Hybridization studies to modify the host preference of Anopheles gambiae

A strategy to decrease the vector competence of Anopheles gambiae sensu stricto (Diptera: Culicidae), the most efficient malaria vector in Africa, may consist of exploiting the genes involved in zoophily. Crossing and backcrossing experiments were performed between An. gambiae s.s. and the zoophilic sibling species Anopheles quadriannulatus. Mosquito strains were tested in a dual-choice olfactometer to investigate their responses to cow odour. Totals of 12% of An. gambiae s.s. and 59% of An. quadriannulatus selected the port with the cow odour. Crosses and backcrosses did not show a significant preference for the cow-baited port. The results indicated that anthropophilic behaviour in An. gambiae s.s. is a dominant or partially dominant trait, which, in conjunction with the unstable zoophilic behaviour observed in An. quadriannulatus, poses a serious obstacle to plans to decrease vector competence by modifying the anthropophilic trait.

Insecticide-treated bed-nets for malaria mosquito control

Pyrethroid-treated bed-nets act against late-night biting mosquitoes, like traps baited by the body odor of the occupant. The personal protective effect of treated nets is considerable, even if they are torn. However, some biting of the occupants does occur, as shown by matching microsatellite alleles in mosquito blood meals to those of net occupants. When whole communities were provided with treated nets, ovarian age grading showed that mosquito survival was reduced, and so was the number of sporozoite-positive mosquitoes in malarious communities. Thus, a high percentage of coverage of all members of malaria-endemic communities is considered to be the most effective way of providing protection for highly malaria-vulnerable children and pregnant women. Teams distributing nets or retreating them free of charge show high productivity, and we consider this the most cost-effective way to proceed. There is evidence for reduced anti-malaria antibody levels in children in communities where treated nets have long been used. However, overall benefits in reduced anemia and mortality are sustained. A high frequency of the kdr resistance gene has not prevented pyrethroid-treated nets from functioning, but it is important to develop alternative fabric treatments in case stronger forms of resistance emerge.

Masked, controlled study to investigate the efficacy of a Staphylococcus intermedius autogenous bacterin for the control of canine idiopathic recurrent superficial pyoderma

A masked, controlled study was designed to investigate the clinical efficacy of a staphylococcal autogenous bacterin for the control of canine idiopathic recurrent pyoderma (IRP). Ten dogs with at least three prior episodes of recurrent superficial pyoderma were recruited. All were screened and found to be free of ectoparasitic and fungal disease and failed to respond favourably to a dietary trial. Those exhibiting signs of pruritus responded completely to antibacterial therapy. Haematological and biochemical parameters were generally unremarkable and all dogs were euthyroid. Staphylococcus intermedius cultures from lesions were used to produce an autogenous bacterin for each animal. A numerical 'lesion score' was allocated and dogs were randomly divided into two groups of five (groups 1 and 2). Both groups received a 4-week course of antibiotic; group 1 also received concurrent s/c injections of bacterin, which continued until week 10. Group 2 received no additional therapy. All dogs were re-examined and rescored at weeks 5 and 10 and repeat blood samples were submitted at week 10 to screen for adverse effects. Comparison of scores at week 0 and week 5 (Mann-Whitney U-test) revealed no significant differences between the groups. At week 10, group 2 (control group) individual lesion scores were significantly higher compared with the group receiving bacterin (P < 0.05) and there was a significantly greater increase in the sum of the individual lesion scores for group 2 compared with group 1, from week 5 to week 10 (P < 0.05). No adverse reactions to bacterin therapy were detected. These results suggest that autogenous bacterins may provide an alternative, safe, effective method for the control of canine IRP. Further studies using larger groups of dogs and for a longer follow-up period are now warranted.

Comparison of coverage with insecticide-treated nets in a Tanzanian town and villages where nets and insecticide are either marketed or provided free of charge

BACKGROUND

There is much emphasis on social marketing as a means of scaling up coverage with insecticide-treated nets and the question has arisen whether nets provided free-of-charge will be looked after by householders.

METHODS

Over several years questionnaires and surveys of usage and condition of nets were carried out throughout a town and 15 villages in north-east Tanzania, where nets and insecticide have to be purchased and in 24 other villages where over 15000 nets had been donated and annual re-treatment is provided free-of-charge.

RESULTS

There was very high population coverage in the town but, in the villages where nets have to be purchased, only 9.3% of people used nets which were intact and/or had been insecticide-treated and could, therefore, provide protection. However, where nets had been provided free, over 90% of the nets were still present and were brought for re-treatment several years later.

CONCLUSION

In this part of Tanzania, social marketing has performed well in a town but very poorly in villages. However, the study showed that people look after and bring for re-treatment nets which had been provided free-of-charge.

Tests of Olyset nets by bioassay and in experimental huts

BACKGROUND

Olyset nets are a type of long-lasting insecticidal net made of polyethylene fibre with permethrin incorporated into it and with a 4 mm mesh size.

BIOASSAYS

Olyset netting was wrapped around a wire frame and the mosquitoes were released inside for bioassays. There was significantly faster knockdown and higher percent mortality than bioassays with the netting attached to a WHO cone with a piece of cardboard on the other side of the net to prevent escapes through the large mesh. It is suggested that with the latter method some mosquitoes place their tarsae through the mesh on to the cardboard, thus avoiding insecticide contact.

