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Biting and feeding behavior of malaria vectors were studied in nine villages (5 from Jeypore zone and 4 from Malkangiri zone) of Koraput District. Man biting catches comprised of 16 anopheline species including the incriminated vectors of this area: An. fluviatilis, An. annularis and An. culicifacies. An. fluviatilis was predominant and biting of this species recorded indoors throughout the year in both the zones. The period, during which the biting activity peaked, was different between the two zones and consequently the time of peak transmission was also different between the zones. The biting activity was at its peak between 21.00 and 03.00 hours in both the zones. However, in cold season the biting activity peaked in the first quarter of the night in Jeypore zone. The anthropophilic index (AI) of An. fluviatilis was 26.2% in Jeypore and 83.7% in Malkangiri and of An. culicifacies the AI was 0.4% in Jeypore and 7% in Malkangiri. Analysis of gonotrophic stages of night resting females indicated that in Jeypore zone, the majority of An. fluviatilis female left indoors for outdoor resting before the completion of gonotrophic cycle, but in Malkangiri, the females remained indoors till the end of the gonotrophic cycle. The presence of full-fed females in night resting catches in Jeypore village further suggested that the females do not leave the house immediately after taking blood meal but rest for some time.
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PMID:Observations on nocturnal activity and man biting habits of malaria vectors, Anopheles fluviatilis, An. annularis and An. culicifacies in the hill tracts of Koraput District, Orissa, India. 782 11

The population growth of Anopheles fluviatilis, the major malaria vector, was studied in the hill tracts of Koraput district. Immature duration ranged from 11 to 14 days (mean = 12.42 +/- 0.99) in rainy and 12 to 17 days (mean = 14.78 +/- 1.64) in cold season. The probability of immature survival through different developmental stages was maximal in ponds. Daily survival rate of adults fluctuated between 0.55 and 0.92. The net reproductive rate (Ro) was estimated to be 3.0200 for cold and 0.6486 for rainy season. The mean generation time (T) was slightly longer in cold season (22.32 days) than rainy season (21.24 days). The intrinsic rate of population increase (rm) and consequently the finite rate of increase (lambda) were estimated for cold and rainy seasons. Population growth based on adult resting density was also assessed for different seasons.
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PMID:Age composition, natural survival and population growth of Anopheles fluviatilis James, 1902, the major malaria vector in the endemic belt of Koraput District, Orissa, India. 782 13

The dilemma of private practitioners is whether to prescribe or not to prescribe iron supplements on suspicion of anaemia. This cross sectional study was done in an urban squatter settlement with a primary health care centre to assess the significance of symptoms and a history of associated diseases in the diagnosis of anaemia. A total of 321 children were sampled from 1800 children < 5 years of age in a population of 11,000, by systematic random sampling. Mothers were asked about the presence of assumed associated symptoms and diseases which were listlessness, irritability, anaemia, pica, poor weight gain, diarrhoea, acute respiratory infection and malaria in last 3 months. There was significant association between anaemia (Hb < 11 gms%) and irriability (P < .02), anorexia for solid foods (P < .04), pica (P < .001), episode of diarrhoea (P < .001) and poor weight gain (P < .006). There was no significant association between malaria, cold, cough and anaemia. Children with these symptoms complex should receive iron supplements.
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PMID:Anaemia in children: Part II. Should primary health care providers prescribe iron supplements by the observation and presence of assumed symptoms? 786 85

This paper opens by briefly tracing the development of vaccines from Edward Jenner's work in 1796 to the present. The proportion of deaths from communicable diseases in developed and developing countries is discussed, and it is noted that, in 1990, communicable diseases killed 575,000 people in industrialized countries and 16 million people in developing countries. In developed countries, there were no deaths from measles, malaria, tetanus, or pertussis, and only seven from diarrheal disease as compared to 1,006,000, 926,000, 505,000, 321,000, and 2,866,000, respectively, in developing countries. By the end of the century, AIDS will overshadow the communicable disease profile. Annual mortality figures from bites by rabid animals, snakes, insects, etc. are also grossly underreported. A look at the common biologicals used in developing countries shows that at least eight bacterial and eight viral vaccines are in common use globally. The origin and indications for each vaccine are tabulated. Data on anti-serum vaccines, plasma-derived preparations, and biological response modifiers (available in industrialized countries) are similarly tabulated. Consideration of the industrial production of immunogens in developing countries reveals that most production relies on outdated technology. Vaccines exhibit suboptimal performance in these settings either due to factors relating to individual vaccines or to community circumstances. Individual vaccines which exhibit inadequate potency in adverse circumstances include liquid vaccines and lyophilized vaccines and prophylactics. This situation is exacerbated by unsatisfactory vaccine administration practices, malnutrition, and cases of immunosuppression. Suboptimal performance at the community level is due to procurement procedure, the cost of vaccines, poverty, population growth, failures in the cold chain, lack of trained personnel, religion and gender bias, and political factors, such as war. A suitable remedial action plan requires integrated action at the international, national, and community levels. Such an effort would be aided by improved mortality data collection techniques and by multidisciplinary research to update indigenous manufacturing technology.
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PMID:Human immunization in developing countries: practical and theoretical problems and prospects. 788 21

