Control Program Research Articles

Diabetes control in public assistance recipients and free/low-cost medical care program beneficiaries in Japan: a retrospective cross-sectional study

IntroductionPrevious research has highlighted the association between socioeconomic factors and diabetes management. This study aimed to elucidate the blood glucose control status among individuals with low income (ie, recipients of...

Understanding how neglected tropical diseases programs in five Asia-Pacific countries adjusted to the COVID-19 pandemic: A qualitative study.

Following the COVID-19 pandemic declaration, the World Health Organization recommended suspending neglected tropical diseases (NTD) control activities as part of sweeping strategies to minimise COVID-19 transmission. Understanding how NTD programs were impacted and resumed operations will inform contingency planning for future emergencies. This is the first study that documents how South-East Asian and Pacific NTD programs addressed challenges experienced during the COVID-19 pandemic. Data was collected through semi-structured interviews with 11 NTD Program Coordinators and related personnel from Fiji, Papua New Guinea, The Philippines, Timor-Leste, and Vanuatu. Constructivist grounded theory methods were drawn on to generate an explanation of factors that enabled or hindered NTD program operations during the COVID-19 pandemic. The COVID-19 pandemic disrupted NTD programs in all countries. Some programs implemented novel strategies by partnering with services deemed essential or used new communications technology to continue (albeit scaled-back) NTD activities. Strong relationships to initiate cross-program integration, sufficient resources to implement adapted activities, and dedicated administrative systems were key enabling factors for recommencement. As the COVID-19 pandemic continued, exacerbating health resources scarcity, programs faced funding shortages and participants needed to find efficiencies through greater integration and activity prioritisation within their NTD units. Emphasising community-led approaches to restore trust and engagement was critical after widespread social anxiety and disconnection. Sustaining effective NTD programs during a global emergency goes beyond managing immediate activity disruptions and requires attention to how NTD programs can be better ensconced within wider health programs, administrative, and social systems. This study underscores the importance of pre-emergency planning that reinforces NTD control programs as a critical service at all health systems levels, accompanied by governance arrangements that increase NTD staff control over their operations and strategies to maintain strong community relationships. Ensuring NTD units are supported via appropriate funding, personnel, and bureaucratic resources is also required.

Health workers’ adherence to malaria case management protocols in Northern Sudan: a qualitative study

BackgroundNonadherence to national standards for malaria diagnosis and treatment has been reported in Sudan. In this study, qualitative research examined the clinical domains of nonadherence, factors influencing nonadherent practices and health workers’ views on how to improve adherence.MethodsIn September 2023, five Focus Group Discussions (FGDs) were undertaken with 104 health workers from 42 health facilities in Sudan’s Northern State. The participants included medical assistants, doctors, nurses, laboratory personnel, pharmacists and public health officers. The FGDs followed a semi-structured guide reflecting the national malaria case management protocol. Qualitative thematic analysis was performed.ResultsNonadherent practices included disregarding parasitological test results, suboptimal paediatric artemether–lumefantrine (AL) dosing, lack of counselling, use of prohibited artemether injections for uncomplicated and severe malaria, artesunate dose approximations and suboptimal preparations, lack of AL follow on treatment for severe malaria; and rare use of primaquine for radical Plasmodium vivax treatment and dihydroartemisinin-piperaquine as the second-line treatment for uncomplicated malaria. Factors influencing nonadherence included stock-outs of anti-malarials and RDTs; staff shortages; lack of training, job aids and supervision; malpractice by specialists; distrust of malaria microscopy and RDTs; and patient pressure for diagnosis and treatment. Health workers recommended strengthening the supply chain; hiring personnel; providing in-service protocol training including specialists; establishing external quality assurance for malaria diagnosis; and providing onsite supportive supervision and public health campaigns.ConclusionsThis study revealed a broad spectrum of behavioural and systemic challenges in malaria management among frontline health workers in Northern Sudan, including nonadherence to protocols due to resource shortages, training gaps, a lack of supportive supervision and patient pressure. These insights, including health workers’ views about improvements, will inform evidence-based interventions by Sudan’s National Malaria Control Programme to improve health systems readiness and the quality of malaria case management.

The National and State Tobacco Control Program: Overview of the Centers for Disease Control and Prevention's Efforts to Address Commercial Tobacco Use.

The National and State Tobacco Control Program: Overview of the Centers for Disease Control and Prevention's Efforts to Address Commercial Tobacco Use.

Where does Aedes albopictus (Diptera: Culicidae) really breed in a Mediterranean residential area? Results from a field study in Valencia, Eastern Spain.

