Cost-effective Control Measures Research Articles

English

Sheep and goats are important contributors to food production in Ethiopia providing meat, milk and income generation for the country. Skins are the most important items to generate foreign currency for developing countries like Ethiopia. However, the huge resource potential of sheep and goats populations of the country are constrained and threatened by compound effect of diseases, poor management and malnutrition. Parasitic skin diseases caused by ectoparasites such as mange mites, lice, keds and ticks are among these threats resulting in serious economic loss to the tanning industry and the country as a whole. The economic impact of ectoparasitism in Ethiopia is not well documented. Tanneries reported that 35% of sheep skin and 56% of goats’ skin are rejected due to external parasites, and out of the reject groups of the processed skin, about 80 to 90% defects were believed to be due to external parasites. The estimated economic loss due to drop in quality of sheep and goat skin is around USD 25.8 million per year. It also takes time before disease affected animals after treatment could return to their normal body condition. Currently, ectoparasites are among major causes in decreased production, reproduction of these animals as well as leather quality deterioration, down grading and rejection of skins. As many as one-quarter to one third of all skins processed at tanneries in Ethiopia have various defects and are unsuitable for export purposes where most of these defects occur in the pre-slaughter stage of production while the animals are alive and are directly related to parasitic skin diseases. Information available so far in Ethiopia indicate that parasitic skin diseases of small ruminants are widely distributed in different agro-climatic areas, causing serious economic loss to the farming community, tanning and leather industry at large, seriously hampering the income generation and foreign currency flow to the country. The extent of the problem has increased continuously during the past few years, threatening the small ruminant population, health, production and reproduction that warrants cost effective control measures. Key words: Control, Ethiopia, ectoparasites, small ruminants, tanning industry.

Immunity, safety and protection of an Adenovirus 5 prime - Modified Vaccinia virus Ankara boost subunit vaccine against Mycobacterium avium subspecies paratuberculosis infection in calves

Vaccination is the most cost effective control measure for Johne¿s disease caused by Mycobacterium avium subspecies paratuberculosis (MAP) but currently available whole cell killed formulations have limited efficacy and are incompatible with the diagnosis of bovine tuberculosis by tuberculin skin test. We have evaluated the utility of a viral delivery regimen of non-replicative human Adenovirus 5 and Modified Vaccinia virus Ankara recombinant for early entry MAP specific antigens (HAV) to show protection against challenge in a calf model and extensively screened for differential immunological markers associated with protection. We have shown that HAV vaccination was well tolerated, could be detected using a differentiation of infected and vaccinated animals (DIVA) test, showed no cross-reactivity with tuberculin and provided a degree of protection against challenge evidenced by a lack of faecal shedding in vaccinated animals that persisted throughout the 7 month infection period. Calves given HAV vaccination had significant priming and boosting of MAP derived antigen (PPD-J) specific CD4+, CD8+ IFN-? producing T-cell populations and, upon challenge, developed early specific Th17 related immune responses, enhanced IFN-? responses and retained a high MAP killing capacity in blood. During later phases post MAP challenge, PPD-J antigen specific IFN-? and Th17 responses in HAV vaccinated animals corresponded with improvements in peripheral bacteraemia. By contrast a lack of IFN-?, induction of FoxP3+ T cells and increased IL-1? and IL-10 secretion were indicative of progressive infection in Sham vaccinated animals. We conclude that HAV vaccination shows excellent promise as a new tool for improving control of MAP infection in cattle.

Stability analysis and optimal control of pine wilt disease with horizontal transmission in vector population

In this paper, we have proposed and mathematically modeled an epidemic problem with vector-borne disease. We have taken three different classes for the trees, namely susceptible, exposed and infected, and two different classes for the vector population, namely susceptible and infected. In the first part of our paper, we rigorously analyze our model using the dynamical systems approach. Global stability of equilibria is resolved by using Lyapunov functional. In the second part, the model is reformulated as an optimal control problem in order to determine the significance of certain control measures on the model. We apply four control parameters, namely the tree injection control to the trees, deforestation of infected trees, eradication effort of aerial insecticide spraying and the effort of restrain of mating. Both numerical and analytical methods are employed to ascertain the existence of cost effective control measures.