TRIALS IN EXPERIMENTAL HUTS

Four mm mesh nets were compared with conventional 1.5 mm mesh nets treated with permethrin. In further trials in huts Olyset nets which were either unwashed or five times washed, with or without subsequent heating, and a Olyset net which had been in domestic use for four years or a new Olyset net were compared with a net treated with bifenthrin.

RESULTS & CONCLUSION

In all cases Anopheles biting on sleepers under the nets was reduced and Anopheles mortality was increased by the use of the insecticidal nets. No significant impact of washing or heating was detected and an Olyset net was as good as new after four years use, but did not cause as much mosquito mortality as bifenthrin treated nets.

Optimal life stage for radiation sterilization of Anopheles males and their fitness for release

Mating by male Anopheles mosquitoes (Diptera: Culicidae) was evaluated in the laboratory to assess fitness effects of radio-sterilization applied during different life stages of the malaria vectors An. stephensi Liston and An. gambiae Giles sensu stricto. After reproductive sterilization by gamma-irradiation (120 Gy), equal proportions of sterile and fertile (unirradiated) male adults were released into cages with virgin females and allowed to compete for matings. Radio-sterilization was applied when the males were pupae aged 0-7 h or 24-32 h, or adults aged <24 h or 24-55 h. After being radio-sterilized in the adult stage, males of both species competed effectively with unirradiated males, whereas those sterilized in the pupal stage obtained significantly fewer matings than unirradiated males from the same cohort. There was no evidence of females obtaining multiple inseminations. These findings emphasize the need to radio-sterilize males as adults in order to minimize the fitness cost. Such males may be intended for sterile insect technique population suppression or for trial releases of transgenic anophelines.

Multi-country field trials comparing wash-resistance of PermaNet and conventional insecticide-treated nets against anopheline and culicine mosquitoes

Insecticide-treated bednets (ITNs) are commonly used as a means of personal protection from malaria transmission by anopheline mosquitoes (Diptera: Culicidae). Long-lasting insecticidal nets (LLINs) have special treatments intended to remain effective after many washes. The present trials assessed the efficacy and wash-resistance of several production batches of PermaNet (polyester net coated with polymer resin containing pyrethroid insecticide deltamethrin 55 mg ai/m2) against malaria vectors in Pakistan, Iran and Tanzania compared to ITNs conventionally treated with alphacypermethrin 15 or 20 mg ai/m2, or deltamethrin 25 or 50 mg ai/m2. Insecticidal efficacy of the nets before and after repeated washing (using W.H.O. recommended and traditional local washing procedures) was monitored through contact bioassays with Anopheles and by experimental hut and outdoor platform tests. Local washing regimes gradually reduced the insecticidal efficacy of conventionally treated nets, but they were not exhausted, even after 21 washes. Using a more rigorous laboratory washing method, insecticide was more readily stripped from conventionally treated nets. PermaNet retained high efficacy after 21 washes, giving more than 97% mortality of Anopheles in contact bioassays with 3-min exposure. Using the more sensitive bioassay criterion of 'median time to knockdown', PermaNet showed no loss of insecticidal activity against Anopheles after washing repeatedly in 2 out of 6 trials; whereas in a further three trials knockdown activity of PermaNet and conventional ITNs declined at comparable rates. Higher mortality levels of Anopheles in contact bioassays did not always translate to superiority in experimental hut or enclosed platform trials. In only one of four comparative field trials did PermaNet out-perform conventional ITNs after washing: this was in the trial of PermaNet 2.0--the product with improved quality assurance. Because PermaNet and conventionally treated nets were both quite tolerant of local washing procedures, it is important in field trials to compare LLINs with conventional ITNs washed an equivalent number of times. Our comparison of PermaNet 2.0 against conventionally treated deltamethrin nets (CTDN) in Pakistan demonstrated superior performance of the LLIN after 20 washes in phase I and phase II bioassays, and this was corroborated by chemical assays of residual deltamethrin. Although PermaNet 2.0 has received WHOPES interim recommendation for malaria control purposes, its performance should be monitored in everyday use throughout its lifespan in various cultural settings to assess its durability and long-term effectiveness for malaria prevention and control. As many millions of conventionally treated nets are already in routine use, and these will require regular re-treatment, programme strategies should be careful to preserve the effectiveness of ITNS before and after establishing the reliability of LLINs in long-term use.

Horizontal and vertical dispersal of dengue vector mosquitoes, Aedes aegypti and Aedes albopictus, in Singapore

To study the dispersal of dengue vector mosquitoes in Singapore, females of Aedes aegypti (L.) and Aedes albopictus (Skuse) (Diptera: Culicidae) were fed blood containing rubidium (Rb), which was detectable in their eggs by means of Graphite Furnace Atomic Absorption Spectrophotometry (GFAAS). Laboratory calibration of the Rb reading, for a range of egg numbers from Rb-fed females, indicated a reasonably linear relationship and an unequivocal distinction between results with zero and one marked egg. Rb-marked female Aedes mosquitoes aged 3-5 days were released in semi-rural and urbanized parts of Singapore, with an array of ovitraps extending to a radius of 320 m from the release point. Subsequently, Rb-marked Aedes eggs were detected throughout the array, with similar distributions on each of the 4 days after release. More Rb was detected nearer the release point. However, when correction was made for the greater areas of zones further from the release point (and therefore presumably existence of more alternative oviposition sites), there were no significant differences in the numbers of marked eggs per ovitrap in the zones nearer or further from the release points. It is concluded that females of both these Aedes (Stegomyia) species could disperse easily and quickly throughout areas of radius 320 m in search of oviposition sites. This contrasts with the general belief that Ae. aegypti seldom flies more than 50 m and that control operations can safely be based on such an assumption. Releases on level 12 of a 21-storey apartment block, with ovitraps on each storey, showed similar easy and rapid dispersal to the top and bottom of the block.