Since its introduction in Spain in 2004, Aedes albopictus has rapidly spread across the country. Its aggressive biting behaviour causes nuisance, limiting outdoor activities. Also, its role as a vector of several arboviruses implies a major public health risk, with several cases of autochthonous dengue having been reported nationwide over the past few years. Control strategies usually focus on interventions in breeding sites. As such, accurate knowledge of the main larval habitats becomes a major priority in infested areas. A detailed identification of breeding sites of Ae. albopictus was carried out in the outdoors of 60 residential properties during July-August 2022 in El Vedat de Torrent (Valencia, Eastern Spain), an area recently colonised by this species. A total of 1444 real and potential breeding sites were examined. The most abundant potential larval habitat were plant pot plates (6.48 units/house), although a low infestation level was found, both for larvae (2.06% positivity, x̄ = 30.5 larvae/container), and pupae (0.51%, x̄ = 2.5 pupae/container). A total of 7715 larvae and 205 pupae were found in a disused flooded water pool depuration system. Animal drinkers, buckets and irrigation water containers were found to be the most common positive containers. No statistical difference was observed among the different container materials. A general statistical increase of 1 larva per 11.7 ml of water in breeding sites was detected. Breeding sites of other species such as Culex pipiens (n = 2) and Culex modestus (n = 1) were also rarely found in this residential area. To our knowledge, this is the first aedic index study carried out in Europe, and it provides valuable information about the main domestic breeding habitats of Ae. albopictus, which can greatly improve control programmes.

Temephos Resistance Status of Aedes aegypti Populations From Havana, Cuba.

Aedes aegypti chemical control remains an indispensable alternative to prevent dengue, Zika, and chikungunya outbreaks in Havana, Cuba. The city of Havana requires constant surveillance because of its bioecological characteristics that favor the proliferation of mosquito vectors of these viruses, which constitutes a high risk to the health of its inhabitants. The goal of this study was to determine the impact of the stopping of temephos applications during the 2 years of the COVID-19 pandemic on the level of susceptibility of Ae. aegypti in 5 municipalities of Havana, Cuba. Larval susceptibility was evaluated by bioassays as described by the World Health Organization. All Ae. aegypti populations tested showed high resistance to temephos. The National Control Program of Ae. aegypti in Cuba will need to promote insecticide rotation policies to prevent the evolution of temephos resistance in Havana.

Synthesis of Optimal Control of Spacecraft Angular Momentum for Spatial Turn Taking into Account Energy Costs Using Quaternions

Background: In this paper, we propose solving the specific original problem of control synthesis of spacecraft attitude. Optimization of the control program is made with the use of a new criterion of quality that combines energy costs and duration of reorientation under restrictions on control (the presence of a time factor limits the duration of slew maneuver). Methods: The construction of optimal control for angular momentum change is based on the quaternion method and L.S. Pontryagin maximum principle. An analytical solution to the problem was obtained on the base of a differential equation relating the orientation quaternion and angular momentum of a spacecraft. Results: Key properties of the optimal solution are formulated in analytical form; the features of optimal motion are studied in detail. The control law is formulated in the form of explicit dependence between control and phase variables. In a case when the controlling torque is limited by the given restriction (at the beginning and end of a turn), analytical formulas have been written for the duration of braking and acceleration. Main relations which determine optimal values of parameters of the algorithm for control of angular momentum are given. Examples and results of mathematical modeling of spacecraft motion formed by optimal control were given. This data in addition to the theoretical descriptions illustrates the process of reorientation in evident form and demonstrates the practical feasibility of a designed method for control of angular momentum during spatial turn. Conclusion: The designed optimal algorithm of control of spacecraft motion improves the efficiency of spacecraft attitude system, and originates more economical performance of spacecraft during flight on orbit.

Development of Predictive Modeling for Removal of Multispecies Biofilms of Salmonella Enteritidis, Escherichia coli, and Campylobacter jejuni from Poultry Slaughterhouse Surfaces.

Salmonella Enteritidis, Escherichia coli, and Campylobacter jejuni are among the most common foodborne pathogens worldwide, and poultry products are strongly associated with foodborne pathogen outbreaks. These pathogens are capable of producing biofilms on several surfaces used in the food processing industry, including polyethylene and stainless steel. However, studies on multi-species biofilms are rare. Therefore, this study aimed to develop predictive mathematical models to simulate the adhesion and removal of multispecies biofilms. All combinations of microorganisms resulted in biofilm formation with differences in bacterial counts. E. coli showed the greatest ability to adhere to both surfaces, followed by S. Enteritidis and C. jejuni. The incubation time and temperature did not influence adhesion. Biofilm removal was effective with citric acid and benzalkonium chloride but not with rhamnolipid. Among the generated models, 46 presented a significant coefficient of determination (R2), with the highest R2 being 0.88. These results provide support for the poultry industry in creating biofilm control and eradication programs to avoid the risk of contamination of poultry meat.