Multiple approaches to analyse and control seepage in hydraulic structures

An excessive and uncontrolled seepage through hydraulic structures generally occurs through the structure; geological formations in vicinity of the reservoir or through the structure–foundation interface. The economical consequences of seepage can be large because of likelihood of induced structural instability. As such, it is imperative to study the complex problem of seepage through hydraulic structures systematically and by applying different methods of analysis such as geological and geotechnical methods, dam instrumentation, geophysical methods, tracer techniques, nuclear logging and mathematical modeling for monitoring, detecting and analysing seepage. The parameters derived through these methods are vital for adopting remedial measures necessary to reduce or prevent seepage effectively and economically. The paper describes the potential of these methods in seepage analysis and adopting suitable cost-effective control measures for mitigating seepage highlighting related case studies The case studies revealed that multidisciplinary approach of employing different methods has provided vital information and parameters on seepage-related problems. A multidisciplinary approach is needed to be followed judiciously and systematically in practice to accomplish the task of reducing or stopping seepage by adopting proper seepage control measures.

Preventing Nosocomial MDR TB Transmission in sub Saharan Africa: Where Are We at?

Background:In sub Saharan Africa, the cocktail of many advanced HIV-infected susceptible hosts, poor TB treatment success rates, a lack of airborne infection control, limited drug-resistance testing (DST) have resulted in HIV-infected individuals being disproportionately represented in Multi drug resistant Tuberculosis (MDR-TB) cases. The prevailing application of the WHO re-treatment protocol indiscriminately to all re-treatment cases sets the stage for an increase in mortality and MDR-TB nosocomial transmission.Method:A comprehensive search was performed of the Cochrane Infectious Diseases Group Specialized Register and Medline database including the bibliographies of the retrieved reference.Findings:The TB diagnosis paradigm which for decades relied on smear sputum and culture is likely to change with the advent of the point-of-care diagnostic, Xpert MTB/RIF assay. Until the new DST infrastructure is available, along with clinical trials for both, current and new approaches to retreatment TB in areas heavily affected by HIV and TB, there are cost effective administrative, environmental, and protective measures that may be immediately instituted.Conclusion:The severe lack of infection control practices in sub Saharan Africa may jeopardise the recent strides in MDR-TB management. Cost effective infection control measures must be immediately implemented, otherwise the development of further drug resistance may offset recent strides in MDR-TB management.Indiscriminate use of the WHO standardized retreatment protocol can lead to nosocomial transmission of MDR-TB by:-Precluding early diagnosis and prompt separation of patients who experienced treatment failure category and thereby more likely to have MDR-TB.-Leaving patients from the treatment failure category in health establishments on ineffective standard retreatment regimen until the DST results are known.-Targeting only patients who have had prior TB therapy, new severely debilitated TB patients having primary unrecognized MDR-TB may continue spreading resistant organisms.

Association mapping for soilborne pathogen resistance in synthetic hexaploid wheat

Soilborne pathogens such as cereal cyst nematode (CCN; Heterodera avenae) and root lesion nematode (Pratylenchus neglectus; PN) cause substantial yield losses in the major cereal-growing regions of the world. Incorporating resistance into wheat cultivars and breeding lines is considered the most cost-effective control measure for reducing nematode populations. To identify loci with molecular markers linked to genes conferring resistance to these pathogens, we employed a genome-wide association approach in which 332 synthetic hexaploid wheat lines previously screened for resistance to CCN and PN were genotyped with 660 Diversity Arrays Technology (DArT) markers. Two sequence-tagged site markers reportedly linked to genes known to confer resistance to CCN were also included in the analysis. Using the mixed linear model corrected for population structure and familial relatedness (Q+K matrices), we were able to confirm previously reported quantitative trait loci (QTL) for resistance to CCN and PN in bi-parental crosses. In addition, we identified other significant markers located in chromosome regions where no CCN and PN resistance genes have been reported. Seventeen DArT marker loci were found to be significantly associated with CCN and twelve to PN resistance. The novel QTL on chromosomes 1D, 4D, 5B, 5D and 7D for resistance to CCN and 4A, 5B and 7B for resistance to PN are suggested to represent new sources of genes which could be deployed in further wheat improvement against these two important root diseases of wheat.

