Biomedical subjects

P Carnevale

Publications and source records attributed to P Carnevale.

At least 19 recordsLinked to original sources

PubMed2006

[Impact of a new parasitologic laboratory for malaria diagnosis on diagnosis and cost of malaria in a company setting: experience from Angola].

In malaria endemic areas treating every fever episode as a malaria onset would result in overdiagnosis with a margin of the error varying in function of epidemiological factors. When further compounded by overestimation related to errors in parasitologic diagnosis, clinical misdiagnosis leads to unwarranted hospitalization and inappropriate treatment. In a company setting this would mean unnecessary loss of employee work time. False positive diagnosis causes overestimation of chemoresistance, overconsumption of antimalarial drugs and underestimation of other infectious diseases. Judging from these high costs, it can be assumed that improving the reliability of parasitologic diagnosis would have a positive impact on the quality of clinical management, efficiency of antimalarial use and accuracy of epidemiological surveys. This assumption was confirmed by analysis of data following start-up of a parasitologic laboratory for malaria diagnosis in the health care clinic at Sonamet's fabrication yard in Lobito, Angola. Laboratory personnel receives expert training and audit findings demonstrate consistently reliable diagnosis. This experience underscores the need for reliable parasitologic diagnosis as a prerequisite for any large-scale malaria control program.

Absenteeism↗

PubMed2006

[Pyrethroid and DDT resistance of Anopheles gambiae s.s. (Diptera: Culicidae) in five agricultural ecosystems from Côte-d'Ivoire].

The promotion of pyrethroid impregnated bednets among the populations is a major activity of the National Malaria Vector Control Programs in African tropical countries. However pyrethroid resistance in Anopheles gambiae, a major malaria vector, has been observed in several parts of Côte-d'Ivoire since 1993. As insecticides used in agriculture against pests are frequently considered as important factors responsible for resistance in malaria vectors, we have evaluated insecticide resistance of An. gambiae populations taking into account the main crops cultivated in Côte-d'Ivoire. Five areas were selected according to the use of insecticide either in agriculture or for domestic purposes: a urban area where vegetables and rice are main crops, a rural rice growing area, a rural area of coffee/cocoa production, a rural area of fruit farming and a rural area without any use of agricultural insecticide. Susceptibility tests were carried out using WHO diagnostic test kits. About 6500 females of An. gambiae were exposed to insecticide impregnated papers (permethrin 1%, deltamethrin 0.05%, DDT 4%) for one hour. Results confirmed that both mortality rates and knockdown time analysis were important to study the resistance data. By using mortality rates, populations of An. gambiae were found to be resistant to pyrethroids and DDT in four of the five areas. Resistance was the highest in urban area, lower in fruit and coffee/cocoa areas and at low level in rice growing area. An. gambiae from area without agricultural treatment was found susceptible to pyrethroids but slightly resistant to DDT A significant increase of knockdown time was observed in all areas with the 3 insecticides. These results agreed with previous studies showing that kdr mutation was the main resistance mechanism to pyrethroids in An. gambiae populations in Côte-d'Ivoire. They also agreed with knockdown time which is an early indicator of resistance development for the population in area without agricultural treatment. In this population the frequency of homozygous resistant individuals was probably too low to have a significant decrease of mortality rates to pyrethroids.

Agriculture↗

PubMed2004

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.

Animals↗

PubMed2004

Efficacy of permethrin-treated uniforms in combination with DEET topical repellent for protection of French military troops in Côte d'Ivoire.

