Control Program Research Articles

The COVID-19 pandemic impacted the activities of the Schistosomiasis Control Program in Brazil: is the goal of controlling the disease by 2030 at risk?

Schistosomiasis continues to represent a serious public health problem in Brazil. With the coronavirus disease 2019 (COVID-19) pandemic, several control strategies were suspended, probably compromising the goals of eradicating the disease in the country. We aimed to assess the impact of the COVID-19 pandemic on Schistosomiasis Control Program (PCE) actions in all endemic states of Brazil. We performed an ecological study using spatial analysis techniques. The PCE variables assessed were the population surveyed, the number of Kato-Katz tests, positive cases of schistosomiasis and the percentage of cases treated between 2015 and 2021. The percent change was calculated to verify if there was an increase or decrease in 2020 and 2021, along with time trend analyses provided by the Joinpoint model. Spatial distribution maps were elaborated considering the percent change. The surveyed population decreased in 2020 (-65.38%) and 2021 (-37.94%) across Brazil. There was a proportional reduction in the number of Kato-Katz tests (2020, -67.48%; 2021, -40.52%), a decrease in the percentage of positive cases (2020, -71.16%; 2021, -40.5%) and a reduction in the percentage of treated cases (2020, -72.09%; 2021, -41.67%). Time trend analyses showed a decreasing trend in most PCE variables. The PCE activities were impacted by the COVID-19 pandemic in Brazil and PCE strategies must be urgently reviewed, focusing on investments in all endemic areas.

Ratio-dependent competitions between a Wolbachia-uninfected bisexual strain and Wolbachia-infected thelytokous strain of the egg parasitoid, Trichogramma dendrolimi Matsumura (Hymenoptera: Trichogrammatidae)

BackgroundWolbachia-infected thelytokous Trichogramma wasps have been considered as potential effective biocontrol agents against lepidopteran pests in agriculture and forests. However, intra-specific competition may arise when Wolbachia-infected thelytokous Trichogramma coexist with their uninfected bisexual counterparts in fields or during mass-rearing procedures. This competition could potentially impact the efficacy of Trichogramma females in biological control programs.ResultsThis study examined the parasitic capacities of bisexual (TdB) and Wolbachia-infected thelytokous (TdT) strains of Trichogramma dendrolimi as influenced by host density (ranging from 5 to 70 host eggs) and wasp density (two, four, and six females per arena). The experiments involved inter-strain competition between TdB and TdT strains (Inter-Td) as well as intra-strain competition within the TdT (Intra-TdT) or TdB (Intra-TdB) strains. Results revealed that females in the Inter-Td group exhibited a higher attack rate compared to those in the Intra-TdT and Intra-TdB groups, irrespective of wasp density. Specifically, when six females were present, the Inter-Td group showed significantly shorter host handling times than the Intra-TdT group. Within intra-strain cohorts, TdT females displayed a lower attack rate than TdB females when four or six females were present, and longer host handling times when six females were present. Mutual interference between individuals was not affected by competition types. Females of the Inter-Td group exhibited a higher probability of superparasitism than those of the Intra-TdB group or Inter-Td group. When both strains coexisted, the proportion of TdT offspring with six females was higher than that with two females or four females. Male ratios of bisexual offspring in Inter-Td groups were higher than those in Intra-TdB groups. The male ratio of bisexual offspring in the Inter-Td group increased with wasp density.ConclusionsOur study highlights the negative impact of Wolbachia on parasitic capacity of Trichogramma females, increasing the likelihood of superparasitism. The coexistence of both strains enhances total parasitic efficacy, albeit resulting in a higher proportion of male offspring compared to scenarios with only uninfected females. The results will provide the reference for the usage of Wolbachia-infected thelytokous strain of T. dendrolimi in augmentative biological control programs.

