Malaria in Laconia, Greece, then and now: a 2500-year-old pattern

Density tunable dispersive solid phase extraction of four organochlorine pesticides from edible oil sample using rhodamine B as a sorbent prior to GC-MS analysis

In this study, a new method was used to evaluate the levels of four organochlorine pesticides in edible samples. In this method, a density tunable dispersive solid phase extraction procedure was coupled with gas chromatography-mass spectrometry. Rhodamine B was used as a sorbent, which was distributed throughout the oil matrix with the aid of evaporation of methanol. This process enabled the possibility of effective extraction and preconcentration of the target analytes. To achieve this goal, several factors affecting the extraction efficiency, including the type and volume of diluent, the amount of rhodamine B, the volume of methanol, and the temperature of the ultrasonic bath were carefully evaluated. This method provided low detection limits (from 0.21 to 0.36 ng g-1), wide linear range (1.1-100 ng g-1) and acceptable extraction recoveries (64-72%) and enrichment factors (102-115). The precision of the method was evaluated by calculating the relative standard deviation, which ranged from 3.6 to 6.8% for intra- and 3.1 to 8.8% for inter-day precisions. The investigated method reduced the interference of the matrix and provided the possibility of quantitative determination of the studied organochlorine pesticides in various oil samples (canola, corn, sunflower, and olive). This method introduced a reliable analytical tool for the monitoring of the pesticide residues in different oil samples by providing capabilities such as simplicity, sensitivity, and compatibility with the environment.

The changing risk patterns of Plasmodium vivax malaria in Greece due to climate change

It has great importance to study the potential effects of climate change on Plasmodium vivax malaria in Greece because the country can be the origin of the spread of vivax malaria to the northern areas. The potential lengths of the transmission seasons of Plasmodium vivax malaria were forecasted for 2041-2060 and 2061-2080 and were combined. The potential ranges were predicted by Climate Envelope Modelling Method. The models show moderate areal increase and altitudinal shift in the malaria-endemic areas in Greece in the future. The length of the transmission season is predicted to increase by 1 to 2 months, mainly in the mid-elevation regions and the Aegean Archipelago. The combined factors also predict the decrease of vivax malaria-free area in Greece. It can be concluded that rather the elongation of the transmission season will lead to an increase of the malaria risk in Greece than the increase in the suitability values.

Malaria in Europe: A Historical Perspective

Endemic malaria, which claimed 229 million new cases and 409,000 deaths in 2019 mainly in Africa, was eradicated from Europe by the mid-20th century. Historical descriptions of intermittent tertian and quartan fever reported in texts of Hippocrates in Greece and Celsus in Italy suggest malaria. A few paleomicrobiology investigations have confirmed the presence of malarial parasite Plasmodium falciparum in 1st, 2nd, and 5th century infected individuals in diverse regions of Italy, and Plasmodium sp. later in Bavaria. The causative Plasmodium pathogens, discovered in the 19th century in Algeria, were controversially used as therapeutic agents in the European pharmacopeia more than two centuries after effective quinine-based treatments had been introduced in Europe. How Europe managed to eradicate malaria and what the history of malaria was in Europe are of medical interest, and this review traces research pathways for a renewed understanding of malaria eradication in Europe through combined historical and paleomicrobiological investigations.

Prevention of Malaria Resurgence in Greece through the Association of Mass Drug Administration (MDA) to Immigrants from Malaria-Endemic Regions and Standard Control Measures