In 2000, 22,000 French military personnel were deployed overseas. The French military health service implemented a vector control strategy including personal protection by the use of permethrin preimpregnated battlefield uniforms (BFUs) and the application on the skin of a topical repellent (50% DEET). In 2000, French forces used an industrial process to impregnate cloth with permethrin by soaking it before cut-out of the BFU. A study was implemented in four experimental huts in Côte d'Ivoire to assess the field efficacy of the impregnated BFUs and their resistance to washing. Taking into account the systematic variations in each variable in the field and using a modeling based on logistic regression and discriminant analysis, this study showed that after 6 h without reapplication, the protective effects of the use of DEET as skin repellent was not significant, perhaps due to the high density of Anopheles mosquitoes during the night catching sessions and an average time of effective repellency of < 2 or 3 h in the field. The analysis also showed that the French process of industrial impregnation of permethrin of the BFU offered in 2000 some protection from mosquito bites but not enough to reduce significantly the incidence of malaria among nonimmune troops. No positive or negative interaction was noted when DEET and the impregnated BFUs were used together.

Animals↗

PubMed2003

Resistance to carbosulfan in Anopheles gambiae from Ivory Coast, based on reduced sensitivity of acetylcholinesterase.

Resistance to carbosulfan, a carbamate insecticide, was detected in field populations of the malaria vector mosquito Anopheles gambiae Giles (Diptera: Culicidae) from two ecologically contrasted localities near Bouaké, Ivory Coast: rural M'bé with predominantly M form of An. gambiae susceptible to pyrethroids; suburban Yaokoffikro with predominantly S form of An. gambiae highly resistant to pyrethroids (96% kdr). The discriminating concentration of 0.4% carbosulfan (i.e. double the LC100) was determined from bioassays with the susceptible An. gambiae Kisumu strain. Following exposure to the diagnostic dosage (0.4% carbosulfan for 1 h), mortality rates of female An. gambiae adults (reared from larvae collected from ricefields) were 62% and 29% of those from M'bé and Yaokoffikro, respectively, 24 h post-exposure. Exposure for 3 min to netting impregnated with the operational dosage of carbosulfan 200 mg/m2 gave mortality rates of 88% of those from M'bé and only 12.2% for Yaokoffikro. In each case the control untreated mortality rate was insignificant. Biochemical assays to detect possible resistance mechanism(s) revealed the presence of insensitive AChE in populations of An. gambiae at both localities, more prevalent in the S form at Yaokoffikro than in M form at M'bé, as expected from bioassays results. Our study demonstrates the need to monitor carbamate resistance among populations of the An. gambiae complex in Africa, to determine its spread and anticipate vector control failure if these insecticides are employed.

Acetylcholinesterase↗

PubMed2003

First report of the oriental mosquito Aedes albopictus on the West African island of Bioko, Equatorial Guinea.

The invasive oriental mosquito Aedes (Stegomyia) albopictus (Skuse) (Diptera: Culicidae) was detected on Bioko Island for the first time in November 2001. It was found to be well established breeding in artificial containers at Planta, near Malabo, the capital of Equatorial Guinea. Associated species of mosquito larvae were Aedes aegypti (L.), Ae. africanus (Theobald), Culex near decens Theobald, Cx. duttoni Theobald, Cx. quinquefasciatus Say, Cx. tigripes De Grandpré & De Charmoy, Eretmapodites quinquevittatus Theobald and Mansonia africana (Theobald). This is the third tropical African country to be invaded by Ae. albopictus, which has recently spread to many parts of the Americas and Europe--with vector competence for dengue, yellow fever and other arboviruses. In the Afrotropical environment, it will be interesting to monitor the ecological balance and/or displacement between introduced Ae. albopictus and indigenous Ae. aegpyti (domestic, peri-domestic and sylvatic populations).

Aedes↗

PubMed2003

Inland valley rice production systems and malaria infection and disease in the savannah of Côte d'Ivoire.