Stump removal to control root disease in Canada and Scandinavia: A synthesis of results from long-term trials

Heterobasidion annosum sensu lato (s.l.), Armillaria ostoyae, and Phellinus sulphurascens are economically important fungal pathogens in temperate forests of the northern hemisphere that cause decay, growth reduction and tree mortality of coniferous hosts. Fungal inoculum residing in roots and stumps after final felling can remain viable for decades and place stands at an increased risk of mortality in subsequent rotations. Stump removal is one strategy that can be used to reduce the impact of root rot fungi in regenerating stands. This paper presents results from five long-term stump removal trials in Canada, Denmark, and Sweden. In all studies, stumps were extracted and larger roots removed. After a period of time ranging between 21 and 50years, tree mortality, infection or both caused by A. ostoyae, P. sulphurascens and H. annosum s.l. was compared between stumped and non-stumped areas. In all but one trial, efficacy of stump removal to reduce disease occurrence over the long-term was 80–100% for A. ostoyae, 85–100% for P. sulphurascens, and 20–72% for H. annosum s.l. Stump removal for H. annosum s.l. was more effective in the Swedish trial than in the Danish trial, but in both locations the frequency of root disease increased with tree age. Results from trials indicate that stump removal is effective in reducing disease incidence and likely improves site productivity in subsequent rotations. Forest managers should consider stump removal as a routine operation when harvesting, especially on sites that have high hazard for A. ostoyae, P. sulphurascens, or both. Even though stump removal can provide adequate control against H. annosum, use of the biocontrol agent Phlebiopsis gigantea on freshly cut stump surfaces after harvest and following thinnings is perhaps a more cost effective control measure to reduce the frequency of H. annosum rot in next rotation forests. New initiatives involving harvesting of stumps for bioenergy may offer the additional benefit of minimizing disease impacts in next rotation forests.

Multimodal supervision programme to reduce catheter associated urinary tract infections and its analysis to enable focus on labour and cost effective infection control measures in a tertiary care hospital in India.

Catheter Associated Urinary Tract Infections (CAUTI) contribute 30%-40% of all the nosocomial infections and they are associated with substantially increased institutional death rates. A multimodal supervision program which incorporates training of the staff with respect to infection control measures can be effective in reducing the CAUTIs in hospitals. To assess the impact of a multimodal UTI supervision program on the CAUTI rates over a year, from January 2009 to December 2009, in a tertiary care hospital in India. A 215 bedded tertiary care private hospital. The CAUTI rates were analyzed for the first 6 months (January 2009-June 2009). A UTI supervision program was instituted in the month of July 2009, which included training with respect to the standard protocols for the sample collection and diagnosis, the bundle components of the urinary catheter checklist and hand hygiene practices. The impact was assessed as per the CAUTI rates in the subsequent months. The average CAUTI rate was reduced by 47.1% (from 10.6 to 5.6) after the introduction of the supervision program. This study presented the mean age of the patients with CAUTIs as 54.5 years and it showed an approximately equal contribution of both the sexes (52.94% in males and 47.05% in females). The impact analysis of the supervision program showed a reduction of 8.7% (from 23 days to 21 days) during the average duration of the catheterization. The adherence to the components of the urinary catheter check list was increased by 44.4% (p=0.069) and the hand hygiene compliance was increased by 56.4% (p=0.004) respectively after the interventions. Components like bladder irrigation and practising perineal cleaning were found to show no effect on the CAUTI rates. The most common labour and cost effective infection control measures as revealed by the supervision programme were adherence to the urinary catheter checklist components (indication for catheter insertion and change, asepsis maintenance during and after the catheter insertion and avoiding urine reflux) and hand hygiene practices, whereas bladder irrigation and practising perineal cleaning thrice a day were unnecessary measures.