Therapeutic efficacy and tolerability of artemether–lumefantrine for uncomplicated Plasmodium falciparum malaria in Niger, 2020

BackgroundMonitoring therapeutic efficacy is important to ensure the efficacy of artemisinin-based combination therapy (ACT) for malaria. The current first-line treatment for uncomplicated malaria recommended by the National Malaria Control Program in Niger is artemether–lumefantrine (AL). In 2020, an in vivo study was carried out to evaluate clinical and parasitological responses to AL as well as the molecular resistance to the drug in three sentinel sites: Agadez, Tessaoua and Gaya, in Niger.MethodsA multi-center, single-arm trial was conducted according to the 28-day World Health Organization (WHO) 2009 therapeutic efficacy study protocol. Children between 6 months and 15 years with confirmed uncomplicated Plasmodium falciparum infection and 1000–200,000 asexual parasites/μL of blood were enrolled and followed up for 28 days. Uncorrected and PCR-corrected efficacy results at day 28 were calculated, and molecular correction was performed by genotyping the msp1, msp2, and glurp genes. The pfk13, pfdhfr, pfdhps, pfcrt and pfmdr genes were analyzed by PCR and Sanger sequencing. The Kaplan–Meier curve assessed parasite clearance.ResultsA total of 255 patients were enrolled in the study. The adequate clinical and parasitological response after PCR correction was 98.9% (95% CI 96.4–101.0%), 92.2% (85.0–98.5%) and 97.1% (93.1–101.0%) in Gaya, Tessaoua and Agadez, respectively. No adverse events were observed. Ten mutations (SNP) were found, including 7 synonyms (K248K, G690G, E691E, E612E, C469C, G496G, P718P) and 3 non-synonyms (N594K, R255K, V714S). Two mutations emerged: N594K and V714S. The R255K mutation detected in Southeast Asia was also detected. The pfdhpsK540E and pfdhfrI164L mutations associated with high levels of resistance are absent. There is a reversal of chloroquine resistance.ConclusionThe study findings indicate that AL is effective and well tolerated for the treatment of uncomplicated malaria in three sites in Niger. The emergence of a pfk13 mutation requires additional testing such as the Ring Stage Assay and CRISPR/Cas9 to confirm the role of these emerging mutations.Trial registration NCT05070520, October 7, 2021.

Distribution and ecological aspects of sand fly species from Kousseri, an endemic focus of visceral leishmaniasis in Northern Cameroon

IntroductionKousseri in the Far North Region of Cameroon has long been known as an endemic focus of visceral leishmaniasis (VL), although the study on sand flies in this focus is scarce. The present study investigates the spatial distribution, seasonality, and ecological aspects of sand flies from Kousseri. This study is based on the need to optimize the effectiveness of leishmaniasis control programs in the northern part of the country. MethodsSand flies were sampled monthly over 12 months in five selected sites using CDC light traps. Only captured females were morphologically identified at species level based on valid keys. Results and discussionOverall, 4,214 sand fly specimens were collected during 360 trapping nights. The male/female sex ratio slightly favored females (1:1.04). The eudominant Sergentomyia antennata followed by both dominant Sergentomyia schwetzi and Sergentomyia squamipleuris were the most common and abundant species, accounting for 76.1% of the collection. Phlebotomus duboscqi, the confirmed vector of cutaneous leishmaniasis (CL) in West African foci, although rare in the collection, was found in four of the five surveyed sites. This sand fly species with Se. schwetzi abounded in peri-urban areas and, respectively, in animal shed and in uninhabited house biotopes, while Se. antennata and Se. squamipleuris prevailed in rural areas and, respectively, in animal shelter biotopes and outside dwellings. All caught sand fly species except Se. schwetzi, Sergentomyia clydei, Sergentomyia inermis, and Sergentomyia adleri prevailed during the dry season. The highest Shannon–Wiener index of sand flies due to the maximal richness and evenness was found in the urban area, in outdoor biotopes, and during the rainy season (H′ = 1.68, 1.80, and 1.74, respectively). These data provide evidence that less urbanized areas, animal shelters around the compounds, and the absence of precipitation (dry season) favored the dispersion of abundant sand fly species in Kousseri. Based on previous reports on Leishmania transmission, a surveillance plan is required to prevent an outbreak of VL or an establishment of CL or canine leishmaniasis (CnL) in this focus. Further research identifying the blood meal source and the Leishmania parasites in these insects is critical for providing insightful data to fight leishmaniasis in Northern Cameroon.

OILVEQ: an Italian external quality control scheme for cannabinoids analysis in galenic preparations of cannabis oil.