Control of vectors and incidence of malaria in an irrigated settlement scheme in Sri Lanka by using the insect growth regulator pyriproxyfen

An evaluation of pyriproxyfen as a larval control agent with the aim of reducing malaria vector populations and incidence of malaria was conducted in 12 villages in an irrigated settlement scheme in the dry zone of central Sri Lanka. In these villages, there are many pools in the beds of rivers, streams, and irrigation ditches during the dry season of the year. These are the major breeding places of the malaria vectors Anopheles culicifacies and An. subpictus. Collections of adult mosquitoes were carried out by using standard methods and parasitological data were collected by daily malaria clinics set up for the project and through the 2 government hospitals. All villages in the study area were under residual house spraying with lambdacyhalothrin water-dispersible powder. Using the 1st year's baseline data collection, the villages were stratified into 6 villages with high malaria incidence and 6 villages with low incidence. Within each group, 3 villages were randomly assigned for larval control by treating all the pools in the beds of rivers, streams, and irrigation ditches and agricultural wells with a granular formulation of the insect growth regulator pyriproxyfen at the rate of 0.01 mg active ingredient/liter. The field bioassays indicated that a single treatment of pyriproxyfen effectively inhibited the emergence of adult mosquitoes in the riverbed pools for a period of 190 days. The treatment caused significant reduction of the adult populations of An. culicifacies (78%) and An. subpictus (72%). Similarly, incidence of malaria was reduced in the treatment villages by about 70% (95% confidence interval 58-78%) compared with the controls. The conclusion is made that pyriproxyfen can be a very effective means of malaria control if all possible vector breeding places in the area can be located.

Vectors and malaria transmission in a gem mining area in Sri Lanka

Anopheline vectors of malaria were studied in the Kaluganga gem mining area in the dry zone of central Sri Lanka. Adult mosquitoes were collected using cattle-baited huts and nets, pyrethrum spray sheets, window exit traps and light traps and partial and full-night human landing collections over a period of 17 mo. The collections produced a total of 13,591 anophelines belonging to 14 species. Using ELISA for circumsporozoite proteins of Plasmodium vivax and P. falciparum, Anopheles culicifacies, An. subpictus and An. varuna were incriminated as malaria vectors. For these species, estimated entomological inoculation rates were 5.9, 5.7, and 6.7 infective bites per person per year, respectively. An. culicifacies and An. subpictus show endophagic behavior, while An. varuna were exophagic. Mosquito larval surveys indicated that the gem pits, when filled with water, contributed 60% of the larvae of the three vector species. Parasitological data were collected by two mobile malaria clinics and by hospitals. The incidence rates of fever per 1,000 person-years with P. vivax and P. falciparum were 122.8 and 26.1 respectively, with a significantly higher rate in males over 15 years of age than in females of that age. Changes in the environment due to gem mining may have caused the emergence of An. subpictus and An. varuna as significant malaria vectors. The conventional view of An. culicifacies being the main vector of malaria in Sri Lanka needs to be reconsidered when planning the vector control programs in this study area. Due to migration of malaria patients, there is a likelihood the disease could be spread to other parts of the island. Therefore, action should be taken to eliminate these pits as breeding sites.

Investigation of negative cross-resistance as a resistance-management tool for insecticide-treated nets

Resistance management for insecticide-treated nets (ITNs) remains a challenge. Options are limited, because a safe and highly active insecticide with a persistence of several months is required. These criteria have only been met by pyrethroids, although organophosphates (OPs) and carbamates have been considered as alternatives for impregnation of eave curtains. It has been observed that some pyrethroid-resistant mosquito strains show increased OP susceptibility over pyrethroid-susceptible strains (i.e., negative cross-resistance). The current study investigated whether this phenomenon applies to a range of mosquito species and strains, because a mixture or rotation strategy for resistance management could then be envisaged. Adult female mosquitoes from laboratory strains of Anopheles stephensi Liston, Anopheles gambiae Giles, and Culex quinquefasciatus Say were tested in World Health Organization susceptibility test kits. For An. stephensi, the highly pyrethroid-resistant DUB 234 strain showed the same level of resistance to malathion as the pyrethroid-susceptible DUB S. The malathion-resistant ST MAL strain was as susceptible to pyrethroids as the insecticide-susceptible BEECH. For An. gambiae, the malathion tolerance of the previously pyrethroid-resistant RSP strain was significantly higher than that of the insecticide-susceptible KWA. For Cx. quinquefasciatus, selection of the QUINQ strain with permethrin abolished preexisting resistance to the OP malathion as pyrethroid resistance increased, rendering the strain more susceptible to malathion than PEL SS. Some indication of negative cross-resistance to malathion was found for the permethrin-resistant MUHEZA strain. The occurrence of negative cross-resistance seems dependent on the history of insecticide selection and is not generally applicable. Resistance management for ITNs will need to use mechanisms other than negative cross-resistance to be effective.

