Endemic City Research Articles

Impact of the dog population and household environment for the maintenance of natural foci of Leishmania infantum transmission to human and animal hosts in endemic areas for visceral leishmaniasis in Sao Paulo state, Brazil.

When it comes to visceral leishmaniasis (VL) in Brazil, one of the main targets of public health policies of surveillance is the control of domestic canine reservoirs of Leishmania infantum. This paper aims to evaluate the effect of the dog population and household environment for the maintenance of natural foci in the transmission to human and animal hosts in an endemic city for VL, Bauru, in Brazil. We collected 6,578 blood samples of dogs living in 3,916 households from Nov.2019 to Mar.2020 and applied geospatial models to predict the disease risk based on the canine population. We used Kernel density estimation, cluster analysis, geostatistics, and Generalized Additive Models (GAM). To validate our models, we used cross-validation and created a receiver operating characteristic (ROC) curve. We found an overall canine VL (CVL) seroprevalence of 5.6% for the sampled dogs, while for the households, the positivity rate was 8.7%. Odds ratios (OR) for CVL increased progressively according to the number of canines for >2 dogs (OR 2.70); households that already had CVL in the past increased the chances for CVL currently (OR 2.73); and the cases of CVL increase the chances for human VL cases (OR 1.16). Our models were statistically significant and demonstrated a spatial association between canine and human disease cases, mainly in VL foci that remain endemic. Although the Kernel density ratio map had the best performance (AUC = 82), all the models showed high risk in the city’s northwest area. Canine population dynamics must be considered in public policies, and geospatial methods may help target priority areas and planning VL surveillance in low and middle-income countries.

Identifying urban hotspots of dengue, chikungunya, and Zika transmission in Mexico to support risk stratification efforts: a spatial analysis

SummaryBackgroundEffective Aedes aegypti control is limited, in part, by the difficulty in achieving sufficient intervention coverage. To maximise the effect of vector control, areas with persistently high numbers of Aedes-borne disease cases could be identified and prioritised for preventive interventions. We aimed to identify persistent Aedes-borne disease hotspots in cities across southern Mexico.MethodsIn this spatial analysis, geocoded cases of dengue, chikungunya, and Zika from nine endemic Mexican cities were aggregated at the census-tract level. We included cities that were located in southern Mexico (the arbovirus endemic region of Mexico), with a high burden of dengue cases (ie, more than 5000 cases reported during a 10-year period), and listed as high priority for the Mexican dengue control and prevention programme. The Getis-Ord Gi*(d) statistic was applied to yearly slices of the dataset to identify spatial hotspots of each disease in each city. We used Kendall's W coefficient to quantify the agreement in the distribution of each virus.Findings128 507 dengue, 4752 chikungunya and 25 755 Zika clinical cases were reported between Jan 1, 2008, and Dec 31, 2016. All cities showed evidence of transmission heterogeneity, with a mean of 17·6% (SD 4·7) of their total area identified as persistent disease hotspots. Hotspots accounted for 25·6% (SD 9·7; range 12·8–43·0) of the population and 32·1% (10·5; 19·6–50·5) of all Aedes-borne disease cases reported. We found an overlap between hotspots of 61·7% for dengue and Zika and 53·3% for dengue and chikungunya. Dengue hotspots in 2008–16 were significantly associated with dengue hotspots detected during 2017–20 in five of the nine cities. Heads of vector control confirmed hotspot areas as problem zones for arbovirus transmission.InterpretationThis study provides evidence of the overlap of Aedes-borne diseases within geographical hotspots and a methodological framework for the stratification of arbovirus transmission risk within urban areas, which can guide the implementation of surveillance and vector control.FundingUSAID, the US Centers for Disease Control and Prevention, the Canadian Institutes of Health Research, International Development Research Centre, Fondo Mixto CONACyT (Mexico)-Gobierno del Estado de Yucatan, and the US National Institutes of Health.TranslationFor the Spanish translation of the abstract see Supplementary Materials section.

Odour of domestic dogs infected with Leishmania infantum is attractive to female but not male sand flies: Evidence for parasite manipulation.

