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Biomedical subjects

J Mouchet

Publications and source records attributed to J Mouchet.

At least 19 recordsLinked to original sources
PubMed1999

[Vectors and environmental factors in malaria].

Malaria is a major risk for more than two billion human beings on Earth, and is the cause of 700,000 to 2.5 million deaths per year. The causative factor, Plasmodium (four species), involves an asexual cycle in man and a sexual one in anopheline mosquitoes. The four species of Plasmodium are pathogenic for man but P. falciparum accounts for more than 90% of deaths. Only black Africans are refractory to P. vivax, a characteristic linked to the lack of Duffy antigen. Among the 400 species of anophelines so far recorded, less than 50 are recognized malaria vectors. Every one has its own geographic and ecological characteristics, which locally induce the epidemiological trends and its biodiversity. In a given site transmission depends on competent anopheline species, their infective rate and their biting rate. Inhabitants of endemic areas develop during infancy immunity which protect them during the rest of their lives. This immunity (premunition) between parasite and its host is acquired at an heavy price of infant mortality. It can decrease rapidly when people leave endemic areas. Because inhabitants of endemic areas continue to harbor asymptomatic parasites they become good parasite reservoirs. The diversity of epidemiological situations needs a diversification of malaria control measures. The prognosis of the evolution of malaria depends on control measures, applied or not, and on the evolution of climatic and anthropic environment, which are very hard to predict for the time being.

Animals↗
PubMed1999

Status of pyrethroid resistance in Anopheles gambiae sensu lato.

The present study confirms the presence of pyrethroid resistance among Anopheles gambiae s.l mosquitos in Côte d'Ivoire and reports the observation of such resistance in two other countries in West Africa (Benin and Burkina Faso). Malaria vector populations from Cameroon (Central Africa), Senegal (West Africa) and Botswana (southern Africa) were found to be susceptible to pyrethroids. In the most resistant mosquito populations, resistance to permethrin was associated with reduced mortality, not only with respect to this compound but also towards deltamethrin. Moreover, a significant increase in knockdown time was observed in some mosquito populations before any decrease in mortality, suggesting that knockdown time could be a good indicator for the early detection of pyrethroid resistance. In view of the current extension of such resistance, there is an urgent need to set up a network in Africa to evaluate its development. It is also vital that the impact of this resistance on pyrethroid-impregnated bednets be assessed.

Africa↗
PubMed1999

[Epidemiological stratification of malaria in the Comoro archipelago].

In the Comoros Islands, the level of malarial endemicity varies greatly from one island to the other, even though the total area (4 islands) covers less than 2,300 km2 and has a population of some 600,000 people only. The epidemiological stratification is based on the diversity of human and physical characterisation. They both determine the presence and the behaviour as well as the size of the vector's populations. Vectorial dynamics can explain varying levels of endemicity given parasitological indicators and specific morbidity. Analyzing these criteria shows up different epidemiological features and serves as a basic guideline for malaria control. The efficiency of this control depends on the relationships between the intensity and the length of the transmission, in the framework of protection mechanisms; it is of crucial importance for clinical treatment. Further elements are the age of the patient, the season and the geographic situation of the area. Stratification provides explanations for these relationships and helps to define antimalarial programmes adapting to each situation a range of therapeutic and antivectorial methods. The availability and accessibility of anti-malarial medicine is the minimum requirement for reducing mortality: domestic spray insecticides for reducing transmission are effective for several years and should be followed by the use of mosquito nets or curtains impregnated with pyrethrinoids, and in the particular case of Grande Comore, the use of larvivorous fish. As anywhere else, the economic development, which is dependent on political stability, is the essential basis for malaria control.

Age Factors↗
PubMed1998

Origin and prevention of airport malaria in France.

Since 1969, 63 cases of airport malaria have been reported in Western Europe, 24 of which occurred in France. Most were due to Plasmodium falciparum. In 1994, 7 cases occurred in and around Roissy Charles de Gaulle airport (CDG), showing 4 types of contamination: among employees working on airstrips or opening containers, among residents living near the airport, among people living at some distance from the airport after a secondary transport of vectors, and by vectors transported in luggage. In-flight or stop-over infection is not considered as airport malaria. The infective anophelines originated from airports where malaria transmission occurs, mostly in subsaharan Africa. A tentative list is given taking into account aerial traffic with France. Surveys in the airports of Dakar (Senegal), Cotonou (Benin), Abidjan (Cote d'Ivoire) and Yaoundé (Cameroun) found potential vectors in all of these from July to September. After 1994, the Contrôle Sanitaire aux Frontières (CSF) in charge at CDG concentrated its efforts on the flights at risk, as well as information and sensitization of airline companies, which resulted in 73% and 87% of the flights at risk being properly disinsected in 1995 and 1996. Despite pyrethroid resistance in Anopheles gambiae s.s. in West Africa, the efficacy of aircraft spraying with permethrin aerosols is still acceptable. However, surveillance of resistance should be improved and search for nonpyrethroid insecticides suitable for aircraft strongly encouraged.

