex pipiens pallens Coquillett L., Cx. orientalis Edwards and Cx. tritaeniorhynchus. Host-seeking activity for most common species showed a similar bimodal pattern. Results from these field trap evaluations can significantly enhance current vector and disease surveillance efforts especially for the primary vector of Japanese encephalitis, Cx. tritaeniorhynchus. (+info)