Globally visceral leishmaniasis (VL) causes thousands of human deaths every year. In South America, the etiologic agent, Leishmania infantum, is transmitted from an infected canine reservoir to human hosts by the bite of the sand fly vector; predominantly Lutzomyia longipalpis. Previous evidence from model rodent systems have suggested that the odour of infected hosts is altered by the parasite making them more attractive to the vector leading to an increased biting rate and improved transmission prospects for the pathogen. However, there has been no assessment of the effect of Le infantum infection on the attractiveness of dogs, which are the natural reservoirs for human infection. Hair collected from infected and uninfected dogs residing in a VL endemic city in Brazil was entrained to collect the volatile chemical odours present in the headspace. Female and male Lu. longipalpis sand flies were offered a choice of odour entrained from infected and uninfected dogs in a series of behavioural experiments. Odour of uninfected dogs was equally attractive to male or female Lu. longipalpis when compared to a solvent control. Female Lu. longipalpis were significantly more attracted to infected dog odour than uninfected dog odour in all 15 experimental replicates (average 45.7±0.87 females attracted to infected odour; 23.9±0.82 to uninfected odour; paired T-test, P = 0.000). Male Lu. longipalpis did not significantly prefer either infected or uninfected odour (average 36.1±0.4 males to infected odour; 35.7±0.6 to uninfected odour; paired T-test, P = 0.722). A significantly greater proportion of females chose the infected dog odour compared to the males (paired T-test, P = 0.000). The results showed that the odour of dogs infected with Le. infantum was significantly more attractive to blood-seeking female sand flies than it was to male sand flies. This is strong evidence for parasite manipulation of the host odour in a natural transmission system and indicates that infected dogs may have a disproportionate significance in maintaining infection in the canine and human population.

Knowledge, attitude and perceptions about Crimean Congo Haemorrhagic Fever (CCHF) among occupationally high-risk healthcare professionals of Pakistan

BackgroundCrimean Congo Haemorrhagic Fever (CCHF), a tropically neglected infectious disease caused by Nairovirus, is endemic in low middle-income countries like Pakistan. Emergency health care professionals (HCPs) are at risk of contracting nosocomial transmission of CCHF. We, therefore, aim to analyze the knowledge, attitudes, and perceptions (KAP) of at-risk physicians, nurses, and pharmacists in Pakistan and the factors associated with good KAP.MethodA validated questionnaire (Cronbach’s alpha 0.71) was used to collect data from HCPs in two CCHF endemic metropolitan cities of Pakistan by employing a cross-sectional study design. For data analysis percentages, chi-square test and Spearman correlation were applied by using SPSS version 22.ResultsOf the 478 participants, 56% (n = 268) were physicians, 37.4% (n = 179) were nurses, and 6.5% (n = 31) were pharmacists. The proportion of HCPs with good knowledge, attitude, and perception scores was 54.3%, 81, and 69%, respectively. Being a physician, having more work experience, having a higher age, working in tertiary care settings, were key factors for higher knowledge (p < 0.001). The correlation coefficient showed significant positive correlation between attitude- perception (r = 0.560, p < 0.001).ConclusionWe have observed average knowledge of HCPs. Therefore, we recommend time to time education campaigns and workshops in highly endemic CCHF regions to be launched by health ministries and HCPs, in particular nurses, encouraged to follow authentic academic sources of information to prevent nosocomial transmission.

Dengue geography in Vientiane Capital, 2012–2019: Combining multiple datasets to understand virus spread in an endemic city