Placental malaria may limit antibody transfer to the fetus. We compared concentrations of tetanus antibody in paired maternal-cord sera from 224 women living in a malarious area of Papua New Guinea. With heavy placental infection (> 35 parasites per 200 white cells) the average cold tetanus antibody corresponding to a maternal level of 1 IU/mL was 0.18 (95% CI 0.12-0.26); corresponding figures after light (< 35 parasites per 200 white cells) or no infection were 0.23 (0.14-0.34) and 0.82 (0.57-1.21), respectively. About 10% of babies born to mothers with a placenta heavily infected with Plasmodium falciparum may fail to acquire protective levels of tetanus antibody despite adequate maternal antibody.
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PMID:Reduced transfer of tetanus antibodies with placental malaria. 790 69

Information on malaria prevention practices in households was obtained in a nationwide knowledge, attitudes, and practices survey in Malawi. Of the 1531 heads of household questioned, 55% were able to identify mosquitoes as the cause of malaria. Use of any type of malaria prevention method was reported by 52% of respondents. Most were male (80%), 20-49 years of age (80%), had no or primary (grade 1-8) education (91%), were married (82%), and had a very low or low annual household income level (72%). 55% of respondents identified mosquitoes as the cause of malaria. Cold weather (19%) was the second most common response. 24% of the respondents replied that they did not know the cause of malaria. A total of 550 (36%) respondents reported hearing or seeing any information about malaria in the previous 12 months. Overall, 795 (52%) of respondents reported any type of malaria prevention used in the household. Among these users, 372 (47%) used commercial products (insecticide, mosquito coils, bednets), 508 (64%) used natural measures (burning leaves, dung, or wood); and 85 (11%) reported having used both. The most common measure used was mosquito coils (16%) followed by insecticide spray (11%) and bednets (7%). Having used a purchased product for malaria prevention in the household was strongly associated with both an increasing education level of the head of the household (Chi-square for linear trend = 128.8; p 0.001) and an increasing household income level (Chi-square for linear trend = 206.6; p 0.001). Respondents reporting secondary or higher education were approximately eight times more likely to have used a purchased product in the household to prevent malaria than were those who reported primary or no education (Odds Ratio [OR] 8.1). Similarly, those with moderate or high incomes were five times more likely to have ever used a purchased product than those with lower incomes (OR 5.3). Educational messages are required to improve use of affordable household malaria preventive measures.
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PMID:Use of malaria prevention measures in Malawian households. 791 45

Since 1986, two West African countries have been delivering immunizations within the framework of reorganized peripheral health systems. This revitalization is based on strategies which are implemented by an increasing number of African countries under the name "Bamako Initiative". It aims at providing universal access to a minimum package of maternal and child health priority interventions starting with immunizations, pre and perinatal care, oral rehydration for diarrhoea, treatment of malaria and acute lower respiratory infections. Within this package, immunization has been given high priority. Several strategies aimed at improving immunization coverage have been implemented: services have been reorganized so that any child or woman making contact with the health system receives immunization if needed. Health information systems have been revised so as to allow for active individual follow up and better management of health centre resources. Health staff have been given training in management and a biannual monitoring/microplanning process at health centre level has been introduced. The goal of monitoring is to enable health personnel to identify the obstacles to attaining optimum coverages with the priority interventions and to select locally appropriate corrective strategies. Health centres have also been provided with a motorcycle allowing for regular outreach activities. To cover the running costs of the services (mainly restocking of drugs, running and maintenance of the cold chain and the motorbike, and staff incentives), financial contribution from local communities have been sought through a fee-for-treatment system. Prices have been set at an affordable level by limiting the number of drugs to a minimal list purchased under generic names by international tendering procedures.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Integration of the Expanded Program on Immunization into primary health care: examples of Benin and Guinea]. 792 89