Italy legalized cannabis oil for specific medical conditions (neuropathic pain, refractory epilepsy and other established pathologies) in 2015, but mandates titration of principal cannabinoids before marketing each batch using iphenated techniques coupled with mass spectrometry. To assess reliability of laboratories from the Italian National Health Service in charge of titrating the batches, the Italian National Institute of Health set up an quality control program on determination of Δ9-tetrahydrocannabinol l (THC), cannabidiol (CBD), Δ9-tetrahydrocannabinolic acid A (THCA-A) and cannabidiolic acid (CBDA) in cannabis oil preparations. Two rounds of exercises have been carried out since 2019, involving sixteen Italian laboratories. Five different cannabis oil samples (19-1A and 19-1B for the first round and 22-1A, 22-1B and 22-1C for the second one were prepared and 1 mL amount of each sample was sent to the laboratories. The quantitative performance of each laboratory was assessed calculating the z-score value, a statistical measurement for value's relationship to the mean of a group of values. In the first round, eight out of fourteen laboratories employed an LC-MS while the remaining six used GC-MS. Differently, in the second round, six out of eleven laboratories employed a GC-MS while the remaining five used LC-MS. In the first round, only 28.6 % laboratories achieved an acceptable performance (z-score±2), and all of them used LC-MS as analytical method. In the second round, none of the laboratories achieved an acceptable performance. Satisfactory results, based on z-scores, were generally low (0.0-75.0 %), with only one exception of 100 % for THCA-A determination in sample 22-1B. In the second round, three false negatives (two THC and one CBD by GC-MS determination) were reported while no false positives were described in the blank sample. The two rounds yielded a mean ERR% of 42 % approximately and a mean CV% around 70 % in GC-MS determination. When applying LC-MS determination, the two rounds yielded a mean ERR% of 36 % approximately and a mean CV% around 33 %. The obtained results underline the need for a clear and consistent protocol to be adopted by all laboratories intending to include the titration of oily cannabis-based products into their routinely analytical techniques. This emphasis on methodology standardization and participation to quality control schemes is essential for ensuring reliable and accurate measurements, ultimately enhancing the overall effectiveness and reliability of medical cannabis treatments.

A New Method for Size‐Resolved Aerosol CCN Activity Measurement at Low Supersaturation in Pristine Atmosphere

AbstractUnderstanding aerosol‐cloud interactions under pristine atmospheric conditions is crucial for meaningful global climate change predictions. However, ability of aerosol particles to act as cloud condensation nuclei (CCN) activity of aerosols in pristine atmosphere remains limited, mainly because of the difficulty of measuring it in pristine environments. Given the extremely low CCN number concentration under low supersaturations (SSs) and the complex impact of the kinetic limitation in CCN measurements, size‐resolved CCN activity measurements at low SSs cannot be achieved with traditional methods using differential mobility analyzers and a CCN counter (CCNC) because of the low sample efficiency and the impact of particles with multiple charges. To overcome this difficulty, we propose a new method for measuring size‐resolved CCN activity at low aerosol number concentrations. The new method is based on a combined system comprising an aerodynamic aerosol classifier (AAC) and a CCNC (AAC‐CCNC system). A control program was developed to achieve high‐resolution scans of the SS and particle size within a reasonable time frame. A data inversion scheme, including corrections for the transfer function and kinetic limitation, was developed to obtain accurate size‐resolved CCN activity. In July‐August 2022, the new method was used to measure the size‐resolved CCN activity on the Tibetan Plateau. This new method can advance the size‐resolved CCN measurements, thereby enhancing our understanding of aerosol‐cloud interactions in pristine atmosphere.

Survey of awareness and beliefs about cancer (ABC) in Tehran Province, Iran

IntroductionKnowledge, attitudes, and practices are essential measures for planning and evaluating cancer control programs. Little is known about these in Iran.MethodsWe conducted a population-based interview survey of adults aged 30–70 using the Farsi version of the Awareness and Beliefs about Cancer questionnaire in the capital province of Tehran, Iran, 2019. We calculated weighted estimates of levels of cancer knowledge, attitudes, and practices to allow for different selection probabilities and nonresponse. We used multivariate logistic regression to understand demographic factors associated with bowel, cervix, and breast screening practices.ResultsWe interviewed 736 men and 744 women. The mean number of recalled cancer warning signs was less than one; 57.7% could not recall any cancer warning signs. Participants recognized 5.6 out of 11 early cancer warning signs and 8.8 of 13 cancer risk factors. Most (82.7%) did not know that HPV infection was a cancer risk factor. Approximately, half had negative attitudes towards cancer treatment, but over 80% had positive attitudes towards the effectiveness of screening for improving survival. Colorectal, breast, and cervical screening rates were 24%, 42%, and 49%, respectively. Higher socioeconomic status increased the odds of taking up screening for cancer. Women aged 60–70 were less likely to report taking up breast and cervical screening than younger women.DiscussionThe Iranian population has poor awareness and negative attitudes about cancer, and participation in screening programs is low. Public awareness and early detection of cancer should be promoted in Iran.