Non-Herbivore-Induced Plant Organic Volatiles of Tomato Cultivars and Their Effect on Pest Biological Control

Herbivore-induced plant organic volatiles (HIPVs) have recently been studied to improve biological pest control. In contrast, the effects of volatile organic compounds (VOCs) that are not induced by herbivory (non-HIPVs) have received less attention. The latter are essential in the first stages of crop colonization by entomophagous insects (predators and parasitoids) used in biological pest control programs. Furthermore, the effects on entomophagous insects of different cultivars of a cultivated botanical species have not been studied. The aim of this work was to study the different non-HIPVs found in 10 tomato cultivars used in tomato greenhouses on two entomophages: the egg parasitoid Trichogramma achaeae (Hymenoptera, Trichogrammatidae) and the zoo-phytophagous predator Nesidiocoris tenuis (Hemiptera, Miridae). The results indicate that although there is considerable quantitative and qualitative variation in the emission of VOCs in the 10 tomato cultivars analysed, this variability made it difficult to determine the influence of the volatiles on the attraction of the predatory species N. tenuis, with only one cultivar (Rebelion) exhibiting a significantly higher attractiveness than the rest of the cultivars. For the parasitoid T. achaeae, these same volatiles had a significant effect (in part) on parasitoid behaviour. However, this attraction was not reflected in the discriminant analysis, at least for the volatiles analysed. The analysis showed four groups of well-differentiated cultivars, according to the non-HIPV composition, and this bore no relation to the levels of attractiveness registered in the different cultivars, with the exception again of the Rebelion cultivar, which seems not to be very attractive for the parasitoid and its parasitism activity. The implications of non-herbivore-induced (non-HPV) VOCs in the biological control of greenhouse pest species are described and discussed.

A framework and process for community-engaged, mixed-methods cancer needs assessments.

Community health needs assessments are required for most state and local public health agencies and non-profit hospitals. Typically based on community health improvement planning models, these assessments encompass overall community health and multiple diseases to inform program planning. National Cancer Institute (NCI)-designated Cancer Centers and community-based cancer-focused programs share the goal of reducing cancer burden in the catchment areas they serve. However, to date, no published models exist to guide cancer-specific needs assessments for a determined geographic area that can inform both public health and research initiatives. The purpose of this article is to outline a cancer needs assessment (CNA) framework and community-engaged, mixed-methods process, along with a case study of how we applied it in Kentucky. We convened a steering committee of key organizational partners to provide input throughout the process. We developed a conceptual framework of multi-level determinants affecting cancer-related outcomes. We incorporated both quantitative and qualitative data gathered through a variety of means, including a novel application of group concept mapping to guide definition of priorities. The resulting CNA has helped guide strategic planning and priorities for Kentucky's Cancer Action Plan, Markey Cancer Center, state agencies, and community-based organizations. This framework and process can be used collaboratively by cancer center Community Outreach and Engagement offices, public health agencies, oncology programs, and community partners to plan impactful cancer control programs and research in their catchment areas. Universities can also use them to inform the planning of community engagement and health equity research efforts.

First report of V1016I, F1534C and V410L kdr mutations associated with pyrethroid resistance in Aedes aegypti populations from Niamey, Niger.