A previous study among Gambian children aged 1-4 years found that overall mortality was reduced by 63% after use of insecticide-treated bednets. In this study, the aim was to determine the degree to which bednets were used and the factors affecting their use in Farafenni, The Gambia; Navrongo in eastern Ghana; suburban Bandim outside Bissau Town, Guinea-Bissau; Niakhar in Senegal; and a rural village around Bo in Sierra Leone. Bednets were known and used to protect children from mosquito bites in the 5 West African countries; bednets were also used for privacy and to protect from falling roof debris. A structured questionnaire was administered. Background information had been collected prior to the survey administration on local terminology for symptoms of malaria, the extent of health education campaigns, availability of Western and traditional treatment regimens, use of bednets, and constraints to use. Each of the study areas was described in terms of the social and demographic characteristics of the population. The findings indicated that about 50% of people in Ghana Guinea-Bissau, and Sierra Leone were aware that mosquitoes caused malaria. Only about 25% were aware in The Gambia. Heavy rains and the cold weather that followed were also linked with malaria causes in Ghana and Guinea-Bissau. Stepping in goat urine was viewed as a cause of malaria in Senegal. In The Gambia, other causes indicated were eating of seasonally foods excessively, and an act of God. Fever was the most common symptom associated with malaria. Some differentiated in subtle ways between malaria fever and other fevers. Treatment was viewed in all countries as herbal, which was available from markets or traditional healers. About 50% of the 996 Ghana respondents used some form of traditional treatment for malaria. 86% used bednets in The Gambia and Guinea-Bissau. Only about 33% used them in Senegal, and very few used bednets in Sierra Leone and Ghana. Most were concerned about the irritation to sleep from mosquitoes. In all countries, cost of bednets was a constraint to use. Public health programs should stress the cost effectiveness and advantages of insecticide treated bednets, and information on malaria causes. Where Ghanians sleep on roofs, a new bednet design is needed.
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PMID:Attitudes to malaria, traditional practices and bednets (mosquito nets) as vector control measures: a comparative study in five west African countries. 817 7

In an attempt to assess concepts of disease, we questioned 33 Ethiopian Jews (Falashas) in Ethiopia about 13 diseases: 8 western and 5 cultural syndromes (in the Amharic language): birrd (cold), wugat (stabbing chest pain), moygnbagegn (neurologic disorder), mitch (sunstroke), and attent hono kere (retained fetus becoming bone). Disease causation was often attributed to spirits and the sun. None of the interviewees understood the cause of: a) epilepsy, most attributing it to spirits and recommending smelling match smoke as treatment, b) prolonged labor, attributed by most to the evil kole spirit and is managed by traditional birth attendants; and c) abortion, believed to be caused by exposure to sun or cold. Less than 20% linked malaria to mosquitoes. Most correlated splenomegaly with malaria. Hepatitis was believed to be caused by a bird or bat flying around the affected person. Multiple factors were linked to diarrhea, including a journey in the sun. Moygnbagegn is the only condition treated by venisection from brachial veins; wugat is treated by "cupping". Modern medicine was recommended by < 30% of those questioned for epilepsy, splenomegaly, hepatitis, and Ethiopian cultural diseases. It was recommended most for malaria (52%), sexually transmitted diseases (55%), and diarrhea (69%).
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PMID:Traditional beliefs and disease practices of Ethiopian Jews. 875 85

Data from sensors on board geostationary and polar-orbiting, meteorological satellites (Meteosat and NOAA series) are routinely obtained free, via local reception systems, in an increasing number of African countries. Data collected by these satellites are processed to produce proxy ecological variables which have been extensively investigated for monitoring changes in the distribution and condition of different natural resources, including rainfall and vegetation state. How these data products (once incorporated, along with other data, into a geographical information system) could contribute to the goals of monitoring patterns of malaria transmission, predicting epidemics and planning control strategies is the subject of the present review. By way of illustration, an analysis of two of these products, normalized difference vegetation index (NVDI) and cold-cloud duration (CCD), is given in conjunction with epidemiological and entomological data from The Gambia, a country where extensive studies on malaria transmission have been undertaken in recent years. Preliminary results indicate that even simple analysis of proxy ecological variables derived from satellite data can indicate variation in environmental factors affecting malaria-transmission indices. However, it is important to note that the associations observed will vary depending on the local ecology, season and species of vector. Whilst further quantitative research is required to validate the relationship between satellite-data products and malaria-transmission indices, this approach offers a means by which detailed knowledge of the underlying spatial and temporal variation in the environment can be incorporated into a decision-support system for malaria control.
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PMID:The ecology of malaria--as seen from Earth-observation satellites. 875 39


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