Expression of high-temperature adult-plant (HTAP) resistance against stripe rust (Puccinia striiformis f. sp. tritici) in Pakistan wheat landraces

Stripe rust (Puccinia striiformis f. sp. tritici, Pst) is an important disease of wheat in the United States and Pakistan. Genetic resistance in wheat is a cost-effective and convenient control measure. In the present study, resistance testing of 115 wheat landraces from Pakistan was carried out initially at the seedling stage with seven races of the pathogen, four from the USA and three from Pakistan. The germplasm showed a general lack of effective seedling resistance. Only two genotypes (PI 210916, PI 219752) were resistant against all races. Adult plants of the wheat genotypes were also tested at high temperatures under greenhouse conditions and at two field locations in Washington State. In the test with US Pst race PST-127, 28 (32%) of the landraces had seedling resistance and 41 (52%) had high-temperature adult-plant (HTAP) resistance. When tested with Pakistan isolate PK07-2, 14 (13%) of the wheat genotypes had seedling resistance and 61 (53%) had HTAP resistance. In the test with Pakistan isolate PK07-6, 32 (40%) had seedling resistance and 38 (48%) had HTAP resistance. In field tests, 94 (86%) genotypes were resistant and four (4%) were intermediate at Pullman, Washington; and 72 (89%) were resistant and none was intermediate at Mount Vernon, Washington. The greenhouse and field tests revealed that the majority of the wheat landraces possess HTAP resistance against stripe rust. These landraces should be useful genetic resources for developing stripe rust resistant cultivars in regions where climatic conditions are suitable for the expression of the durable type of resistance.

Cost Effectiveness of Tobacco Control Policies in Vietnam

Tobacco smoking is one of the leading public health problems in the world. It is also possible to prevent and/or reduce the harm from tobacco use through the use of cost-effective tobacco control measures. However, most of this evidence comes from developed countries and little research has been conducted on this issue in developing countries. The objective of this study was to analyse the cost effectiveness of four population-level tobacco control interventions in Vietnam. Four tobacco control interventions were evaluated: excise tax increase; graphic warning labels on cigarette packs; mass media campaigns; and smoking bans (in public or in work places). A multi-state life table model was constructed in Microsoft® Excel to examine the cost effectiveness of the tobacco control intervention options. A government perspective was adopted, with costing conducted using a bottom-up approach. Health improvement was considered in terms of disability-adjusted life-years (DALYs) averted. All assumptions were subject to sensitivity and uncertainty analysis. All the interventions fell within the definition of being very cost effective according to the threshold level suggested by the WHO (i.e. <GDP per capita). Graphic warning labels on cigarette packs was the most cost-effective option, followed by excise tax increases, mass media campaigns, public smoking bans and work place smoking bans. If the cost offset was included in the analysis, all interventions would provide cost savings to the government health sector. All four interventions to reduce the harm from tobacco use appear to be highly cost effective and should be considered as priorities in the context of Vietnam. The government may initially consider graphic warning labels and tax increase, followed by other interventions.