Ae. aegypti is the vector of important μ arboviruses, including dengue, Zika, chikungunya and yellow fever. Despite not being specifically targeted by insecticide-based control programs in West Africa, resistance to insecticides in Ae. aegypti has been reported in countries within this region. In this study, we investigated the status and mechanisms of Ae. aegypti resistance in Niamey, the capital of Niger. This research aims to provide baseline data necessary for arbovirus outbreak prevention and preparedness in the country. Ovitraps were used to collect Ae. aegypti eggs, which were subsequently hatched in the insectary for bioassay tests. The hatched larvae were then reared to 3-5-day-old adults for WHO tube and CDC bottle bioassays, including synergist tests. The kdr mutations F1534C, V1016I, and V410L were genotyped using allele-specific PCR and TaqMan qPCR methods. Ae. aegypti from Niamey exhibited moderate resistance to pyrethroids but susceptibility to organophosphates and carbamates. The kdr mutations, F1534C, V1016I and V410L were detected with the resistant tri-locus haplotype 1534C+1016L+410L associated with both permethrin and deltamethrin resistance. Whereas the homozygote tri-locus resistant genotype 1534CC+1016LL+410LL was linked only to permethrin resistance. The involvement of oxidase and esterase enzymes in resistance mechanisms was suggested by partial restoration of mosquitoes' susceptibility to pyrethroids in synergist bioassays. This study is the first report of Ae. aegypti resistance to pyrethroid insecticides in Niamey. The resistance is underpinned by target site mutations and potentially involves metabolic enzymes. The observed resistance to pyrethroids coupled with susceptibility to other insecticides, provides data to support evidence-based decision-making for Ae. aegypti control in Niger.

A 5-week Digital Intervention to Reduce Attention Problems in Children With ADHD: A Double-Blind Randomized Controlled Trial.

Growing evidence suggests digital interventions may provide neurocognitive benefits for children with ADHD. This study aimed to investigate the efficacy of a digital attention intervention in children with ADHD. In this double-blind randomized controlled trial 55 children with ADHD (5-9 years) were allocated to the intervention (N = 28) or control program (N = 27). Both programs were delivered via touchscreen tablets at home 5 days a week for 5 weeks. The primary outcome was change in the Test of Variables of Attention (TOVA) Attention Comparison Score (ACS) from pre- to post-intervention. Participants who received the intervention had significantly greater improvements in the TOVA ACS from pre- to post-intervention than those in the control (p < .044). No intervention effects were observed on secondary outcomes assessing executive functioning, ADHD symptoms, or functional impairment. Collectively these findings provide insufficient evidence for the implementation of digital attention interventions for children with ADHD.

Impact of a School Trachoma Program Emphasizing Facial Cleanliness and Environmental Improvement in Amhara, Ethiopia.

The SAFE (Surgery, Antibiotics, Facial cleanliness, Environmental improvement) strategy is the WHO's endorsed approach for eliminating trachoma as a public health problem; however, not all components have been treated equally. Historically, the F and E components have not been prioritized owing to their perceived complexity. With school enrollment increasing in Ethiopia, development of a national school health program that is focused on the F and E components represents an opportunity to strengthen the SAFE strategy in the country. In 2016, the Trachoma Control Program in Amhara, Ethiopia, along with its partners, developed a School Trachoma Program (STP) that offers grade-specific lessons to improve sanitation and hygiene knowledge and practices among primary school-aged children. To assess its impact, schools were sampled before implementation and then up to 1 year after STP rollout. The aim of this report is to detail STP outcomes and the associations between outcomes and school-level variables. By 2018, adoption of an STP was strong within Amhara, with 85% of the 137 surveyed schools completing their quarterly reports and nearly 80% having at least one teacher trained in the STP. By the end of the third quarter, nearly all schools (86%) had access to a latrine, and 89% of students had a clean face. A schoolwide orientation was associated with increased STP lessons and activities (P = 0.01). Development of an STP, with buy-in from principals and teachers, represents a promising approach for the adoption of a new F- and E-specific curriculum and may help advance efforts to eliminate trachoma.

A Knowledge, attitude and practice (KAP) study on sheep owners regarding fasciolosis in northwest of Tunisia

Fasciolosis is a worldwide zoonotic snail-borne infection that affects ruminants, it causes high economic losses among livestock. A participatory epidemiological survey was conducted on 204 sheep owners of Sejnane region (District of Bizerte, Northwest Tunisia) to assess their knowledge, attitude and practice regarding fasciolosis. All interviewed sheep owners are aware of this parasitic infection (100%, 204/204), among them, 81% (165/204) reported history of clinical cases in their sheep flocks. According to 33.73% (113/335) of them, sheep get infected by fasciolosis mainly by grazing in wet areas, 79.9% (163/204) of these farmers think that wet climate is the most favourable for the infection. Weight loss (28.40%, 121/426) and submandibular oedema (20.42%, 87/426) are the main clinical signs of fasciolosis cited by interviewed sheep owners and the majority of them (98.53%; 201/204) confirmed that fasciolosis causes significant economic losses. Fasciolosis infection persists in Sejnane region despite the use of antiparasitic drugs, this is due mainly to the fact that animals graze in moist grass (39.88%, 132/331). Treat animals (51.47%, 193/375), prohibit grazing on moist grass (15.20%, 57/357), prohibit grazing on wet soils (14.33%, 53/357) and avoid pastures (10.93%, 41/357) are the main prevention measures cited by interviewed sheep owners. Only 18,14% (37/204) of responders knew that fascioliasis is a zoonotic disease. These results could be considered by animal health decision makers and field veterinarians when implementing control programmes in order to increase breeders' knowledge of fasciolosis.