Side of chute does not affect the sensitivity of Tritrichomonas foetus sample collection in bulls when using dominant hand for collection

Tritrichomonas foetus, a sexually transmitted disease in cattle, continues to plague the cattle industry despite years of control programs. One reason for this continued prevalence through­out the U.S. and the world is that accurate diagnosis is compli­cated in the fact that retrieval of organisms for diagnosis and subsequent testing may be compromised by multiple factors in­cluding, but not limited to, how samples are collected. A commonly used sampling technique for diagnosing T. foetus in bulls is scraping of the preputial and penile mucosa with ei­ther an artificial insemination pipette or specially designed T. foetus testing device such as the Pizzle Stick Trich Testing De­vice (Lane Manufacturing Denver, CO). Parker et al. noted that right-hand dominant practitioners were more commonly suc­cessful in retrieving T. foetus in known positive bulls when col­lecting from the right side of the bull compared to the left; how­ever, the opposite was not investigated for left-hand dominant practitioners and only cultures were used to declare whether a sample was positive or not. The objective of this study was to determine if using current RT-qPCR testing if there is a differ­ence in rate of positive tests pending side of chute and use of dominant hand for testing.

Comparative Responses of Two Major Cucurbit Pests, Zeugodacus cucurbitae and Zeugodacus tau to Phenylbutanoid Male Lures

Comparative Responses of Two Major Cucurbit Pests, Zeugodacus cucurbitae and Zeugodacus tau to Phenylbutanoid Male Lures

The prevalence of malaria in the five districts of Limpopo Province, South Africa, 2015 - 2017

Background. In South Africa (SA), malaria is endemic in three of nine provinces – KwaZulu-Natal, Mpumalanga and Limpopo. During 2010 - 2014, SA reported that ~47.6% of all malaria cases were imported. Contemporary estimates for the prevalence of malaria in the five districts of Limpopo Province are limited, with unknown proportions of imported malaria cases. We estimated the prevalence of malaria, and the proportion of imported malaria cases in the five districts of Limpopo, from January 2015 to December 2017. Objective. To measure the prevalence of malaria in Limpopo Province, the proportion of malaria cases that are imported and to determine factors associated with malaria from January 2015 to December 2017.Methods. We retrospectively reviewed data routinely collected through the Malaria Information System and Laboratory Information System of the National Health Laboratory Services, and assessed associations with age, sex and district, using a multivariable logistic regression model. Results. From 2015 to 2017, a total of 43 199 malaria cases were reported, of which 3.5% (n=1 532) were imported. The prevalence of malaria in Limpopo Province was the highest in 2017, at 331.0 per 100 000 population. The highest malaria prevalence district was Vhembe, with 647.9 in 2015, 220.3 in 2016 and 659.4 in 2017 per 100 000 population. However, Waterberg had the highest proportion of imported malaria cases 28.5% (437/1 532). In adjusted analyses, ages 15 - 49 years (adjusted odds ratio (aOR) 1.58, 95% confidence interval (CI) 1.48 - 1.68, p<0.001) and <1 year (aOR 1.55, 95% CI 1.37 - 0.74, p<0.001) were at higher odds of having malaria compared with ages ≥65 years. Conclusion. These findings highlight the significant burden of imported malaria in Limpopo Province. There is a need for strengthened surveillance and control programmes in neighboring countries (such as Mozambique, Zimbabwe and Botswana) to reduce the importation and spread of malaria in this region.