Targeting Antibiotics to Households for Trachoma Control

BackgroundMass drug administration (MDA) is part of the current trachoma control strategy, but it can be costly and results in many uninfected individuals receiving treatment. Here we explore whether alternative, targeted approaches are effective antibiotic-sparing strategies.Methodology/Principal FindingsWe analysed data on the prevalence of ocular infection with Chlamydia trachomatis and of active trachoma disease among 4,436 individuals from two communities in The Gambia (West Africa) and two communities in Tanzania (East Africa). An age- and household-structured mathematical model of transmission was fitted to these data using maximum likelihood. The presence of active inflammatory disease as a marker of infection in a household was, in general, significantly more sensitive (between 79% [95%CI: 60%–92%] and 86% [71%–95%] across the four communities) than as a marker of infection in an individual (24% [16%–33%]–66% [56%–76%]). Model simulations, under the best fit models for each community, showed that targeting treatment to households has the potential to be as effective as and significantly more cost-effective than mass treatment when antibiotics are not donated. The cost (2007US$) per incident infection averted ranged from 1.5 to 3.1 for MDA, from 1.0 to 1.7 for household-targeted treatment assuming equivalent coverage, and from 0.4 to 1.7 if household visits increased treatment coverage to 100% in selected households. Assuming antibiotics were donated, MDA was predicted to be more cost-effective unless opportunity costs incurred by individuals collecting antibiotics were included or household visits improved treatment uptake. Limiting MDA to children was not as effective in reducing infection as the other aforementioned distribution strategies.Conclusions/SignificanceOur model suggests that targeting antibiotics to households with active trachoma has the potential to be a cost-effective trachoma control measure, but further work is required to assess if costs can be reduced and to what extent the approach can increase the treatment coverage of infected individuals compared to MDA in different settings.

Identifying malaria vector breeding habitats with remote sensing data and terrain-based landscape indices in Zambia

BackgroundMalaria, caused by the parasite Plasmodium falciparum, is a significant source of morbidity and mortality in southern Zambia. In the Mapanza Chiefdom, where transmission is seasonal, Anopheles arabiensis is the dominant malaria vector. The ability to predict larval habitats can help focus control measures.MethodsA survey was conducted in March-April 2007, at the end of the rainy season, to identify and map locations of water pooling and the occurrence anopheline larval habitats; this was repeated in October 2007 at the end of the dry season and in March-April 2008 during the next rainy season. Logistic regression and generalized linear mixed modeling were applied to assess the predictive value of terrain-based landscape indices along with LandSat imagery to identify aquatic habitats and, especially, those with anopheline mosquito larvae.ResultsApproximately two hundred aquatic habitat sites were identified with 69 percent positive for anopheline mosquitoes. Nine species of anopheline mosquitoes were identified, of which, 19% were An. arabiensis. Terrain-based landscape indices combined with LandSat predicted sites with water, sites with anopheline mosquitoes and sites specifically with An. arabiensis. These models were especially successful at ruling out potential locations, but had limited ability in predicting which anopheline species inhabited aquatic sites. Terrain indices derived from 90 meter Shuttle Radar Topography Mission (SRTM) digital elevation data (DEM) were better at predicting water drainage patterns and characterizing the landscape than those derived from 30 m Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) DEM.ConclusionsThe low number of aquatic habitats available and the ability to locate the limited number of aquatic habitat locations for surveillance, especially those containing anopheline larvae, suggest that larval control maybe a cost-effective control measure in the fight against malaria in Zambia and other regions with seasonal transmission. This work shows that, in areas of seasonal malaria transmission, incorporating terrain-based landscape models to the planning stages of vector control allows for the exclusion of significant portions of landscape that would be unsuitable for water to accumulate and for mosquito larvae occupation. With increasing free availability of satellite imagery such as SRTM and LandSat, the development of satellite imagery-based prediction models is becoming more accessible to vector management coordinators.

"Plain packaging" regulations for tobacco products: the impact of standardizing the color and design of cigarette packs

Tobacco packaging and labeling policies have emerged as prominent and cost-effective tobacco control measures. Although packaging policies have primarily focused on health warnings, there is growing recognition of the importance of packaging as a marketing tool for the tobacco industry. The current paper reviews evidence on the potential impact of standardizing the color and design of tobacco packages -so called "plain" packaging. The evidence indicates three primary benefits of plain packaging: increasing the effectiveness of health warnings, reducing false health beliefs about cigarettes, and reducing brand appeal especially among youth and young adults. Overall, the research to date suggests that "plain" packaging regulations would be an effective tobacco control measure, particularly in jurisdictions with comprehensive restrictions on other forms of marketing.