In sub-Saharan Africa, lowlands developed for rice cultivation favour the development of Anopheles gambiae s. l. populations. However, the epidemiological impact is not clearly determined. The importance of malaria was compared in terms of prevalence and parasite density of infections as well as in terms of disease incidence between three agroecosystems: (i) uncultivated lowlands, 'R0', (ii) lowlands with one annual rice cultivation in the rainy season, 'R1' and (iii) developed lowlands with two annual rice cultivation cycles, 'R2'. We clinically monitored 2000 people of all age groups, selected randomly in each agroecosystem, for 40 days (in eight periods of five consecutive days scheduled every 6 weeks for 1 year). During each survey, a systematic blood sample was taken from every sick and asymptomatic person. The three agroecosystems presented a high endemic situation with a malaria transmission rate of 139-158 infective bites per person per year. The age-standardized annual malaria incidence reached 0.9 malaria episodes per person in R0, 0.6 in R1 and 0.8 in R2. Children from 0 to 9-year-old in R0 and R2 had two malarial attacks annually, but this was less in R1 (1.4 malaria episodes per child per year). Malaria incidence varied with season and agroecosystem. In parallel with transmission, a high malaria risk occurs temporarily at the beginning of the dry season in R2, but not in R0 and R1. Development of areas for rice cultivation does not modify the annual incidence of malarial attacks despite their seasonal influence on malaria risk. However, the lower malaria morbidity rate in R1 could be explained by socio-economic and cultural factors.

Adolescent↗

PubMed2003

Efficacy of mosquito nets treated with insecticide mixtures or mosaics against insecticide resistant Anopheles gambiae and Culex quinquefasciatus (Diptera: Culicidae) in Côte d'Ivoire.

Only pyrethroid insecticides have so far been recommended for the treatment of mosquito nets for malaria control. Increasing resistance of malaria vectors to pyrethroids threatens to reduce the potency of this important method of vector control. Among the strategies proposed for resistance management is to use a pyrethroid and a non-pyrethroid insecticide in combination on the same mosquito net, either separately or as a mixture. Mixtures are particularly promising if there is potentiation between the two insecticides as this would make it possible to lower the dosage of each, as has been demonstrated under laboratory conditions for a mixture of bifenthrin (pyrethroid) and carbosulfan (carbamate). The effect of these types of treatment were compared in experimental huts on wild populations of Anopheles gambiae Giles and the nuisance mosquito Culex quinquefasciatus Say, both of which are multi-resistant. Four treatments were evaluated in experimental huts over six months: the recommended dosage of 50 mg m(-2) bifenthrin, 300 mg m(-2) carbosulfan, a mosaic of 300 mg m(-2) carbosulfan on the ceiling and 50 mg m(-2) bifenthrin on the sides, and a mixture of 6.25 mg m(-2) carbosulfan and 25 mg m(-2) bifenthrin. The mixture and mosaic treatments did not differ significantly in effectiveness from carbosulfan and bifenthrin alone against anophelines in terms of deterrency, induced exophily, blood feeding inhibition and overall mortality, but were more effective than in earlier tests with deltamethrin. These results are considered encouraging, as the combination of different classes of insecticides might be a potential tool for resistance management. The mixture might have an advantage in terms of lower cost and toxicity.

Animals↗

PubMed2002

Stable chromosomal inversion polymorphisms and insecticide resistance in the malaria vector mosquito Anopheles gambiae (Diptera: Culicidae).

Anopheles gambiae Giles has been implicated as a major vector of malaria in Africa. A number of paracentric chromosomal inversions have been observed as polymorphisms in wild and laboratory populations of this species. These polymorphisms have been used to demonstrate the existence of five reproductive units in West African populations that are currently described as incipient species. They have also been correlated with various behavioral characteristics such as adaptation to aridity and feeding preference and have been associated with insecticide resistance. Two paracentric inversions namely 2La and 2Rb are highly ubiquitous in the wild and laboratory populations sampled. Both inversions are easily conserved during laboratory colonization of wild material and one shows significant positive heterosis with respect to Hardy-Weinberg proportions. Inversion 2La has previously been associated with dieldrin resistance and inversion 2Rb shows an association with DDT resistance based on this study. The stability and maintenance of these inversions as polymorphisms provides an explanation for the transmission and continued presence of DDT and dieldrin resistance in a laboratory strain of An. gambiae in the absence of insecticide selection pressure. This effect may also be operational in wild populations. Stable inversion polymorphism also provides a possible mechanism for the continual inheritance of suitable genetic factors that otherwise compromise the fitness of genetically modified malaria vector mosquitoes.