Africa, Western↗
PubMed1998

[Origin of malaria epidemics on the plateaus of Madagascar and the mountains of east and south Africa].

The Highlands of Madagascar were malaria free until 1878, when a severe epidemic occurred, following the development of irrigated rice farming. Then, the disease became endemic. Between 1949 and 1962, malaria was "eradicated" on the Highlands by joint house spraying and chemoprophylaxis measures. The main vector An. funestus disappeared. In 1986-1988, a very severe epidemic with high lethality rate devastated the Highlands. It is now under control. Thanks to the data of a religious dispensary, we could follow the evolution of malaria on the Highlands from 1971 to 1995. The number of cases begin to grow in 1975 when the surveillance was neglected. A second step was observed in 1979, when chemoprophylaxis/chemotherapy centres were closed. Then, the increase of malaria became exponential up to 1988. At the time, the prevalence had became similar to that of 1948, before the eradication. The epidemic is not due to global warming because the temperature has been stable for the last 30 years. The malaria rise was due the cancellation of control measures. When control was reactivated, the epidemic ceased. In Swaziland, Zimbabwe and South Africa, malaria epidemics were also due to control failure. In Uganda Highlands, above 1500 m, malaria rise seems linked to the environmental changes, e.g. the cultures which replace papyrus swamp in the valley. But malaria did not overcame the altitude of 1900 which it had already reached in 1960. Rainfall should also be considered as a key factor in the epidemics. In the Sahel West Africa, temperature increased from 0.5 degree C to 01 degree C degree in the last 25 years, but rainfall decreased from 30%. As a result, one of the vector, Anopheles funestus disappeared and malaria prevalence dropped by 60 to 80%. It is not acceptable to predict the future evolution of malaria in taking in account only one parameter: the temperature. The whole factors involved in the epidemiology should be taken into account. The predictions based only on the temperature increase (global warming) can be totally wrong if the rainfall, for example, decreases.

Africa↗
PubMed1998

[Impact of antivectorial control on malarial morbidity and mortality in a health district of the Madagascar highlands].

After the dramatic increase of malaria infections from 1985 to 1988 in the Highlands of Madagascar, the vector control programme was reactivated. In order to evaluate the impact of this strategy in the district of Arivonimamo, we have analysed the morbidity and the mortality data collected in all the health care centers of this district. Since 1988, extensive residual house spraying has been carried out on a yearly basis in the eastern part of this district whereas the western part was not included in this spraying programme. Data from each area were compared. In the eastern part, a dramatic decrease of morbitity and mortality related to malaria was observed, the benefit was 69% of expected simple cases, 87% of expected serious cases and 40% of expected deaths due to malaria. It has to be noted that only presumptive cases have been reported since no laboratory facilities are available in these health centers. Nevertheless such findings provide strong support to the continuation of the spraying programme, maybe in a less intensive way, together with an accurate epidemiological surveillance.

Humans↗
PubMed1998

[Human diseases transmitted by Culicidae in southwest Indian Ocean islands].

South-West Indian Ocean islands were inhabited at the beginning and free from all kind of vector. In Madagascar, Mayotte, Moheli and Anjouan, malaria vectors were carried by the first settlements. According to epidemics, the anopheles arrived in 1867 in Mauritius, 1869 in La Reunion and 1920 in Grande Comore. Rodrigues, Saint-Brandon and the Seychelles are still free from malaria vectors in the coastal part of Madagascarcar and in Comores archipelago, malaria is stable with a permanent transmission. Unstable malaria is seasonaly transmitted in the high territories of Madagascar; it was the same in Mauritius and Reunion island before the eradication campaign. Lymphatic filariasis is quoted in Madagascar, but Comores archipelago is an area with high transmission. The incidence of the disease is moderate in La Reunion and Mauritius and very low in Chagos and Seychelles archipelagos. There is no transmission in Rodrigues and St Brandon. Epidemics of dengue were described during the second part of the XIXth century in Mauritius and La Reunion, then in 1943 in Mayotte. But the disease was controlled in the fifties by the antimalaria campaign. A new epidemy appeared in Seychelles by the end of 1976 and then in Reunion and Mauritius next year. An isolated outbreak was described in Grande Comore only in 1994.