Vaccination with recombinant Plasmodium vivax MSP-10 formulated in different adjuvants induces strong immunogenicity but no protection

Although largely considered benign, Plasmodium vivax causes disease in nearly 75 million people each year and the available strategies are not sufficient to reduce the burden of disease, therefore pointing to vaccine development as a cost-effective control measure. In this study, the P. vivax merozoite surface protein 10 (MSP-10) was expressed as a recombinant protein in Escherichia coli and purified by affinity chromatography. High antigenicity was observed since sera from P. vivax-infected patients strongly recognized rPvMSP10. The immunogenicity of rPvMSP10 was tested in Aotus monkeys, comparing responses induced by formulations with Freund's adjuvant, Montanide ISA720 or aluminum hydroxide. All formulations produced high antibody titers recognizing the native protein in late schizonts. Despite inducing strong antibody production, none of the formulations protected immunized Aotus monkeys upon experimental challenge.

Lead exposure study among workers in lead acid battery repair units of transport service enterprises, Addis Ababa, Ethiopia: a cross-sectional study.

BackgroundLead exposure is common in automobile battery manufacture and repair, radiator repair, secondary smelters and welding units. Urinary Aminolevulinic acid has validity as a surrogate measure of blood lead level among workers occupationally exposed to lead. This study had therefore assessed the magnitude of lead exposure in battery repair workers of three transport service enterprises.MethodsTo this effect, a cross-sectional study was carried out on lead exposure among storage battery repair workers between November 2004 and May 2005 from Anbasa, Comet and Walia transport service enterprises, Addis Ababa, Ethiopia. Subjective information from the workers was obtained by making use of structured questionnaire. Other information was obtained from walkthrough evaluation of the repair units. Aminolevulinic acid levels in urine were used as an index of the exposure. This was coupled to measurements of other relevant parameters in blood and urine collected from adult subjects working in the repair units as well as age matched control subjects that were not occupationally exposed to lead. Aminolevulinic acid was determined by spectrophotometry, while creatinine clearance, serum creatinine, urea and uric acid levels were determined using AMS Autolab analyzer.ResultsUrinary aminolevulinic acid levels were found to be significantly higher in exposed group (16 μg/ml ± 2.0) compared to the non-exposed ones (7 μg/ml ± 1.0) (p < 0.001). Alcohol taking exposed subjects exhibited a significant increase in urinary aminolevulinic acid levels than non-alcohol taking ones (p < 0.05). Moreover, urinary aminolevulinic acid levels of exposed subjects increased with age (p < 0.001) as well as duration of employment (p < 0.001). Whereas serum uric acid levels of exposed subjects was significantly higher than non-exposed ones (p < 0.05), no statistically significant difference had been found in renal indices and other measured parameters between exposed and non-exposed subjects. From the questionnaire responses and walkthrough observations, it was also known that all the repair units did not implement effective preventive and control measures for workplace lead exposure.ConclusionTaken together, these findings indicated that workers in lead acid battery repair units of the transport service enterprises are not protected from possibly high lead exposure. Thus, strict enforcement of appropriate and cost effective preventive and control measures is required by all the enterprises.

Diversity of Malaysian aquatic ecosystems and resources

Malaysia has rich aquatic ecosystems that supply vital resources such as water, food, medicine, commercial aquatic resources, energy and transport for economic and social development of its people. In addition, they also provide other services such as flood control, erosion prevention and shoreline protection, recreational fisheries and resources for tourism industry. However, the ubiquitous and abundant supplies of these resources in the past have resulted in minimal concern about their conservation and sustainable exploitation. In fact, these resources are continuously threatened by human activities such as overexploitation of living resources, massive land reclamation and development, discharge of harmful industrial and domestic wastes, and large energy development projects. Threats to the sustainability of these resources in the form of land-based and sea-based pollution are becoming serious, and have affected the health and wealth of the people. The manifestations of the disregard to the aquatic environment are already obvious, as evidenced by the frequent reports on water shortage, polluted rivers and seas, decrease in fisheries commodities, decline of aesthetic values in water-based recreational areas and decrease in biodiversity. Various laws and regulations have not been able to deter some of these ecosystems from being continually exploited on unsustainable basis. Concerted efforts from all stakeholders are critical to protect these valuable ecosystems such that their resources would continue to provide life necessities for generations to come. Preventive measures, such as the implementation of holistic environmental management, increased public education and the early use of efficient and cost-effective pollution control measures through research efforts and the acquisition of clean technology, should be implemented to achieve desired level of pollution abatement. These efforts by the Government should be complemented and supplemented by investments from the private sector to achieve a clean, healthy and productive aquatic environment for both present and future generations.

