Why the SAFE-S Strategy for Trachoma? Are Musca sorbens or Scatophaga stercoraria Really the Culprit?-A Brief Historical Review from an Italian Point of View

The biological history of Chlamydia trachomatis is intertwined with the evolution of the man. Infecting Elemental Bodies (EBs), having penetrated mucosal epithelial cells, wrap themselves in a cloak (ĸλαμις) of glycogen that ensures their obligatory intracellular survival and protects this differentiation into Reticulate Bodies (RBs) that feed on cellular ATP. Multiple chemokines and cytokines are involved under the direction of IL-6 in the florid phase and IL-17A in the scar phase. The WHO has successfully identified the SAFE strategy against trachoma (Surgery, Antibiotics, Facial cleansing, Environment) as the blueprint to eliminate the disease by 2020. Recently, interest has been increasingly focused on changing sexual attitudes in different areas of the world, leaving Musca sorbens, Scatophaga stercoraria, and stepsisters fairly blameless, but extolling the role of Chlamydia trachomatis in apparently "sterile" chronic prostatitis or conjunctivitis or, less frequently, in oropharyngitis and proctitis. The addition of an S (SAFE-S) standing for "sexual behavior" was then proposed to also attract the interest and attention not only of Ophthalmologists and Obstetricians/Gynecologists, Urologists/Andrologists, and the School Authorities for information on the prevention of sexually transmitted diseases, but also of Social Physicians and Pediatricians. This means that sexually transmitted infections should be screened in asymptomatic patients with risky sexual behavior or sexual contact with people diagnosed with a transmitted infection.

Evaluation of the efficacy of insecticide-treated scarves to protect children from the trachoma vector Musca sorbens (Diptera: Muscidae): A phase II randomised controlled trial in Oromia, Ethiopia

Background

The eye-seeking fly Musca sorbens can act as a vector for ocular Chlamydia trachomatis, causing trachoma, yet there has been very little research on control measures. We investigated whether insect repellent products, specifically insecticide-treated clothing, could provide personal protection to the user from eye-seeking flies.

Methods

We first conducted a series of phase I laboratory studies to inform our choice of field intervention. We then conducted a phase II randomised controlled trial testing the efficacy of permethrin-treated scarves (PTS) in reducing fly-face contact in Oromia, Ethiopia. Children aged 4-10 years in full health and with no known adverse reactions to permethrin or other insecticides were allocated to either arm using restricted randomisation. Intervention arm children wore Insect Shield® versatile wraps (as PTS) for 28 days. The primary outcomes, fly-eye, -nose and -mouth contact, were assessed on the first day (0/30/60/180 minutes), on day 7 and on day 28. All participants present per timepoint were included in analyses. This trial was registered with ClinicalTrials.gov (NCT03813069).

Findings

Participants were recruited to the field trial between 29/10/2019 and 01/11/2019, 58 were randomised to test or control arm. More fly (-eye, -nose and -mouth) contacts were observed in the PTS arm at baseline. After adjusting for baseline contact rates, across all timepoints there was a 35% decrease in fly-eye contacts in the PTS relative to control arm (rate ratio [RR] 0.65, 95% CI 0.52-0.83). Similar cross-timepoint reductions were seen for fly-nose and fly-mouth contacts (RR 0.69, 95% CI 0.51-0.92 and RR 0.79, 95% CI 0.62-1.01, respectively). All children were included on day 0. Two in the control arm were absent on day 7, one left the study and four were excluded from analysis at day 28. No adverse events occurred in the trial.

Interpretation

Musca sorbens flies are sufficiently repelled by PTS to reduce fly-eye contacts for the wearer, thus possibly reducing the risk of trachoma transmission. Permethrin-treated scarves may therefore an alternative to insecticide space spraying for protection from these flies.

Funding

Wellcome Trust.

Comparing trap designs and methods for assessing density of synanthropic flies in Odisha, India

Background

There are many different traps available for studying fly populations. The aim of this study was to find the most suitable trap to collect synanthropic fly populations to assess the impact of increased latrine coverage in the state of Odisha, India.

Methods

Different baits were assessed for use in sticky pot traps (60% sucrose solution, 60 g dry sucrose, half a tomato and an non-baited control), followed by different colours of trap (blue versus yellow) and finally different types of trap (baited sticky pot trap versus sticky card traps). The experiments were undertaken in a semi-urban slum area of Bhubaneswar, the capital of Odisha. The first experiment was conducted in 16 households over 30 nights while experiments 2 and 3 were conducted in 5 households over 30 nights.

Results

The traps predominantly caught adult Musca domestica and M. sorbens (78.4, 62.6, 83.8% combined total in experiments 1–3 respectively). Non-baited traps did not catch more flies (median 7.0, interquartile range, IQR: 0.0–24.0) compared with baited traps (sucrose solution: 6.5, 1.0–27.0; dry sucrose: 5.0, 0.5–14.5; tomato: 5.0, 1.5–17.5). However, there were significantly more flies collected on blue sticky pot traps, which caught nearly three times as many flies as yellow sticky pot traps (Incidence Rate Ratio, IRR = 2.91; 95% CI: 1.77–4.79); P < 0.001). Sticky card traps (27, 8–58) collected significantly more flies than the non-baited sticky pot traps (10, 1.5–30.5).

Conclusions

Blue sticky card traps can be recommended for the capture of synanthropic fly species as they are non-intrusive to residents, easy to use, readily allow for species identification, and collect sufficient quantities of flies over 12 hours for use in monitoring and control programmes.

The complete mitochondrial genome of the bazaar fly, Musca sorbens Wiedemann (Diptera: Muscidae)

The bazaar fly, Musca sorbens (Diptera: Muscidae) Wiedemann, 1830 is a world-wide species with sanitary, medical, and veterinary importance. The complete mitochondrial genome of M. sorbens is sequenced to better understand the mitogenomic characteristics and phylogeny of this species. The circular mitogenome is 16,120 bp in length, contains 13 protein-coding genes (PCGs), 22 tRNA genes (tRNAs), two rRNA genes, and an AT-rich control region. The mitogenome comprises an A + T content of 77.4%. All PCGs start with "ATN" codons except for COI which starts with TCG, and terminate with the common stop codons TNN. A phylogenetic tree, including six Muscidae species, is reconstructed based on the whole mitogenome sequences. The interspecific distances of mitogenomes between the six Muscidae species range from 0.059 to 0.168.