Upscaling irradiation protocols of Aedes albopictus pupae within an SIT program in Reunion Island.

The implementation of the sterile insect technique against Aedes albopictus relies on many parameters, in particular on the success of the sterilization of males to be released into the target area in overflooding numbers to mate with wild females. Achieving consistent sterility levels requires efficient and standardized irradiation protocols. Here, we assessed the effects of exposure environment, density of pupae, irradiation dose, quantity of water and location in the canister on the induced sterility of male pupae. We found that the irradiation of 2000 pupae in 130ml of water and with a dose of 40Gy was the best combination of factors to reliably sterilize male pupae with the specific irradiator used in our control program, allowing the sterilization of 14000 pupae per exposure cycle. The location in the canister had no effect on induced sterility. The results reported here allowed the standardization and optimization of irradiation protocols for a Sterile Insect Techniqueprogram to control Ae. albopictus on Reunion Island, which required the production of more than 300,000 sterile males per week.

Innovative high degree of freedom single-multipoint incremental forming system for manufacturing curved thin-walled components

This study proposed a new design and control framework for a novel high degree of freedom single-multipoint incremental forming (HDoF-SMIF) system to manufacture curved thin-walled components. First, a novel HDoF-SMIF system was designed based on the principles of HDoF-SMIF technology (including the description of the mechanical structure and network topology). Following that, to realize the process control of the HDoF-SMIF process, this study introduced a novel control strategy for the tool deflection angle specific to robotic incremental forming. It also developed a synergistic motion control approach for the lifting platform and an accelerated computation method to determine the forming parameters for a multipoint reconfigurable die. Then, a novel HDoF-SMIF principle prototype and control program were built for the designed HDoF-SMIF system structure and control method. Finally, the feasibility of the HDoF-SMIF system was verified with the forming test on the domed component, and the geometrical accuracy and wall thickness distribution of the samples were measured using a 3D optical scanner system to evaluate the forming quality of the established HDoF-SMIF system. The results showed that compared to the conventional single-point incremental forming (SPIF) process, the developed HDoF-SMIF system can provide a more uniform thickness distribution of the formed part with a lower overall thickness thinning rate. Furthermore, by increasing the tool deflection angle with a 1 mm elastomeric interpolator, the overall part's forming accuracy and surface quality can be effectively improved.

Infection prevention and control: Qualitative study of the preparedness and response of Christian health Association of Ghana to Marburg virus disease in Ghana

ObjectiveRecent disease outbreaks underscore the importance of robust disease surveillance and infection prevention and control (IPC) programmes to bolster Africa's public health response system. Yet, available evidence shows extensive gaps in the emergency response capacity of faith-based healthcare providers on the continent. Accordingly, this study examines the IPC and surveillance strategies adopted by a faith-based healthcare provider and the challenges encountered during Marburg Virus Disease outbreak (MVD) in Ghana. MethodWe collected data from 15 clinical and nonclinical health workers from the Christian Health Association of Ghana (CHAG) and the Ghana Health Service (GHS). Data was collected through online interviews to examine two pillars of the WHO COVID-19 SPRP-AFR (2021) framework. We analyzed the data using Braun and Clarke's thematic analysis. FindingsThe facility performed creditably well with contact tracing and other quarantine protocols during MVD outbreak in Ghana. However, it also encountered several challenges in the enforcement of IPC protocols, including human resource constraints, the lack of decontamination equipment, and limited infrastructure, among others. Given these limitations, we assessed that the facility cannot handle major outbreaks. ConclusionDue to numerous infectious disease outbreaks in Sub-Saharan Africa in recent years, the government of Ghana and faith-based healthcare providers must resource their facilities with the relevant equipment and qualified human resources against future disease outbreaks.