Cost-Effectiveness of Nutrient Management and Buffers: Comparisons of Two Spatial Scenarios

Farmers and taxpayers would benefit from more cost-effective agricultural nutrient pollution control measures. The objectives of our study are (1) to assess compliance costs and reductions in phosphorus loadings from implementation of nutrient management and riparian buffers; and (2) to estimate how the spatial scenario, which is the method of representing farms within the watershed, affects estimated compliance costs and reductions in phosphorus deliveries. Estimated compliance costs are quite sensitive to the spatial scenario. Buffers are more cost-effective than nutrient management under one of the two spatial scenarios, whereas nutrient management is more cost-effective under the other scenario. Shifts to more erosive crops reduce the effectiveness of both pollution control measures.

New polish for Institute of Corrosion

The UK's Institute of Corrosion is (IC) launching a ”new look” in a bid to encourage new members. The IC will be seeking to promote sound corrosion management practice, the advancement of cost-effective corrosion control measures, and a sustained effort to raise awareness at all stages of design and manufacture. It estimates that corrosion costs the UK 4 per cent of GNP every year. This is a short news story only. Visit www.metal-powder.net for the latest powder metallurgy industry news.

Nosocomial infections in developing countries: cost effective control and prevention.

To review the efficient and cost-effective preventive, control and surveillance measures that could be employed against nosocomial infections in developing countries. Literature search on compact disk-read only memory (CD-ROM), Medline and Internet, using the key words: nosocomial infection, prevention and control, use of antibiotics and use of computers. Some articles were manually reviewed. Relevant studies or articles on nosocomial infections in developing and developed countries were included in the review. From individual studies or articles. Information on nosocomial infections from developing and developed countries with some emphasis on Kenya is synchronized under the headings; introduction, historical background of nosocomial infections. Current situation of nosocomial infections and predisposing factors, nosocomial infections and antimicrobial resistance, consequences of nosocomial infections, hospital infection control programme and use of computers in nosocomial infection surveillance, and the cost benefit of infection prevention and control programme. Nosocomial infections may be contained more effectively by having an infection prevention and control programme. Computer-assisted epidemiological surveillance appears to be the most important aspect of monitoring infection control programmes, and to identify changes in risk factors that can increase the infection rate. Even minimally, effective infection control programmes are cost-effective. For the war against nosocomial infections to be won, the whole exercise should be handled as a global project with significant inputs from developing countries.

Stage-dependent Localization of a Novel Gene Product of the Malaria Parasite, Plasmodium falciparum

A novel Plasmodium falciparum gene, MB2, was identified by screening a sporozoite cDNA library with the serum of a human volunteer protected experimentally by the bites of P. falciparum-infected and irradiated mosquitoes. The single-exon, single-copy MB2 gene is predicted to encode a protein with an M(r) of 187,000. The MB2 protein has an amino-terminal basic domain, a central acidic domain, and a carboxyl-terminal domain with similarity to the GTP-binding domain of the prokaryotic translation initiation factor 2. MB2 is expressed in sporozoites, the liver, and blood-stage parasites and gametocytes. The MB2 protein is distributed as a approximately 120-kDa moiety on the surface of sporozoites and is imported into the nucleus of blood-stage parasites as a approximately 66-kDa species. Proteolytic processing is favored as the mechanism regulating the distinct subcellular localization of the MB2 protein. This differential localization provides multiple opportunities to exploit the MB2 gene product as a vaccine or therapeutic target.