Animals↗

PubMed2002

[Dynamics of malaria transmission in Kafiné, a rice growing village in a humid savannah area of Côte d'Ivoire].

A study on malaria transmission based on samples of mosquitoes caught on human subjects was conducted from February to August 1995 in the rice growing area of Kafine, a village located in the Niakaramandougou district of northern Côte d'Ivoire. The village is surrounded by 117,500 acres of rice fields. Irrigation is sub-permanent in the rice field and harvests number two a year. During the 6 months of the study, 12.353 mosquitoes were caught. The average biting rate was 118.8 bites per man per night (b/m/n). Mansonia, Culex and Aedes represented only 17.5% of the total number of mosquitoes caught. Anopheles accounted for 82.5% of the number of anthropophilic mosquitoes. Anopheles gambiae s.s. represented 83.7% of the total Anopheles species. As a whole, the average biting rate recorded for the Anopheles was 98 b/m/n. The average biting rate of An. gambiae was 90.4 b/m/n. The highest rate (121.5 b/m/n) was recorded in April. During the dry and rainy season, the indoor biting cycle per hour of An. gambiae s.s. was studied from 6 p.m. to 6 a.m. In both seasons, a marked biting activity was noticed between 10 p.m. and 5 a.m. The average annual parity rate reached 40.2% but it ranged from 59.8% (n = 82) in February to 19% (n = 63) in May. The mean sporozoitic index of An. gambiae throughout the study period was 1.1% (14 positive salivary glands/1.251 dissected). The index ranged from 0 in April, May and June to 6.2 (n = 192) in July. The rate did not vary with rainfall but with the different stages of rice growing. The non-synchronisation of agricultural practises for each growing cycle seemed to be a conclusive factor in the transmission of malaria in this locality. Malaria transmission at Kafine can be characterised by 3 main elements: transmission is intensive with an estimated inoculation rate of 1 ib/m/n; transmission is more related to double phase rice cultivation (regardless of synchronisation on plots) than to rainfall; transmission shows particular variations linked to rice cultivation cycles with an increase during periods of ripeness and harvest. The nuisance caused by higher mosquito density has brought people to comply with use of pyrethroid impregnated bed nets advocated for wide use by the National Malaria Control Program.

Aedes↗

PubMed2002

[The epidemiology of malaria in the southwestern forests of the Ivory Coast (Tai region)].

An epidemiological study on malaria was undertaken between July 1995 and July 1996 in two villages (Zaïpobly and Gahably) and their encampments (Kouassikro, Hamanikro and Konankro), in the south-western forest area of Côte d'Ivoire (region of Taï). The parasitological scheme comprised a total of 2023 tests performed on children aged from 0 to 14 years. The species found were Plasmodium falciparum, P. malariae and P. ovale with a proportion of 84%, 14% and 2% respectively. The global parasite prevalence of all Plasmodium species was 85% and malaria was holoendemic. The average parasitic density decreased progressively as the age increased, in contrast to the plasmodic index which did not vary. All the malarial indexes were similar in the villages and their encampments. Only overall fever prevalence was permanent and in all age groups it was higher in the encampments than in the villages. The entomological findings showed that transmission was permanent and intense throughout the year, with a recrudescence during the rainy season. Transmission was attributed to Anopheles gambiae s.l. in 85% of the cases whereas An. funestus played a secondary role. The average sporozoïtic index was 7.6% and varied between 1.1% and 16.7%. The entomological inoculation rate was of 400 infected bites per person-year for An. gambiae s.l. In such conditions of intense transmission, acquisition of premunition starts at a very early age. This assertion is verified by the average parasite density and the frequency of high parasitic densities which were at their maximum between 1 and 4 years of age and decreased thereafter as the age increased. The paludometric and entomologic indexes obtained are the most elevated ever to have been observed in Côte d'Ivoire, as a result of considerable ecological changes linked to the deterioration of the forest environment over the past 30 years. This deterioration has probably been caused by demographic pressure resulting from internal and foreign immigration to the Taï region and more especially by the influx of Liberian refugees.