Experimental hut comparisons of nets treated with carbamate or pyrethroid insecticides, washed or unwashed, against pyrethroid-resistant mosquitoes

The efficacy against mosquitoes (Diptera: Culicidae) of a bednet treated with carbamate insecticide [carbosulfan capsule suspension (CS) 200 mg/m(2)] was compared with four types of pyrethroid-treated nets in veranda-trap huts at Yaokoffikro near Bouaké, Côte d'Ivoire, where the malaria vector Anopheles gambiae Giles carries the kdr gene (conferring pyrethroid resistance) at high frequency and Culex quinquefasciatus Say is also pyrethroid resistant. Pyrethroids compared were lambdacyhalothrin CS 18 mg/m(2), alphacypermethrin water dispersible granules (WG) 20 mg/m(2), deltamethrin 50 mg/m(2) (Permanet) and permethrin emulsifiable concentrate (EC) 500 mg/m(2). Insecticidal power and personal protection from mosquito bites were assessed before and after the nets were used for 8 months and hand washed five times in cold soapy water. Before washing, all treatments except permethrin significantly reduced blood-feeding and all had significant insecticidal activity against An. gambiae. The carbosulfan net gave significantly higher killing of An. gambiae than all pyrethroid treatments except the Permanet. Against Culex spp., carbosulfan was more insecticidal and gave a significantly better protective effect than any of the pyrethroid treatments. After washing, treated nets retained various degrees of efficacy against both mosquito genera - but least for the carbosulfan net. Washed nets with three types of pyrethroid treatment (alphacypermethrin, lambdacyhalothrin, permethrin) gave significantly higher mortality rates of Culex than in huts with the same pyrethroid-treated nets before washing. After five washes, the Permanet, which is sold as a long-lasting insecticidal product, performed no better than the other nets in our experimental conditions.

Chronic illness as a result of low-level exposure to synthetic pyrethroid insecticides: a review of the debate

Synthetic pyrethroid insecticides are widely used in public health and agriculture throughout the world and generally considered to be the safest class of insecticides available. In contrast to this belief stands a recent debate in Germany, around possible chronic effects of exposure to low levels of pyrethroid residues, particularly in the household. The debate is reviewed with a view to its potential implications on the use of synthetic pyrethroids on insecticide-treated nets (ITNs) for malaria control. Media coverage, rather than conclusive evidence from carefully planned scientific investigations, seems the underlying factor in the debate. However, chronic effects can presently not be excluded with certainty, as relevant toxicological data do not exist in the open scientific literature. Properly designed neuro-behavioural studies on groups with long-term exposure to low doses of synthetic pyrethroids should be conducted. This will require establishment of a working definition of "case" and "exposure". Meanwhile pyrethroids should continue to be used for public health interventions that contribute substantially to morbidity and mortality reduction, such as ITNs for malaria control.

Pyrethroid resistance/susceptibility and differential urban/rural distribution of Anopheles arabiensis and An. gambiae s.s. malaria vectors in Nigeria and Ghana

Resistance to pyrethroid insecticides and DDT caused by the kdr gene in the malaria vector Anopheles gambiae Giles s.s. (Diptera: Culicidae) has been reported in several West African countries. To test for pyrethroid resistance in two more countries, we sampled populations of the An. gambiae complex from south-western Ghana and from urban and rural localities in Ogun State, south-west Nigeria. Adult mosquitoes, reared from field-collected larvae, were exposed to the WHO-recommended discriminating dosage of exposure for 1 h to DDT 4%, deltamethrin 0.05% or permethrin 0.75% and mortality was recorded 24 h post-exposure. Susceptibility of An. gambiae s.l. to DDT was 94-100% in Ghana and 72-100% in Nigeria, indicating low levels of DDT resistance. Deltamethrin gave the highest mortality rates: 97-100% in Ghana, 95-100% in Nigeria. Ghanaian samples of An. gambiae s.l. were fully susceptible to permethrin, whereas some resistance to permethrin was detected at 4/5 Nigerian localities (percentage mortalities 75, 82, 88, 90 and 100%), with survivors including both An. arabiensis Patton and An. gambiae s.s. identified by PCR assay. Even so, the mean knockdown time was not significantly different from a susceptible reference strain, indicating absence or low frequency of kdr-type resistance. Such low levels of pyrethroid resistance are unlikely to impair the effectiveness of pyrethroid-impregnated bednets against malaria transmission. Among Nigerian samples of An. gambiae s.l., the majority from two urban localities were identified as An. arabiensis, whereas the majority from rural localities were An. gambiae s.s. These findings are consistent with those of M. Coluzzi et al. (1979). Differences of ecological distribution between molecular forms of An. gambiae s.s. were also found, with rural samples almost exclusively of the S-form, whereas the M-form predominated in urban samples. It is suggested that 'urban island' populations of An. arabiensis and of An. gambiae s.s. M-form in the rainforest belt of West Africa might be appropriate targets for elimination of these malaria vectors by the sterile insect technique.