Impact of COVID-19 on antimicrobial stewardship activities in Italy: a region-wide assessment

BackgroundIn the region of Piedmont, in Northern Italy, formal monitoring of antimicrobial stewardship (AMS) programs has been in place since 2012. The objective of our study was to provide an updated assessment of AMS programs operating in our region, and to assess the impact of the COVID-19 pandemic on stewardship activities.MethodsA retrospective observational study was conducted to investigate AMS programs implemented in acute-care trusts participating in a broader healthcare-associated infections and antimicrobial resistance (AMR) prevention and control program, promoted by the regional health department. Within this program, structure, process, and outcome indicators of AMS programs were investigated, using a previously developed scoring system. Differences between scores prior to (2019) and during the pandemic (2021) were assessed. Linear regression was used to assess whether the 5-year trends (2017–2021) in outcome measures in relation to structure and process scores were statistically significant. Compound annual growth rates (CAGR) for each outcome were calculated to illustrate changes in outcome rates over time.ResultsAll public trusts in the Region (20) and a small number of private institutions (3) provided data for this study. A modest, non-significant improvement was found for 2021 structure, process, and total scores compared to respective 2019 scores. A significant improvement was found concerning the definition of a formal mission statement, whereas significantly less trusts included monitoring adherence to antimicrobial policy or treatment guidelines in their programs. Overall consumption of antibiotics for systemic use saw an increase in 2021, with 2021 recording the highest median overall consumption compared to all previous years considered in this study. Methicillin-resistant Staphylococcus aureus (MRSA) and carbapenem-resistant enterobacteria (CRE) rates decreased over the 5-year period. Significant downwards trends in MRSA rates were identified for high-outlier structure and process groups.ConclusionsResults of this study suggest AMS programs in Piedmont were not set back following the pandemic. This outcome was possible thanks to well-established programs, coordinated within a regional framework. Continued efforts should be dedicated to supporting AMS programs and contrasting AMR, even when the focus is shifted towards other public health emergencies.

Diversity of wasps (Hymenoptera) in alfalfa (Medicago sativa L.) farms in Basrah Governorate, Southern Iraq

Studies on the diversity of parasitoid wasps in agroecosystems exemplify the first stage of recognizing the best species to be used in biological control programs. There is an increased effort to recognize the diversity of pests in agroecosystems, but information on agricultural environments in Iraq is still unknown. This study is interested in the diversity of wasps in a cultivated area in Basrah governorate and the identification of dominant species for potential application in biological control studies. Samples were collected from alfalfa farms between January and December 2020 using two insect collection methods: sweep nets and yellow pan traps in four stations in Basrah governorate. This paper confirms that there is a high diversity of wasp species in agricultural environments. During this study, 18 wasp species were recorded for the first time in Iraq. Gronotoma micromorpha recorded the highest annual relative abundance value of 26.5%, while Chalcis biguttata recorded the lowest relative abundance of 0.89% in most agricultural environments. Numerous studies on G. micromorpha indicate that it is a parasitoid of Liriomyza species (Diptera). Thus, this species may be an important agent in the biological control of this pest.

Health workers' perspectives on school-based mass drug administration control programs for soil-transmitted helminthiasis and schistosomiasis in Ogun State, Nigeria.

Soil-transmitted helminthiasis (STH) and schistosomiasis (SCH) are among the most prevalent neglected tropical diseases (NTDs), affecting 1.5 billion globally, with a significant burden in sub-Saharan Africa, particularly Nigeria. These diseases impair health and contribute to socio-economic challenges, especially in children, undermining educational and future economic prospects. The 2030 NTD Roadmap highlights Mass Drug Administration (MDA) as a critical strategy for controlling these NTDs, targeting vulnerable populations like school-age children. Despite some successes, challenges persist, indicating the need for deeper insights into program implementation. This study focuses on the perspectives of health workers implementing MDA in selected local government areas (LGAs) of Ogun State, Nigeria, aiming to identify challenges and enablers that align with the broader NTD 2030 goals. The study used a qualitative research approach involving focus group discussions and in-depth interviews with health workers engaged in neglected tropical disease control programs in Ogun State, Nigeria, between July and September 2022. A semi-structured questionnaire guided the exploration of ideas, and the data were analyzed using the QRS Nvivo 12 software package. The study found that the school-based MDA control program's efficacy largely relies on strong collaborations and partnerships, particularly with educators, community heads, and other stakeholders. These alliances and strategic communication methods, like town announcements and media campaigns, have been pivotal in reaching communities. However, the program does grapple with hurdles such as parental misconceptions, limited funds, insufficient staffing, and misalignment with the Ministry of Education. It is recommended to boost funding, foster early stakeholder involvement, enhance mobilization techniques, and consider introducing a monitoring card system similar to immunization. The MDA Integrated Control Programs for STH and SCH in Ogun State schools demonstrate a holistic approach, integrating knowledge, collaboration, communication, and feedback. Health workers have shown commitment and adeptness in their roles. However, achieving maximum efficacy requires addressing critical barriers, such as parental misconceptions and funding challenges. Adopting the recommended strategies, including proactive communication, increased remuneration, and introducing a tracking system, can significantly enhance the program's reach and impact. The involvement of all stakeholders, from health workers to community leaders and parents, is essential for the program's sustainability and success.