Adolescent↗

PubMed2002

[An experimental tool essential for the evaluation of insecticides: the testing huts].

The following study analyses the potentialities of the experimental huts built in M'be Valley (Côte d'Ivoire) where the evaluations of the insecticide products have been carried out for many years in line with the WHOPES protocol on the methodology of stage 2 assays. Starting a testing station first requires a good knowledge of the sensitivity of Anopheles gambiae to the main insecticide families. Then thanks to the experimental huts the efficacy of the various means of treatment can be compared with the one in untreated huts; this study focuses on house spraying using 100 mg a.i./m2 and bednets impregnated with lambda-cyhalothrin at a dose of 15 mg a.i./m2. The fipronil used in house spraying doesn't show any repellent effect, however it does have an irritating effect that increases the natural exophily of An. gambiae females entering the testing huts. The blood-feeding rate recorded in the treated huts was reduced to 24% and to 38% mortality rate consisting mainly of a 24 hours delayed mortality. The bednets treated with lambda-cyhalothrin have greatly reduced the contact between man and vector since the entry rate of An. gambiae females was cut down by 68% compared to the control. The exophily of this anopheles was twofold greater with the impregnated bednets and the blood-feeding rate reduced to 47%. Finally the global mortality rate, two thirds of immediate mortality, one third of delayed mortality, reached 35%. The experimental huts in the M'be Valley therefore provide essential information regarding the selection of the most efficacious insecticides against An. gambiae. This experimental method must be extended to other sites in order to finalize ever more selective and appropriate means of control against nuisance and disease-vector mosquitoes.

Animals↗

PubMed2001

Olyset Net efficacy against pyrethroid-resistant Anopheles gambiae and Culex quinquefasciatus after 3 years' field use in C te d'Ivoire.

Pyrethroid-impregnated bednets are advocated for personal protection against malaria vectors. To avoid the need for periodic re-treatment, it would be advantageous to have nets that retain insecticidal efficacy for years and withstand repeated washing. Such a type of commercially produced bednet with permethrin 2% incorporated in polyethylene fibres (trademark Olyset Net supplied by Sumika Life-Tech Co., Osaka, Japan) was evaluated against mosquitoes in veranda-trap huts at Yaokoffikro, near Bouaké, C te d'Ivoire, by standard WHOPES phase II procedures. Four Olyset Nets were compared with a standard untreated polyester net as control. They comprised three examples previously used in a village for over 3 years (one washed, one dirty, one very dirty) and a previously unused Olyset Net, newly unwrapped, from the same original batch. Bioassays with 3 min exposure of susceptible Anopheles gambiae Giles (Diptera: Culicidae) gave >99% mortality of female mosquitoes tested on the 'new' Olyset Net. The used Olyset Nets gave mortality rates averaging 83% for the washed net, 85% for the dirty net and 55% for the very dirty net (within 24-h following 3 min exposure). Thus, Olyset Nets were found to remain remarkably effective against susceptible An. gambiae for at least 3 years under field conditions. Wild pyrethroid-resistant populations of Culex quinquefasciatus Say and An. gambiae (savanna cytotype with 96% kdr) were assessed during June-August 1999 for their responses to sleepers protected by nets in the experimental huts. With regard to hut entry by foraging female mosquitoes, Olyset Nets showed some deterrency against An. gambiae (44% reduction by the new net, approximately 20% by the dirty nets, none by the washed net), but not against Cx. quinquefasciatus. Among mosquitoes entering the hut with untreated control net, 30-34% tried to leave (exophily) but were caught in the verandah trap. The permethrin repellency of Olyset Nets increased exophily by 19% for An. gambiae and 14% for Cx. quinquefasciatus. Blood-feeding rates were 16% An. gambiae and 35% Cx. quinquefasciatus in the hut with sleeper under the untreated net (showing considerable prevention of biting), 22-26% of both species in huts with washed or dirty used Olyset Nets (not significantly different from control), while the biting success rate of Cx. quinquefasciatus (but not kdr An. gambiae) was more than halved by the 'new' Olyset Net. Mortality rates of pyrethroid-resistant An. gambiae and Cx. quinquefasciatus from the huts were, respectively, 3% and 8% with the untreated polyester net, 27.5% and 17% with the 'new' Olyset, 15% and 17.5% with the washed Olyset, 16-25% and 17-20% with dirty old Olyset Nets. Kill differences between nets are significantly different for both An. gambiae and Cx. quinquefasciatus. Unfortunately the washed used Olyset Net showed least activity against resistant mosquitoes, despite its greatest activity against susceptible An. gambiae. In each case there was evidence that a high proportion of mosquitoes failed to feed through the net (many of them dying from starvation when they could not leave the closed hut), with indications that dirty Olyset nets enhanced this protective value.