Comparative evaluation of carbosulfan- and permethrin-impregnated curtains for preventing house-entry by the malaria vector Anopheles gambiae in Burkina Faso

Pyrethroid-impregnated bednets and curtains are widely employed to reduce the risk of malaria transmission, but pyrethroid-resistance is becoming more prevalent among malaria vector Anopheles mosquitoes (Diptera: Culicidae). As an alternative treatment for curtains, we assessed carbosulfan (a carbamate insecticide) in comparison with permethrin as the standard pyrethroid, against endophilic female mosquitoes of the Anopheles gambiae Giles complex in a village near Ouagadougou, Burkina Faso. The main criterion evaluated was the impact of curtains (hung inside windows, eaves and doorways) on the number of An. gambiae s.l. females active indoors at night. Light-traps were operated overnight (21.00-06.00 hours beside occupied untreated bednets) to sample mosquitoes in houses fitted with net curtains treated with carbosulfan 0.2 g ai/m2 or permethrin 1 g ai/m2 or untreated, compared with houses without curtains. The treated and untreated curtains significantly reduced the numbers of mosquitoes collected indoors, compared with houses without curtains. Carbosulfan-treated curtains had a highly significantly greater effect than permethrin-treated or untreated curtains, the scale of the difference being estimated as three-fold. However, there was no significant difference between the impact of untreated and permethrin-treated curtains on densities of An. gambiae s.l. trapped indoors. Samples of the An. gambiae complex comprised An. arabiensis Patton and both the S- and M-forms of An. gambiae Giles s.s. Susceptibility tests revealed some resistance to DDT and low frequencies of permethrin-resistance, insufficient to explain the poor performance of permethrin on curtains. Among survivors from the diagnostic dosage of permethrin were some specimens of all three members of the An. gambiae complex, but the kdr resistance mechanism was detected only in the S-form of An. gambiae s.s. Questions arising for further investigation include clarification of resistance mechanisms in, and foraging behaviour of, each member of the An. gambiae complex in this situation and the need to decide whether carbosulfan-treated curtains are acceptably safe for use to reduce risks of malaria transmission.

The pyrethroid knock-down resistance gene in the Anopheles gambiae complex in Mali and further indication of incipient speciation within An. gambiae s.s

In Mali the Anopheles gambiae complex consists of An. arabiensis and Mopti, Savanna and Bamako chromosomal forms of An. gambiae s.s. Previous chromosomal data suggests a complete reproductive isolation among these forms. Sequence analysis of rDNA regions led to the characterization of two molecular forms of An. gambiae, named M-form and S-form, which in Mali correspond to Mopti and to Savanna/Bamako, respectively, while it has failed so far to show any molecular difference between Savanna and Bamako. The population structure of An. gambiae s.l. was analysed in three villages in the Bamako and Sikasso areas of Mali and the frequency of pyrethroid resistance of the knock-down resistance (kdr) type was calculated. The results show that the kdr allele is associated only with the Savanna form populations and absent in sympatric and synchronous populations of Bamako, Mopti and An. arabiensis. This is the first molecular indication of barriers to gene flow between the Bamako and Savanna chromosomal forms. Moreover, analyses of specimens collected in the Bamako area in 1987 show that the kdr allele was already present in the Savanna population at that time, and that the frequency of this allele has gradually increased since then.

Insecticide treated nets: impact on vector populations and relevance of initial intensity of transmission and pyrethroid resistance

Insecticide treated bednets locate a deposit of a quick-acting insecticide of low human toxicity between a sleeper and host-seeking mosquitoes. Thus a chemical barrier is added to the often incomplete physical barrier provided by the net. Treated nets may be considered as mosquito traps baited by the odour of the sleeper. Trials in Assam, Tanzania and elsewhere have shown that when a whole community is provided with treated nets, so many mosquitoes of anthropophilic species are killed by contact with the nets that the density and/or sporozoite rate of the vector population is reduced. In order to gain this "mass" or community effect, in addition to widespread personal protection, and thus to achieve the full potential of the treated net method, a high per cent coverage of the community is needed. This suggests that organised free provision of treated nets, comparable to a house spraying programme, is likely to be more cost-effective than trying to market nets and insecticide to very poor rural people. In areas with high malaria transmission, where acquisition of immunity to malaria is very important, it has been argued that vector control (without vector eradication) could, in the long run, make the situation worse by preventing the normal build-up of immunity. However, our data from Tanzania do not support this idea--3-4 years after provision of nets (which are re-treated annually) young children are still showing clear health benefits; older children are not "paying" for this by showing worse impact of malaria. There is less malaria morbidity in a highland area where malaria transmission is about 15x less intense than in a nearby lowland area. The per cent impact of treated nets malaria morbidity in both area was very similar. At present only pyrethroids are used for net treatment which suggested that emergence of pyrethroid resistance would have a disastrous effect. However, in West Africa, where there is now a high frequency of the kdr resistance gene in Anopheles gambiae, it is reported that treated nets continue to have a powerful impact on vector populations. In Tanzania, pyrethroid resistance has not been detected in malaria vectors, but it has emerged in bedbugs after seven years use of treated nets.

Irritant effect, prevention of blood feeding and toxicity of nets impregnated with different pyrethroids on An. stephensi

A resistant strain of An. stephensi was confirmed to have high resistance to knock down and kill by four different pyrethroids in bioassays in comparison with a susceptible strain. Permethrin, lambda-cyhalothrin and deltamethrin were more irritant to the susceptible strain than the resistant as judged by time for first take-off, but nets treated with alphacypermethrin appeared to be more irritant to the resistant An. stephensi than the susceptible. With all the pyrethroids tested, the resistant strain spent a longer time in contact with a treated net, which was in contact with a human arm, than did the susceptible strain. With permethrin the resistant strain fed significantly more successfully through the treated netting than did the susceptible strain. With deltamethrin there was a non-significant tendency in the same direction in comparing the two strains. However, with alphacypermethrin there was a non-significant tendency in the reverse direction. After 15 min in the cage which tested for the ability to feed through a pyrethroid treated net, observed mortality was higher with the susceptible than the resistant strain. Thus there was no sign that the longer resting of the resistant strain on treated netting would compensate for the fact that a higher dose was needed to kill this strain. Such compensation has been suggested with West African An. gambiae where treated nets continue to work well against a highly resistant wild population. However, this does not seem to apply to our resistant An. stephensi.