Factors influencing presentation delay among cancer patients: a cross-sectional study in Malaysia

BackgroundCancer represents a significant global public health challenge, with escalating incidence rates straining healthcare systems. Malaysia, like many nations, has witnessed a rise in cancer cases, particularly among the younger population. This study aligns with Malaysia’s National Strategic Plan for Cancer Control Programme 2021–2025, emphasizing primary prevention and early detection to address cancer’s impact. Therefore, we aim to describe the timeliness of cancer care for symptom presentation, socio-demographic, patient, as well as organizational-related factors among patients in Malaysia diagnosed with breast, colorectal, nasopharyngeal, and cervical cancer.MethodsThis cross-sectional study enrolled adult cancer patients diagnosed with breast, cervical, colorectal, or nasopharyngeal cancer from 2015 to 2020 in seven public hospitals/oncology centres across Malaysia. Data were collected through patient-administered surveys and medical records. Presentation delay, defined as the duration between symptom onset and the patient's first visit to a healthcare professional exceeding 30 days, was the primary outcome. Statistical analysis included descriptive statistics and chi-square tests.ResultsThe study included 476 cancer patients, with breast cancer (41.6%), colorectal cancer (26.9%), nasopharyngeal cancer (22.1%), and cervical cancer (9.5%). Over half (54.2%) experienced presentation delays with a median interval of 60 days. Higher proportions of presentation delay were observed among nasopharyngeal cancer patients, employed patients with lower socioeconomic statuses, and those without family history of cancer. Most patients self-discovered their first cancer symptoms (80%), while only one-third took immediate action for medical check-ups. Emotional and organizational factors, such as long waiting times during doctor's visits (47%), were potential barriers to seeking cancer care.ConclusionThis study highlights the significant problem of presentation delay among cancer patients in Malaysia. The delay is influenced by various factors encompassing sociodemographic characteristics, health-seeking behaviours, and healthcare system-related issues. A comprehensive approach addressing both individual barriers and institutional obstacles is imperative to mitigate this presentation delay and improve cancer outcomes.

Carbapenem-Resistant Klebsiella pneumoniae Bacteremia: Counterbalance between the Endemic Load and the Infection Control Program in a Hospital

Carbapenem-resistant Klebsiella pneumoniae (CRKP) remains a significant public health threat, given the associated increased healthcare burden and mortality rate. The objective of the current study was to investigate the association between the incidence of CRKP bacteremia, antibiotic consumption, and infection control measures in a tertiary-care hospital spanning the years 2013–2018. The analyzed indices included the incidence of CRKP bacteremia, antibiotic consumption, the use of hand hygiene solutions, and isolation rates of multidrug-resistant (MDR) carriers. In the total hospital, the incidence of CRKP bacteremia exhibited an absolute decrease during the study period, although this decrease did not reach statistical significance. Antibiotics used to treat CRKP infections, including carbapenems, colistin, tigecycline, and fosfomycin, as well as all classes of antibiotics, correlated positively with an increased incidence of CRKP bacteremia. On the contrary, increased use of scrub disinfectant solutions correlated negatively with a decreased incidence of CRKP bacteremia (IRR: 0.74, 95%CI: 0.59–0.93, p-value: 0.008) in the Adults ICU. Additionally, increased isolation rates of MDR carrier patients correlated negatively with a decreased incidence of CRKP bacteremia (IRR: 0.35, 95%CI: 0.13–0.97, p-value: 0.044). In conclusion, the implementation of multimodal infection control measures in our hospital contributed to the containment of CRKP, particularly in specific hospital sectors. However, the study suggests the need for additional strategies to overcome the endemic plateau.