Animals↗

PubMed2001

Combined pyrethroid and carbamate 'two-in-one' treated mosquito nets: field efficacy against pyrethroid-resistant Anopheles gambiae and Culex quinquefasciatus.

A new approach is proposed in the treatment of mosquito nets, using a 'two-in-one' combination of pyrethroid and non-pyrethroid insecticides applied to different parts of bednets. The objectives are mainly to overcome certain limitations of pyrethroid-impregnated bednets currently recommended for malaria control purposes. Apart from developing alternatives to pyrethroid dependency, we sought to counteract pyrethroid irritant effects on mosquitoes (excito-repellency) and resistance to pyrethroids. The idea takes advantage of the presumed host-seeking behaviour of mosquitoes confronted by a net draped over a bed, whereby the mosquito may explore the net from the top downwards. Thus, nets could be more effective if treated on the upper part with residual non-irritant insecticide (carbamate or organophosphate) and with a pyrethroid on the lower part. Sequential exposure to different insecticides with distinct modes of action is equivalent to the use of a mixture as a potential method of managing insecticide resistance. We also intended to improve the control of nuisance mosquitoes, especially Culex quinquefasciatus Say (Diptera: Culicidae) that often survive pyrethroids, in order to encourage public compliance with use of insecticide-treated nets (ITNs). Polyester bednets were pretreated with residual pyrethroid (bifenthrin 50 mg/m2 or deltamethrin 25 mg/m2) on the lower half and with carbamate (carbosulfan 300 mg/m2) on the upper half to minimize contact with net users. Unreplicated examples of these 'two-in-one' treated nets were field-tested against wild mosquitoes, in comparison with an untreated net and bednets treated with each insecticide alone, including PermaNet wash-resistant formulation of deltamethrin 50 mg/m2. Overnight tests involved volunteers sleeping under the experimental bednets in verandah-trap huts at Yaokofikro, near Bouaké in C te d'Ivoire, where the main malaria vector Anopheles gambiae Giles, as well as Culex quinquefasciatus Say, are highly resistant to pyrethroids. Efficacy of these ITNs was assessed in the huts by four entomological criteria: deterrency and induced exophily (effects on hut entry and exit), blood-feeding and mortality rates (immediate and delayed). Overall, the best impact was achieved by the bednet treated with carbosulfan alone, followed by 'two-in-one' treatments with carbosulfan plus pyrethroid. Blood-feeding rates were 13% An. gambiae and 17% Cx. quinquefasciatus in huts with untreated nets, but only 3% with carbosulfan ITNs, 7-11% with combined ITN treatment, 6-8% An. gambiae and 12-14% Cx. quinquefasciatus with pyrethroid alone. Mosquitoes that entered the huts were killed sooner by nets with combined treatment than by pyrethroid alone. Mortality-rates in response to ITNs with carbosulfan (alone or combined with pyrethroid) were significantly greater for Cx. quinquefasciatus, but not for An. gambiae, compared to ITNs with only pyrethroid. About 20% of sleepers reported potential side-effects (headache and/or sneezing) from use of ITN treated with carbosulfan alone. Further development of this new 'two-in-one' ITN concept requires a range of investigations (choice of effective products, cost-benefit analysis, safety, etc.) leading to factory production of wash-resistant insecticidal nets treated with complementary insecticides.