Greece was declared malaria-free in 1974 after a long antimalarial fight. In 2011–2012, an outbreak of P. vivax malaria was reported in Evrotas, an agricultural area in Southern Greece, where a large number of immigrants from endemic countries live and work. A total of 46 locally acquired and 38 imported malaria cases were detected. Despite a significant decrease of the number of malaria cases in 2012, a mass drug administration (MDA) program was considered as an additional measure to prevent reestablishment of the disease in the area. During 2013 and 2014, a combination of 3-day chloroquine and 14-day primaquine treatment was administered under direct observation to immigrants living in the epicenter of the 2011 outbreak in Evrotas. Adverse events were managed and recorded on a daily basis. The control measures implemented since 2011 continued during the period of 2013–2014 as a part of a national integrated malaria control program that included active case detection (ACD), vector control measures and community education. The MDA program was started prior to the transmission periods (from May to December). One thousand ninety four (1094) immigrants successfully completed the treatment, corresponding to 87.3% coverage of the target population. A total of 688 adverse events were recorded in 397 (36.2%, 95% C.I.: 33.4–39.1) persons, the vast majority minor, predominantly dizziness and headache for chloroquine (284 events) and abdominal pain (85 events) for primaquine. A single case of primaquine-induced hemolysis was recorded in a person whose initial G6PD test proved incorrect. No malaria cases were recorded in Evrotas, Laconia, in 2013 and 2014, though three locally acquired malaria cases were recorded in other regions of Greece in 2013. Preventive antimalarial MDA to a high-risk population in a low transmission setting appears to have synergized with the usual antimalarial activities to achieve malaria elimination. This study suggests that judicious use of MDA can be a useful addition to the antimalarial armamentarium in areas threatened with the reintroduction of the disease.

Greece was declared malaria-free in the year 1974 after a long antimalarial fight. In 2011–2012, a number of malaria cases reported in Evrotas, Laconia, in Southern Greece, where a large number of immigrants from malaria-endemic countries live and work. A total of 84 malaria cases, both in immigrants (38 cases) and in Greeks (46 cases), were detected. A number of malaria control measures were deployed in the area since 2011. Despite a decrease of the number of malaria cases in 2012, elimination could not be achieved, and thus antimalarial MDA was considered as an additional measure to prevent the reestablishment of the disease. During 2013 and 2014, a combination of two drugs was administered under direct observation to all immigrants in the epicenter of the 2011 Evrotas outbreak. The antimalarial MDA program was started on July-August and was successfully completed by 1094 immigrants (87.3% coverage). No serious adverse events were recorded except one case of primaquine-induced hemolysis due to false G6PD test result. In 2013 and 2014, no malaria cases were recorded in Evrotas, Laconia. This study suggests that careful use of supervised antimalarial MDA is a useful addition to the antimalarial control measures in areas threatened with the reintroduction of the disease.

Big Events in Greece and HIV Infection Among People Who Inject Drugs

Big Events are processes like macroeconomic transitions that have lowered social well-being in various settings in the past. Greece has been hit by the global crisis and experienced an HIV outbreak among people who inject drugs. Since the crisis began (2008), Greece has seen population displacement, inter-communal violence, cuts in governmental expenditures, and social movements. These may have affected normative regulation, networks, and behaviors. However, most pathways to risk remain unknown or unmeasured. We use what is known and unknown about the Greek HIV outbreak to suggest modifications in Big Events models and the need for additional research.

Study of Culex tritaeniorhynchus and species composition of mosquitoes in a rice field in Greece

Mosquito species composition and seasonal abundance were studied in a rice field in western Greece over a three-year period (2009-2011). A total of 11,716 larvae and pupae of mosquitoes were recorded, representing seven species, namely Aedes caspius (Pallas), Anopheles hyrcanus (Pallas), Anopheles sacharovi Favre, Culex theileri Theobald, Culex tritaeniorhynchus Giles, Culex pipiens Linnaeus, Uranotaenia unguiculata Edwards and belonging to four genera. Cx. tritaeniorhynchus constituted the most abundant species. It is the second recorded occurrence of this species in Greece, but the first time that a high population of this mosquito species is recorded in the country. In all three years, the total population density of mosquitoes was found to be higher in early August. The number of immatures of all species was found higher in 2009 and 2010 than in 2011, as well was that of the Cx. tritaeniorhynchus adults derived from the rearing of the collected immatures. This regularity is probably due to the lack of water in the rice field in early August 2011. Cx. tritaeniorhynchus was found to be the most abundant species after the rearing of immatures representing 85.1%, 93.5% and 96.1% of the total number of the mosquito adults in 2009, 2010 and 2011, respectively. The rice culturing practices may have affected the seasonal occurrence of mosquito immatures in all of the study years.