Animals↗
PubMed1998

Evolution of malaria in Africa for the past 40 years: impact of climatic and human factors.

Different malarial situations in Africa within the past 40 years are discussed in order to evaluate the impact of climatic and human factors on the disease. North of the equator, more droughts and lower rainfall have been recorded since 1972; and in eastern and southern Africa, there have been alternating dry and wet periods in relation to El Niño. Since 1955, the increase in human population from 125 to 450 million has resulted in both expansion of land cultivation and urbanization. In stable malaria areas of West and Central Africa and on the Madagascar coasts, the endemic situation has not changed since 1955. However, in unstable malaria areas such as the highlands and Sahel significant changes have occurred. In Madagascar, cessation of malaria control programs resulted in the deadly epidemic of 1987-88. The same situation was observed in Swaziland in 1984-85. In Uganda, malaria incidence has increased more than 30 times in the highlands (1,500-1,800 m), but its altitudinal limit has not overcome that of the beginning of the century. Cultivation of valley bottoms and extension of settlements are in large part responsible for this increase, along with abnormally heavy rainfall that favored the severe epidemic of 1994. A similar increase in malaria was observed in neighboring highlands of Rwanda and Burundi, and epidemics have been recorded in Ethiopia since 1958. In contrast, in the Sahel (Niayes region, Senegal), stricken by droughts since 1972, endemic malaria decreased drastically after the disappearance of the main vector, Anopheles funestus, due to the destruction of its larval sites by cultivation. Even during the very wet year of 1995. An funestus did not reinvade the region and malaria did not increase. The same situation was observed in the Sahelian zone of Niger. Therefore, the temperature increase of 0.5 degree C during the last 2 decades cannot be incriminated as a major cause for these malaria changes, which are mainly due to the combination of climatic, human, and operational factors.

Africa South of the Sahara↗
PubMed1998

[The anopheles of Niger].

Nineteen species of Anopheles have been observed in the Republic of Niger but only Anopheles gambiae, An. arabiensis and An. funestus are of epidemiological importance as malaria vectors. The two species of the An. gambiae complex have the same breeding sites. But in a large part of the country they disappear all during the dry season because of the lack of adequate pools of water. Their survival is as yet an unexplained phenomenon. The most northern wet season distribution of An. gambiae complex, depending on the latitude of the intertropical front. An. funestus was no longer found after 1970 because its breeding places were destroyed both by dryness and human activity. The Republic of Niger is a border area between the palearctic Mediterranean biogeographical region and the Afrotropical one. Two different vectorial systems of malaria transmission are separated by the Sahara desert. The risk of importation of an African vector such as An. gambiae and a parasite such as Plasmodium falciparum must be considered. For the time being, the low volume of road traffic limits the risk but the construction of a paved Transsaharian highway with new human settlements and developing cultivated areas with irrigation increases the dangers of epidemic outbreaks in these oases.

Animals↗
PubMed1997

Indoor resting by outdoor biting females of Anopheles gambiae complex (Diptera:Culicidae) in the Sahel of northern Senegal.

Three villages in the Senegal River basin were selected to study the biting and resting behavior of Anopheles gambiae s.l. in relation to human habits, rainfalls, and rice culture irrigation. All inhabitants sleep outside throughout the year, mainly under poor quality bednets. Mosquitoes were collected host-seeking during the night on human bait outside and resting during the day inside and outside in pit shelters. An. gambiae s.s. and An. arabiensis fed mainly outside, the only place where hosts are available; fed and gravid females resting indoors fed outside. The proportions of An. gambiae s.s. and An. arabiensis in outdoor biting catches and in indoor spray catches were not significantly different, but they differed from year to year with the latter sampling method, An. gambiae s.s. predominated in 1990, a more wet and humid year, whereas An. arabiensis was more common in 1991, which was an arid year. Both species are highly endophilic in this arid area where outdoor-resting places are limited.

Animals↗
PubMed1997

[The progress of malaria in sahelian eastern Niger. An ecological disaster zone].