Use of floating layers of polystyrene beads to control populations of the filaria vector Culex quinquefasciatus

Floating layers of polystyrene beads suffocate mosquito larvae and pupae and inhibit egg laying. The layers are very durable in breeding sites with water contained within walls, as in wet pit latrines and soakage pits. In some areas such pits constitute an important breeding site for Culex quinquefasciatus. Trials have been conducted in communities in Zanzibar, Tanzania, and in Tamil Nadu, India, where such mosquito populations were the vectors of Wuchereria bancrofti. In each case, treatment of all the pits with polystyrene beads was integrated with mass treatment of the people with antifilarial drugs-in Zanzibar in 1988 with diethylcarbamazine (DEC) and in India in the 1990s with DEC plus ivermectin. The results were compared with those in communities with the mass drug treatment alone and with control communities with neither treatment. The polystyrene-bead treatments greatly and sustainably reduced the vector populations. Comparison of the communities after drug treatment ceased showed that this form of vector control contributed markedly to the prevention of a resurgence of filarial infection. Where Cx. quinquefasciatus breeding in pits form a major component of the vector population, use of polystyrene-bead layers could assist considerably in the process of eliminating lymphatic filariasis by mass drug administration.

Pyrethroid resistance in tropical bedbugs, Cimex hemipterus, associated with use of treated bednets

When Tanzanian villages were provided with pyrethroid-treated bednets, bedbugs (Cimicidae) disappeared; however, after about 6 years they have re-appeared in these villages. Using a newly devised test-kit, susceptibility tests of bedbugs Cimex hemipterus (Fabricius) from five of these villages showed that there is resistance to permethrin and alphacypermethrin in bedbugs from each of the villages, in contrast to those from five villages without treated nets. Circumstantial evidence indicates that bedbug resistance to pyrethroid insecticides may evolve more readily in villages with incomplete coverage rates of treated bednets, allowing bedbug infestations to become re-established. Bedbugs have not returned to a village where nearly all the beds have been provided with pyrethroid-treated bednets for 14 years.

Effect of community-wide use of insecticide-treated nets for 3-4 years on malarial morbidity in Tanzania

OBJECTIVES

To investigate (1) benefits due to personal protection of individual net users vs. mass killing of mosquitoes within villages as a result of widespread net usage; (2) sustainability over several years of benefits against malarial morbidity of insecticide-treated nets; (3) distribution of the benefits in different age groups of children and (4) whether, as a result of fading immunity, older age groups 'paid for' the benefits which they had enjoyed when younger.

METHODS

(1) Tabulation of earlier data to compare personal and community-wide effects against mosquito vectors; (2) two cross-sectional surveys for malaria parasitaemia, malarial fever, anaemia and splenomegaly in children in eight Tanzanian villages, in which there had been community-wide use of bednets which had been annually re-treated with alphacypermethrin for 3-4 years; (3) comparison between children of different age groups and with intact, torn or no nets in these villages and in 4-6 villages without nets.

RESULTS

A 90-95% reduction in infective bites outside nets in netted villages and an additional 54-82% reduction of bites among individual net users. Highly significant reductions (by 55-75%) in malarial morbidity for children aged 6 months to 2 years were found in netted villages with, for some outcomes, better results among individuals who themselves had intact treated nets. For older children, benefits were less clear or absent, but there was no sign that the benefits early in life were 'paid for' by worse outcomes in the netted villages later in childhood.

CONCLUSIONS

The overall benefits to the community of widespread use of treated nets are sustainable and are not reversed in 3-4 years as a result of fading immunity. It is important to ensure high enough coverage to realize the full potential of the treated net method. By showing an impact on the vector population in the community these results provide a strong argument for organized free provision of net treatment, rather than relying on marketing.

Comparative insecticidal power of three pyrethroids on netting

Adult mosquitoes, Anopheles gambiae Giles and Culex quinquefasciatus Say (Diptera: Culicidae), were exposed for 3 min to replicate samples of polyester netting cut from replicate bednets treated with pyrethroid insecticide formulations at the recommended concentration (alphacypermethrin SC at 40mg ai/m2; cyfluthrin EW at 50 mg ai/m2; deltamethrin WT at 25 mg ai/m2), or treated with only a quarter of those dosages. After 4 months domestic use of the bednets in Malawi, chemical assays showed that pyrethroid deposits on the netting were somewhat less than the target concentrations. Comparing the pyrethroid bioassay results with Anopheles at both treatment concentrations, deltamethrin gave significantly higher mortality (99.7-100%) than the other compounds (alphacypermethrin 94-96%, cyfluthrin 80-89%). Culex bioassay mortality was lower (alphacypermethrin 56-74%; cyfluthrin 63-65%; deltamethrin 50-81 %) and results with the three pyrethroid insecticides at their recommended doses did not differ significantly.