Animals↗

PubMed2001

[Investigation surrounding a fatal case of yellow fever in Côte d'Ivoire in 1999].

Côte d'Ivoire is an endemic country for yellow fever, but no case was officially notified in recent years. In July 1999, however, one fatal case was reported. A German citizen was infected in the national park of Comoe, in the north eastern area of the country. In order to evaluate the extent of amaril virus circulation and the risk for local people, a virological, entomological and epidemiological investigation was carried out by the ministry of health, the OCCGE, the Côte d'Ivoire Pasteur Institute (IPCI) and the World Health Organisation in the area where the fatal case had been staying. 18 suspected and 24 confirmed mosquito catchers were identified by interview and a blood specimen was collected from each of them. In addition, 159 batches of mosquitoes from which 94 batches of potential vectors were collected; among the suspected cases, 22% were immunised against yellow fever. Serological and virological analyses were made at IPCI and the Paris Pasteur Institute by ELISA technique and isolation on cells cultures and newborn mice. All the suspicious sera and 87.5% of the catchers were positive for IgG anti-amaril virus. One catcher's serum was positive for IgM anti-amaril virus. 11 suspected sera were positive for IgG anti-dengue virus with 1 positive for IgM. 1 strain of amaril virus and 3 strains of Zika virus were isolated from mosquitoes at IPCI and confirmed by CRORA in Dakar. These results indicated that there is a yellow fever and dengue virus are prevalent among the human and vector populations in the study area. Preventive measures must be adopted to protect human beings at risk for amaril infection.

Adolescent↗

PubMed2001

[Antimalarial guidelines and therapy practices of the population of Bouake, Ivory Coast].

This survey of 162 households in the city of Bouaké, Côte d'Ivoire was undertaken to study the behavior of the population in diagnosing and treating malaria. Findings indicate that awareness of symptoms and ability to evaluate the severity of malaria is high. In most cases, mild malaria is treated at home. In case of presumptive diagnosis of malaria, 87.6% of households undertake self-treatment, 9.3% seek institutional healthcare, 1.2% go to traditional healers, and 1.9% use traditional remedies. The most frequent drug for primary treatment is chloroquine (68.3%) which is generally obtained from pharmacies (98.8%). However, proper dosages are rarely used. If primary treatment fails, behavior is complex depending on the estimated severity of disease. Although many causes of malaria are mentioned, most people implicate mosquitoes (75.6%). In 95.1% of households surveyed, chloroquine prophylaxis was used for newborns. Most households (89.5%) practice mosquito bite protection but use of mosquito nets is low (4.9%). These results showing the preference for family-based management suggest that informational campaigns are needed to promote effective and consistent home treatment. Education is also needed to increase knowledge about mosquito nets and insecticides.

Adult↗

PubMed2001

[Malaria vector control in Cameroon: past, present, future. Reflections].