The south eastern part of the Republic of Niger was ecologically damaged by the dryness since 1971. Rainfall decreased by 30 to 40% as compared to 1961-70 and lake Chad retreated 100 km to the south. Now it does not reach any more the Republic of Niger. Malaria studies have been carried out in urban and suburban places in Zinder and in the Diffa area at the extreme east. In Zinder parasitic indexes (PI) after the rainy season were around 30% to 10% according to the situation of the corner in respect with surface waters during the rains. In dry season the index fell to 3%. In Diffa in a part of the city at high risk because lining the Komadougou river, PI was only 6.7% in October after the rains. Before 1970 PI recorded in Niamey were up to 50%. In Diffa area they were of 49% in N'Guigmi and 32% in Bosso, ecologically similar to Diffa. Obviously there was a sharp decrease of malaria which could be due to the disappearance of An. funestus after 1970. It was one of the main malaria vectors. Its larvae were developing in pools remaining after the rains with heavy standing vegetation. These breeding sites have been destroyed by both dryness and human activities. Now the area has became hypoendemic and is suitable for epidemic because population has not much immunity. A surveillance system for epidemic control should be settle.

Animals↗
PubMed1997

[Eco-epidemiology of malaria in Niamey and in the river valley, the Republic of Niger, 1992-1995].

The Niger valley is an original ecosystem in the Sahelian belt. For more than 25 years it has been affected by dryness and rainfall decreased by more than 30% as compared to the period 1950-1960. Moreover the demography has sharply increased and the capital town Niamey grew by 10% a year. The Niger valley including Niamey has about 1 million inhabitants. Three sites have been selected to study the status of malaria and its evolution for the last 30 years: Niamey, Karma 40 km on the N.W. on the river and the nearby fossil valley of Fatay-Karma. In the sixties the malaria vectors were An. gambiae, An. arabiensis et An. funestus. The last species was no more harvested after 1970 because its breeding places have been destroyed on the combined action of dryness and human activities. In Niamey, parasite index was very low in the dry season but grew by 5 to 10 times during the rainy season to reach 50% in certain corners. The highest plasmodic index (PI) were recorded along the river banks where vectors are found all the year long. It decreases in the central part of the city and becomes very low in some peripheral suburban settlements. This situation is quite different of most of the cities of the area where prevalence decrease from outskirts to city centre. The serology confirms these points. In Karma, along the Niger and despite a perennial transmission, the PI removes low as well as the malaria antibodies, probably because of the self use of antimalarial drugs by the population. In Fatay-Karma the PI of 23.9% after the rainy season drops to 6% in the dry one. In data prior to 1970 the PI was over 60%, reaching 89% in young children of Niamey suburbs. Obviously it has strongly decreased. It is very likely that this is due partly to the disappearance of An. funestus after the drought.

Adolescent↗
PubMed1997

[The reconquest of the Madagascar highlands by malaria].

A strong malaria epidemic with a high mortality rate occurred on the Madagascar Highlands in 1986-88. Vector control and free access to antimalaria drugs controlled the disease. The authors have searched for the causes of the epidemic to propose a strategy avoiding such events. The Highlands on Madagascar were known as malaria free. In 1878 a very severe epidemic flooded all the country. Development of irrigated ricefields which house both An. arabiensis and An. funestus had created a new anthropic environment. Moreover manpower imported from malarious coastal areas for rice cultivation and also for building large temples, could have brought P. falciparum. After several outbreaks the disease became endemic up to 1949. In 1949 a malaria eradication programme based on DDT spraying and drug chemoprophylaxis and chemotherapy was launched. By 1960 malaria was eliminated and DDT spraying cancelled. Only 3 foci were kept under surveillance with irregular spraying until 1975. The prophylaxis and treatment centres ("centres de nivaquinisation") were kept open up to 1979. The catholic dispensary of Analaroa, 100 km N.E. of Tananarive, opened in 1971 and worked without interruption up to now. The malaria diagnosis has always been controlled by microscopy. Its registers are probably the more reliable source of information on malaria in the area. They show that malaria was already present on the Highlands in 1971 but at a low prevalence; in 1980 when the "centres de nivaquinisation" were closed the number of cases increased by three times the progressive increase of the number of cases became exponential from 1986 to 1988 which was the peak of the epidemic; malaria remained at a high level until the end of 1993; yearly DDT spraying since 1993 have decreased the number of malaria cases among the dispensary attendants by 90%. The epidemic peak of 1988 was well documented by the Pasteur Institute of Madagascar around Tananarive. Before the epidemic started it was observed a come back of An. funestus which had been previously eliminated of most of the villages by DDT spraying. More than an epidemic the malaria increase in 1988 was a reconquest by malaria of the land from which it had been eliminated in the years 1950. This episode became dramatic because the lack of immunity of the population and the shortage of medicaments. The global warming which was advocated to explain the epidemic has no responsibility because the temperature on the Madagascar Highlands has not changed during the last 30 years. Also the cyclones do not seem to have played any role. It is very likely that the gradual decline of control measures, first DDT spraying, later drug distributions, had the main responsibility in the Highlands drama. Everywhere An. funestus reached a high level during the time where the parasite reservoir was rebuilding. They synergised each other. These findings should be taken in account in drawing the strategy planning for the next years.