Healthcare professionals perspectives on tuberculosis barriers in Portuguese prisons-a qualitative study.

Tuberculosis (TB) remains a significant public health concern, particularly within prison settings, where the confluence of adverse health factors and high-risk behaviors contribute to a heightened risk of transmission. This study delves into the perspectives of medical doctors, regarding the implementation of the 2014 TB protocol in Portugal. The study has a qualitative, descriptive design. Individual semi-structured interviews with medical doctors from TB outpatient centers in Porto and Lisbon were used for data collection. For the analysis thematic analysis method was used. The study population comprised 21 medical doctors with the majority being female (61.9%) and 57.1% specializing in pulmonology. The results indicate varied perceptions of the protocol's usefulness, with positive impacts on coordination reported by some participants. Improved communication and evolving collaboration between TB outpatient centers and prisons were highlighted, although challenges in contact tracing and resource constraints were acknowledged. The study also sheds light on the role of nurses in patient education. Despite overall positive perceptions, challenges such as sustaining therapy post-symptomatic improvement and delays in diagnostic methods were identified. The findings underscore the importance of continuous collaboration between prisons and TB control programs to address challenges, improve disease control and prevent TB transmission.

Vibrational communication in Scolypopa australis: characterising spontaneous and intrasexual calls in an invasive orchard pest

AbstractVibrational communication in the Auchenorrhyncha is an avenue of growing interest, with many pesticide‐free vibrational pest control programmes against auchenorrhynchan agricultural pests continuing to be developed around the world. Passion vine hoppers (PVH), Scolypopa australis (Walker) (Hemiptera: Ricaniidae), are an economically damaging pest species in New Zealand, where they facilitate the growth of sooty mould in kiwifruit orchards. Scolypopa australis is already known to use vibrational signals, therefore a further understanding of the spectral and temporal characteristics of its calls will be an essential next step to developing vibration‐based pest management strategies. Here, we aimed to characterise the properties of spontaneous S. australis calls in solitary and intrasexual communication contexts. We used laser Doppler vibrometry to record vibrational signals produced by male and female S. australis (separately), when in groups of three or individually. We sorted calls and call sub‐units (syllables) into groups based on cluster analyses of various spatio‐temporal parameters. We define four male calls and three female calls, and newly describe a ‘two‐syllable’ calling structure that may be involved in male intrasexual competition. Certain syllables were more prevalent at the beginning or end of calls for males, and were more homogenously distributed throughout calls for females. The types of calls used differed between single males and groups, with more energetically intense call types observed in the group settings. Additional studies on the behavioural context of S. australis vibrational calls and their responses to playback of such calls will be necessary to assess the viability of vibration‐based pest management for this species.