Laboratory and field comparisons of pyriproxyfen, polystyrene beads and other larvicidal methods against malaria vectors in Sri Lanka

Hand-dug gem pits are important breeding sites for larvae of malaria vectors in Sri Lanka. Therefore, studies were carried out to help to select an effective, economic and convenient method that could be used to control malaria vector mosquito breeding in gem pits in a mining area. The effectiveness of four types of floating layers of polystyrene was compared in the laboratory and it was found that 2 mm expanded beads were the most effective for suffocating Anopheles larvae and pupae. The insect growth regulator, pyriproxyfen at dosages of 0.01 and 0.1 mg/l were tested in the laboratory and complete inhibition of emergence was found at both concentrations. A small-scale field trial was carried out for over a year to assess the efficacy of two concentrations of pyriproxyfen, 2 mm diameter expanded polystyrene beads, temephos, used engine oil and filling pits with soil. Pyriproxyfen only required re-application twice a year, whereas temephos or oil require 12 applications per year. Due to re-excavation by gem miners, polystyrene beads and filling of pits were not as permanent solutions as was expected. Calculations based on all available data showed that two annual treatments with pyriproxyfen at 0.01 mg/l would be the most cost-effective method with oil only slightly more expensive. However, the reduced required frequency for visiting every pit made the pyriproxyfen method the one of choice. The same low concentration of pyriproxyfen also effectively inhibited emergence of adults from river-bed pools.

Control of malaria vectors with the insect growth regulator pyriproxyfen in a gem-mining area in Sri Lanka

The study was conducted in eight adjacent villages in central Sri Lanka where there are many shallow pits dug by gem miners that fill with water. These become breeding places of the main malarial vector Anopheles culicifacies, and of the second most important vector Anopheles subpictus, but not of Anopheles varuna, the third most important vector. With the help of local volunteers, data on the adult populations of these three species was collected by various standard methods, and data on the incidence of malaria cases was collected by two clinics set up for the project and through the existing hospitals. Prevalence of malaria infection in symptom-less people was investigated by mass blood surveys. On the basis of a year's pre-intervention data the villages were stratified into four with high levels of malaria transmission and four with lower transmission. Within each stratum two villages were randomly assigned for mosquito control by treating all the gem pits, as well as river bed pools, with a granular formulation of the insect growth regulator pyriproxyfen at a target dose of 0.01 mg a.i./litre. The intervention caused significant reductions in the adult populations of An. culicifacies and An. subpictus. Similarly, incidence of malaria was reduced in the intervention villages to about 24% (95% c.l. 20-29%) of that in the controls. Prevalence of parasitaemia also declined significantly. It is concluded that in this situation where, with active community participation, the breeding sites of the main vectors could be located; vector control by a highly active and persistent insect growth regulator can be a very effective means of malaria control.

Diagnostic techniques and sample collection

With the advancing knowledge of medicine, diagnostic techniques and laboratory equipment, practicing veterinary surgeons are increasingly capable of processing many of their patients' blood, urine, and tissue samples on-site. No case is better suited to this scenario than the dermatology case, which enjoys a unique privilege in the clinic because the clinician is frequently able to harvest, process, and analyze pathologic samples from affected animals during or shortly after the consultation, eliminating the need to wait for results from external laboratories and consequently reducing the time to recovery. Good sampling techniques are crucial for the acquisition of optimal data however, and this article highlights the key points of these procedures and recommends when they are best employed.

The feeding behaviour and Plasmodium infection of Anopheles mosquitoes in southern Ethiopia in relation to use of insecticide-treated livestock for malaria control

Anopheles arabiensis and An. quadriannulatus species B mosquitoes were collected at sites of human and livestock housing and analysed for blood feeding patterns and infection with malaria sporozoites. A low percentage of human blood meals at some sites suggested that zooprophylaxis could be effective in reducing challenge from Plasmodium falciparum.

Unexpected anthropophagic behaviour in Anopheles quadriannulatus

The strongly anthropophilic behaviour of Anopheles gambiae Giles sensu stricto (Diptera: Culicidae), the most important malaria vector in Africa, has been demonstrated by field and laboratory studies. Other members of the An. gambiae complex express varied degrees of anthropophily. Anopheles quadriannulatus (Theobald) species A and B are more zoophilic members of the complex and hence are considered to be of no medical importance. Olfactometer experiments with An. quadriannulatus species A have demonstrated attraction to both human and cow odour. To extend these olfactometer observations a choice experiment was conducted in an outdoor cage with a human and a calf as baits, using laboratory-reared mosquitoes. Anopheles gambiae s.s. (from Liberia) and two strains of An. quadriannulatus species A (SKUQUA from South Africa, SANGQUA from Zimbabwe), marked with different coloured fluorescent powders for identification purposes, were released simultaneously and given an equal opportunity to feed on either host. The experiment was repeated six times. Bloodmeals were identified using the precipitin technique. Anopheles gambiae s.s. showed highly anthropophagic behaviour, taking 88% of bloodmeals from the human host. In contrast, both strains of An. quadriannulatus fed with equal frequency on the human or the calf; the response to either host was not significantly different. These results confirm the olfactometer findings and demonstrate anthropophagic behaviour not previously recorded in this species. This finding has implications for prospective manipulation of host preference for genetic control purposes.