During the fifties, large scale malaria vector control projects based upon house spraying were implemented in Southern and Northern parts of Cameroon in line of malaria eradication concept. In the South, the pilot zone of Yaounde gathered about 150,000 inhabitants, in the forest area. First operations started in 1953 but the programme became actually operational in 1956. It was divided in two parts: the western part was treated with DDT, while the eastern one was treated with dieldrin. At the same time, the whole forested area was also treated with dieldrin until 1960. Yaounde itself was not treated because it was free of anopheles and malaria. House spraying in the pilot area of Yaounde was a complete success and plasmodic index dropped below 1%. The same success was observed in most of the southern treated areas. Unfortunatly dieldrin resistance of An. gambiae hampered this programme which stopped in 1960. The northem pilot project dealt with some 250,000 inhabitants around Maroua, in a savanna area. To avoid dieldrin resistance observed in 1956, DDT was selected and house spraying started in 1959. From a strictly operational point of view, the campaign was considered as a success. But after two years, it was noticed that plasmodic index remained still around the same value of 35% and the programme stopped. It was thus stated that according to available techniques it was not possible to reach the ultimate goal of eradication even when chemoprophylaxis (chloroquin + pyrimethamin) was added. The comparison between south (= success) and north (= failure) was very interesting as it underlined the big differences between epidemiological faces, an unaccepted concept at that time. Now ecological and epidemiological diversity is the well acknowledged. It also underlined the need of diversity of strategies according to the epidemiology of the disease and the ecology of its vector Vector control was then stopped for a while. In the eighties, Primary Health Care was promoted and malaria control shifted from vector to parasite control, vector control remaining as a prevention method. But chemioresistance of Plasmodium falciparum appeared and. quickly spread, at different levels, across the country. A new emphasis was therefore given to vector control thank to the newly developed technique of insecticide impregnated mosquito nets. Two kinds of studies were undertaken: - what people were actually doing in term of mosquito control at family level, the main reason and the costs as well as current use of mosquito nets - the efficacy of pyrethroid treated mosquito nets (IMN) in different areas of southern forested area against different malaria vectors: An. gambiae, An. nili, An. moucheti. It thus clearly appeared that IMN were very successful in sharply reducing malaria transmission aAd morbidity. But its promotion is limited by the current poor use of mosquito nets in Yaoundé (1 mosquito net for 27 "beds") while in Douala, where IMN are largely used against the bite of the huge population of Culex. quinquefasciatus, the implementation of the first riational centre for impregnation of mosquito net was a great success, as long as it was headed by a motivated and skill manager Impregnated mosquito nets appear thus as a tool of great efficacy but their sustainability is still matter of concern and promotional campaigns must be developed involving private and public, political and scientific spheres as well as the general population who should be encouraged to become partners and even actors of vector and malaria control at their household level.

Animals↗

PubMed2000

Experimental and molecular genetic analysis of the impact of pyrethroid and non-pyrethroid insecticide impregnated bednets for mosquito control in an area of pyrethroid resistance.

Experimental huts in Côte d'Ivoire were used to evaluate the pyrethroid alpha-cypermethrin, the non-ester pyrethroid etofenprox, the organophosphate pirimiphos-methyl and the carbamate carbosulfan on bednets against pyrethroid-resistant Anopheles gambiae Giles. To test for selection for the resistance gene by the treated nets, A. gambiae collected live or dead from the huts were kept and analysed for the presence of the kdr gene using a new polymerase chain reaction followed by sequence-specific oligonucleotide probing (PCR-SSOP) for kdr-genotyping. Deliberately holed bednets freshly treated with pirimiphos-methyl or carbosulfan caused over 90% kill of A. gambiae s.s. and Culex spp. However, the mortality with alpha-cypermethrin or etofenprox treated nets was similar to that with untreated nets. Bloodfeeding of A. gambiae s.s. on the sleepers under the nets was only significantly reduced by alpha-cypermethrin and carbosulfan. Tests of the residual activity of the bednets after seven months showed that pirimiphos-methyl had lost its efficacy while carbosulfan still performed well. Once again the pyrethroid treated nets gave similar results to the untreated nets. Selection for the kdr-allele by alpha-cypermethrin and etofenprox, but not by carbosulfan, was indicated by PCR-SSOP genotyping of mosquitoes. Thus carbamates such as carbosulfan, or organophosphates of longer persistence than pirimiphos-methyl and of low mammalian toxicity, would seem to be a promising alternative to be used on bednets, particularly in areas of pyrethroid resistance.

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