93 Evaluating the efficacy of anthelmintics in an upper Midwest horse herd

Abstract Cyathostomins in the gastrointestinal tract are ubiquitous in horses around the world and remain a target in parasite control programs. Resistance to anthelmintics has risen in recent years with widespread resistance to benzimidazoles and pyrantels and emerging resistance to macrocyclic lactones. Thus, investigating the efficacy of anthelmintics in different locations is important to direct future parasite control programs. This 2-yr study evaluated the efficacy of three anthelmintic drugs in a university-owned equine herd in the upper Midwest using fecal egg count reduction tests (FECRT). Additionally, the effect of age group and body condition score (BCS) on fecal egg shedding was evaluated. We hypothesized that drug resistance is present in the parasite population of this equine herd. Fecal egg counts (FEC) of strongelid eggs were determined using the McMaster method. The efficacy of anthelmintics was determined by calculating the percentage of reduction in FEC between d 0 and d 14 post-treatment. Eighteen horses of various breeds were used in the study. The horses were grouped by age (< 10, 10-16, and > 16 yr; n = 6 in each group) and BCS using the Henneke system (5.0-5.5, n = 9; 6.0-6.5., n = 6; and 7.0-8.0, n = 3). In yr 1, horses within age group were randomly assigned to anthelmintic treatment: pyrantel pamoate, fenbendazole, or ivermectin. In yr 2, all horses received ivermectin. Individual FEC were performed on the day of anthelmintic treatment (d 0) using freshly voided feces. FEC were repeated 14 d after treatment. FEC were log transformed before analysis. Efficacy of the anthelmintics were compared using a mixed model ANOVA with repeated measures (SAS 9.4). Results were considered significant when P < 0.05. The FECRT was greater when treated with ivermectin and pyrantel pamoate (94.8 ± 11.6 % and 96.6 ± 14.3 %, respectively) compared with fenbendazole (54.4 ± 10.8 %; P < 0.05). The FECRT increased from 54.4% when treated with fenbendazole to 100% when the same horses were treated with ivermectin (P < 0.05). Age tended to affect egg shedding in horses (P = 0.0548). Young horses (< 10 yr) had a greater FEC compared with older horses (>16 yr; P < 0.05) but were not different from horses aged 10 to 16 yr (P > 0.05). There was no effect of BCS on strongelid egg shedding in this study (P = 0.9468). These results indicate the efficacy was within the expected range with no signs of resistance to pyrantel pamoate (93.3 to 100% reduction). There was evidence of emerging resistance to ivermectin (70.4 to 100% reduction) and significant resistance to fenbendazole (0 to 71.5% reduction) in the cyathostomin population in this horse herd. The findings of this study agree with previous research demonstrating resistance to anthelmintics. These results highlight the importance of designing improved parasite control programs to limit the spread of drug resistance with the ultimate goal of improving overall health of the horse.

Cancer control Co-benefits of the Climate-Related provisions in the American inflation reduction act.

The American Inflation Reduction Act (IRA) of 2022 contains climate-related provisions that may have significant implications for cancer control and prevention. This commentary assesses the potential co-benefits of the IRA for cancer control efforts, specifically policies and programs to reduce carcinogen exposure via air quality monitoring and air pollution reduction. Allocations through the IRA for air quality improvement, paired with its environmental justice provisions, holds promise for advancing cancer prevention by targeting resources to communities most susceptible to environmental hazards. Moreover, climate resilience measures dictated by the IRA are crucial for oncology professionals grappling with the dual challenges of climate change and cancer care. Climate-driven extreme weather events can exacerbate carcinogen exposure and disrupt access to cancer care, underscoring the need for resilient healthcare infrastructure. The IRA's provisions for clean energy incentives and infrastructure upgrades offer oncology care institutions opportunities to mitigate emissions and bolster resilience against climate-related disruptions, ultimately improving cancer outcomes. Climate-related initiatives funded by the IRA present a unique and timely avenue to advance equitable cancer control efforts. This commentary underscores the critical intersection between climate resilience policy and oncology care, highlighting the potential to promote a healthier and more resilient future for all.

Testing the Effects of Prey Type on the Life History and Population-Level Parameters of Chrysoperla externa (Neuroptera: Chrysopidae)

Green lacewings are valuable predators, utilized in augmentative biological control against various agricultural pests. However, further studies are required to comprehend the performance of these predators when consuming natural prey. We investigated the capacity of Chrysoperla externa (Hagen) to utilize the following three distinct prey types: the pupae of the coffee leaf miner Leucoptera coffeella (Guérin-Mèneville & Perrottet), the eggs of the sugarcane borer Diatraea saccharalis (F.), and the eggs of the Mediterranean flour moth Ephestia kuehniella (Zeller). The first two of these species are naturally occurring prey found in field crops, while the last serves as a factitious prey species for the mass rearing of natural enemies. We hypothesized that the type of prey would differentially affect the life history and population-level parameters of C. externa. Laboratory experiments were conducted to compare the pre-imaginal survival and developmental times, adult longevity and reproduction, and population growth of C. externa when larvae were provided with each of the three prey items. Results indicated that C. externa utilized the two natural prey items, L. coffeella pupae and D. saccharalis eggs, for its development, reproduction, and population growth. However, larvae developed significantly faster and females exhibited higher reproductive parameters, including fecundity and daily oviposition, when consuming the factitious prey, E. kuehniella eggs. This resulted in a higher intrinsic rate of population increase, as well as shorter times for the population to double in size. Understanding the population dynamics of C. externa when consuming different prey items is crucial for optimizing their utilization in augmentative biological control programs.