Differential behaviour of Anopheles gambiae sensu stricto (Diptera: Culicidae) to human and cow odours in the laboratory

A dual port olfactometer was used to study the response of Anopheles gambiae Giles sensu stricto to odours of human and animal origin. Human odour consisted of human skin emanations collected on a nylon stocking, which was worn for 24 h. This was tested alone or together with 4.5% carbon dioxide, the concentration in human and cattle breath. Cattle odours consisted of cow skin emanations and/or carbon dioxide. Cow skin emanations were collected by tying a nylon stocking ('cow sock') around the hind leg of a cow for 12 h. Anopheles gambiae s.s. was consistently highly attracted by human odour, which is consistent with the high degree of anthropophily in this mosquito. Anopheles gambiae s.s. was not attracted by human or cattle equivalent volumes of carbon dioxide and this gas did not enhance the effect of human skin residues. Furthermore, A. gambiae s.s. showed a high degree of aversion to cow odour. When human odour and cow odour were tested together in the same port, mosquitoes were still highly attracted, indicating that whilst cattle odour may deter A. gambiae s.s., these mosquitoes can detect human odour in the presence of cattle odour. It was concluded that carbon dioxide plays a minor role in the host seeking behaviour of A. gambiae s.s., whilst host specific cues such as human skin residues play a major role and very effectively demonstrated anthropophilic behaviour in the laboratory.

A trial of proguanil-dapsone in comparison with sulfadoxine-pyrimethamine for the clearance of Plasmodium falciparum infections in Tanzania

Considerable levels of resistance to sulfadoxine-pyrimethamine (SP) have been reported in Plasmodium falciparum in north-eastern Tanzania, and the identification of a suitable antimalarial to replace SP is now a high priority. We conducted a trial in July 2000 to determine the efficacy of proguanil (PG) plus dapsone (DS), compared with that of SP, for the treatment of asymptomatic falciparum infection. A total of 220 children with parasitaemia > or = 2000 per microL completed the study; 112 had received a single dose of SP (dosage calculated for pyrimethamine 1.25 mg/kg and sulfadoxine 25 mg/kg) and 108 had taken PG 10 mg/kg with DS 2.5 mg/kg each day for 3 days. Clearance of asexual parasites at day 7 was 14.3% with SP, but 93.5% with PG-DS. The remarkably high failure rate with SP was not associated with occurrence of leucine substitution at position 164 of the dhfr gene. Both treatment regimens were well tolerated. Compared with available data on another antifolate combination, chlorproguanil-dapsone ('Lapdap'), PG-DS was slightly but significantly inferior in achieving parasite clearance (99.5% versus 93.5%). The estimated cost of a 3-day course of PG-DS treatment for a child weighing 18 kg is US $0.15. With the rising incidence of SP-resistant P. falciparum infection, PG-DS could provide an effective, affordable and already available therapeutic alternative for malaria in East Africa at least until chlorproguanil-dapsone is registered.

Evaluation of a commercially available enzyme-linked immunosorbent assay for the diagnosis of canine sarcoptic mange

This study was designed to assess the accuracy of a commercial enzyme-linked immunosorbent assay for the diagnosis of canine scabies. Serum samples from 37 dogs were examined blind; 12 had sarcoptic mange confirmed by the identification of mites in skin scrapings, 12 were atopic (with positive intradermal reactions to one or more aeroallergens, including Dermatophagoides farinae), and 13 were healthy dogs with no history of skin disease. Optical density values of more than 0.16 were considered positive, 0.145 to 0.16 were considered questionable and less than 0.145 were considered negative. Ten of the 12 dogs with scabies were positive, all 12 atopic dogs were negative, and 11 of the 13 healthy dogs were negative and two were questionable.

Infectious disease. The case for deemphasizing genomics in malaria control

Solving the enormous problem of malaria worldwide will require a balance between investments in research and control. In this point-counterpoint, two scientists describe the rationales for these very different strategies. Steve Hoffman believes that genomics research is the best investment in the future if we have the vision of malaria eradication. Chris Curtis presents an opposing viewpoint, that low-tech control approaches are the practical ones under current conditions.

Amazonian onchocerciasis: parasitological profiles by host-age, sex, and endemicity in southern Venezuela

This paper describes, for the human onchocerciasis focus of southern Venezuela, the age profiles of Onchocerca volvulus microfilarial (mf) and nodule prevalence, mf intensity, and mf aggregation for the whole examined population (836 Yanomami people) living in 20 villages, and for these communities classified according to endemicity levels (hypoendemic: < or = 20 %; mesoendemic: 21-59 %; hyperendemic: < or = 60 % infected). Mf prevalence and intensity increased with age, particularly in the hyperendemic areas, and there were no marked differences between the sexes. The prevalence of nodules followed the same age pattern. Fifty percent mf prevalence was reached in the 15-19 year age-class when the population was taken as a whole; nearly in the 10 to 14-year-olds for the hyperendemic level, in those aged 20-29 years in mesoendemic areas, and not reached at all in hypoendemic villages. The degree of mf aggregation was measured by the k value of the negative binomial distribution and by the variance to mean ratio (VMR). The relationship between the standard deviation (S.D.) of mf counts and the mean mf density was also explored. These 3 indices (k, VMR, and S.D.) showed a tendency to increase with both mean mf load and host age. Since infection intensity and host age were themselves positively related, it was not possible to draw definite conclusions about age-specific changes of parasite aggregation. There was not a significant decrease of mf intensity after an earlier peak neither was there a shift towards younger ages of the maximum no. of mf/mg reached as the endemicity level increased. These results are discussed in relation to detection of density dependence in the human host, selection of an indicator age-group for rapid epidemiological assessment (REA) methods, and strategies of ivermectin distribution in the Amazonian focus. It is recommended that, for the Amazonian onchocerciasis focus, the indicator group for REA consists of all those aged 15 years and over.