DDT↗
PubMed1997

[Individual protection against insect vectors].

Many diseases for which no vaccine is available are transmitted by insect and arthropod vectors, the main exceptions being yellow fever and Japanese encephalitis B. Treatment is less and less effective due to the development of chemoresistance to therapeutic and prophylactic drugs as is well-illustrated by malaria. One of the best methods of preventing these diseases is personal protection against insect bites. Personal protection measures can be divided into three categories which can be used separately or in combination : application of repellents to the skin, wearing clothes impregnated with insecticides, and use of bed nets and other barriers impregnated with insecticides. The choice of method depends on the type of insect vector involved. For insects that are active during the day or at dusk, application of repellents to the skin gives good short-term protection and wearing impregnated clothes is useful. Bed nets that have been properly impregnated with pyrethroids are highly effective for night-time protection. Since personal protection methods are not 100% effective, they must be used in association with chemoprophylaxis according to medical guidelines. Medical advice should be sought if fever should occur especially after returning from a trip in the tropics.

Animals↗
PubMed1995

Impact of deltamethrin-impregnated bednets on biting rates of mosquitoes in Zaire.

In a rural area of Zaire, the whole population of a village was protected by deltamethrin-impregnated mosquitoes bednets. A similar village was observed as a control. Biting rates for mosquitoes were recorded in both villages. The principal man-biting species were Mansonia africana, Mansonia uniformis, and Aedes aegypti. In the village protected by the impregnated mosquito bednets, the number of Mansonia bites was reduced 96% indoors and at a lesser rate outdoors. Biting rates of Ae. aegypti dropped to 0 indoors, but the outdoor biting rate remained unchanged. It is concluded that the reduction in mosquito bites is not only caused by the repellent action of the deltamethrin but also by a reduction in mosquito numbers.

Animals↗
PubMed1995

[Study of 6 cases of malaria acquired near Roissy-Charles-de-Gaulle in 1994. Necessary prevention measures in airports].

During the very hot 1994 summer, six new cases of airport malaria have been observed in and around Roissy-Charles-de-Gaulle airport. Four patients were regular or occasional airport employees. The two other cases were inhabitants of a city at 7 km. Entomological investigations suggest that cars of airport employees served to disseminate anophelines outside the airport areas. The six cases were very severe. One patient died. Apparently, W.H.O. recommendations on aircraft disinsecting procedures have not been fully followed. There is obviously a threat for areas near the airports.

Adult↗
PubMed1995

[Comparison of the transmission of malaria in 2 epidemiological patterns in Senegal: the Sahel border and the Sudan-type savanna].

From September 1992 to October 1993 a longitudinal entomological study was carried out in two villages located in different ecological conditions of Senegal, a sahelian area and a sudan-type savanna. Mosquitoes were sampled by night-bites catches and by daytime pyrethrum spray collections. In both villages Anopheles gambiae s.l. is the main vector with An. gambiae in the savanna area of Wassadou and An. arabiensis in the sahelian area of Thiaye. Malaria transmission is mainly seasonal with a man biting rate (ma) and an entomological inoculation rate (h) higher in Wassadou than in Thiaye. In this last one (sahelian area), a high variation of An. gambiae s.l. density was observed, females disappear in the dry season. In the rainy season the main biting rate increases but no infected bite was recorded. In Wassadou (sudan-type savanna), a great difference in An. gambiae s.l. specific composition was observed with An. gambiae predominant in the rainy season and An. arabiensis generally more abundant in the dry season. The biting and inoculation rates were minimum during the dry season (ma = 4 bites/man/night; h = 0.07 infected bites/man/night-, they increase during the rainy season (ma: 52 bites/man/night; h = 1.6 infected bites/man/night). An inhabitant of this village gets annually some 63, bites and 220 infected bites of An. gambiae s.l., mainly during the six months of the rainy season and the early dry season.

Animals↗