A novel organoselenium-based Schiff base for selective separation of copper and zinc from food samples using ultrasonic-assisted solidified floating organic drop microextraction strategy

Herein, we document the development of a novel organoselenium-based Schiff base, 2-((4-((2-hydroxy-4-nitrobenzylidene)amino)phenyl)selanyl)-N-phenylacetamide (HOASe), to selectively separate zinc and copper from food samples. To the best of our knowledge, OSe compound has never been used in microextraction procedures before, until today. HOASe was synthesized from aniline by a simple four-step procedure. The structure of HOASe was elucidated by various spectroscopic techniques (e.g., IR, MS, 1H- and 13C NMR). After that, HOASe was used to extract Cu2+ and Zn2+ by ultrasonic-assisted dispersive liquid-liquid microextraction based on the solidification of floating organic drop (UA-DLLME-SFOD) combined with flame atomic absorption spectrometry. Important experimental parameters including amount of the extraction solvent, initial pH, amount of HOASe, ultrasonication time, centrifugation, and salt addition, were studied and optimized to offer quantitative separation of the analytes. The detection limits and the linear ranges for Cu2+ and Zn2+ were 1.9, 8.0 – 400.0, and 2.4, 6 – 150 μg L-1, respectively. The method's greenness and applicability were assessed using the Analytical GREEnness metric methodology and the Blue Applicability Grade Index, respectively. Finaly, this approach was used for quantification of Cu2+ and Zn2+ in food samples and, therefore, can be further developed for food safety and quality control programs.

LGBTQ+ cancer: priority or lip service? A qualitative content analysis of LGBTQ+ considerations in U.S. state, jurisdiction, and tribal comprehensive cancer control plans.

The National Comprehensive Cancer Control Program, a Centers for Disease Control and Prevention funded program, supports cancer coalitions across the United States (US) in efforts to prevent and control cancer including development of comprehensive cancer control (CCC) plans. CCC plans often focus health equity within their priorities, but it is unclear to what extent lesbian, gay, bisexual, transgender, queer/questioning, plus (LGBTQ+) populations are considered in CCC plans. We qualitatively examined to what extent LGBTQ+ populations were referenced in 64 U.S. state, jurisdiction, tribes, and tribal organization CCC plans. A total of 55% of CCC plans mentioned LGBTQ+ populations, however, only one in three CCC plans mentioned any kind of LGBTQ+ inequity or LGBTQ+ specific recommendations. Even fewer plans included mention of LGBTQ+ specific resources, organizations, or citations. At the same time almost three fourths of plans conflated sex and gender throughout their CCC plans. The findings of this study highlight the lack of prioritization of LGBTQ+ populations in CCC plans broadly while highlighting exemplar plans that can serve as a roadmap to more inclusive future CCC plans. Comprehensive cancer control plans can serve as a key policy and advocacy structure to promote a focus on LGBTQ+ cancer prevention and control.

Chilean Botrytis cinerea Isolates with Reduced Sensitivity to Fludioxonil Exhibit Low to Null Fitness Penalties.

The main phytosanitary problem for table grape production in Chile is gray mold caused by the fungus Botrytis cinerea. To manage this issue, the primary method utilized is chemical control. Fludioxonil, a phenylpyrrole, is highly effective in controlling B. cinerea and other plant pathogens. Consistently, there have been no field reports of reduced efficacy of fludioxonil; however, subpopulations with reduced sensitivity to fludioxonil are on the rise globally, as per increasing reports. Our study involved a large-scale evaluation of B. cinerea's sensitivity to fludioxonil in the Central Valley of Chile's primary table grape production area during the growing seasons from 2015 to 2018. Out of 2,207 isolates, only 1.04% of the isolates (n = 23) exceeded the sensitivity threshold value of 1 μg/ml. Remarkably, 95.7% are concentrated in a geographic region (Valparaíso Region). Isolates with reduced sensitivity to fludioxonil showed growth comparable with sensitive isolates and even more robust growth under nutritional deficit, temperature, or osmotic stress, suggesting greater environmental adaptation. When table grape detached berries were stored at 0°C, isolates less sensitive to fludioxonil caused larger lesions than sensitive isolates (2.82 mm compared with 1.48 mm). However, the lesions generated by both types of isolates were equivalent at room temperature. This study found no cross-resistance between fludioxonil and fenhexamid, an essential fungicide integrated with fludioxonil in Chilean B. cinerea control programs. All the Chilean isolates with reduced sensitivity to fludioxonil were controlled by the fludioxonil/cyprodinil mixture, a commonly employed form of fludioxonil. The cyprodinil sensitivity in the isolates with reduced sensitivity to fludioxonil explains their low field frequency despite their null fitness penalties. However, the emergence of fludioxonil-resistant isolates inside the Chilean B. cinerea population demands a comprehensive analysis of their genetic bases, accompanied by monitoring tools that allow the permanence of field fludioxonil efficacy.