Background: Dengue is a vector borne disease transmitted by Aedes mosquito species. The disease affects all major cities in South-east Asia. Urbanization of the world is a clear factor that led to Aedes and dengue spread during the past decades. In Lao PDR, two epidemics hit the country in 2010 and in 2013, affecting respectively more than 22,890 and 44,171 individuals. However, if some researches were conducted in some localities of Vientiane (Vallée and al, 2011), the overall dengue context and its geography are little known. This presentation has two aims: 1° to present dengue epidemiology and its geography in Vientiane Capital using surveillance system implemented by Institut Pasteur du Laos 2° to uncover what drives the dengue force of infection among built up, socio-economic, local temperature and more innovative data which allow to describe commuting pattern of millions of individuals. Methods and materials: To study the link between environmental disparities and incidence rate of cases, we rely on several data: (i) Global Human settlement, which allows to quantify the sprawl of built-up areas, (ii) surface temperature detected trough Landsat 8, (iii) census data which will help us to qualify the social economic disparities (iv) commuting patterns of Facebook users to understand the migration flow in the city and its link with dengue spread. Results: A total of 2699 cases were recorded and could be located at village level. The effect of village typology (i.e. urban core, 1st, 2nd peripheries and rural areas) on dengue incidence was investigated using a Poisson regression. We could underline that the main risk factors in Vientiane Capital are not linked with poverty but are associated with the percentage of individuals that recently migrated to the city. The second risk factor stands precisely in the degree of urban centrality of a village. Conclusion: This research suggest that risk factors do not only depend on the local context but are also impacted by the structure and intensity of connectivity between villages composing Vientiane Capital. This results underline that dengue could be better model by introducing mobility of individuals at city level.

Identification of Ross River virus hot spots along urban fringes of South East Queensland, Australia

Background/Aim: Ross River virus (RRV) is responsible for the most common vector-borne disease of humans reported in Australia. The virus circulates in enzootic cycles between multiple species of mosquitoes, wildlife reservoir hosts and humans. Despite regular outbreaks, ongoing morbidity and substantial economic costs, the underlying determinants of epidemics remain unclear. Public health concern about RRV has recently increased due to rising incidence rates in Australian urban centres, along with increased circulation in Pacific Island countries. We aimed to provide a detailed analysis of disease trends and explore potential links between disease patterns and transmission pathways of RRV. Methods: We assessed the spatial and temporal distribution of notified RRV cases, and associated epidemiological features in south east Queensland, Australia, from 2001-2016. This included fine-scale analysis of disease patterns across the suburbs of the endemic capital city of Brisbane, and those of 8 adjacent Local Government Areas. Results: The mean annual incidence rate for the region was 41/100,000 with a consistent seasonal peak between February and May. The highest RRV incidence was in adults aged from 30-64 years (mean incidence rate: 59/100,000), and females had higher incidence rates than males (mean incidence rates: 44/100,000 and 34/100,000, respectively). Spatial patterns of disease were heterogeneous between years, and there was a wide distribution of disease across both urban and rural areas of SEQ. Overall, the highest incidence rates were reported from predominantly rural suburbs to the north of Brisbane City, with significant hot spots located in peri-urban suburbs where residential, agricultural and conserved natural land use types intersect. Conclusions: Although RRV is endemic across all of SEQ, transmission is most concentrated in areas where urban and peri-urban environments intersect. The drivers of RRV transmission across rural-urban landscapes should be prioritised for further investigation, including identification of specific vectors and hosts that mediate human spillover.

Diversity of mosquito (Diptera: Culicidae) vectors in a heterogeneous landscape endemic for arboviruses

BackgroundIn Brazil and several countries in the Americas, where dengue, chikungunya and Zika are cocirculating, there is a need to understand how different mosquito species relate to landscape and humans. Mosquito ecology and distribution, especially at finer spatial scales, are key factors to study since the relationship of mosquito communities to their habitats might have important consequences in the risk of disease transmission to humans. The aim of this study was to evaluate the diversity of resident culicids along heterogeneous landscapes in different endemic cities for dengue, chikungunya and Zika. MethodsFourteen collection sites were randomly selected in six landscapes characterized as urban, periurban and rural along two endemic metropolitan cities in Rio de Janeiro, Brazil: Itaboraí and Cachoeiras de Macacu, Rio de Janeiro. In each site, adult mosquito collections were performed using different traps and backpack aspiration. Collections took place during the rainy and dry seasons of 2015 and 2016. To measure diversity in each landscape, we generated species accumulation curves and used different indexes: rarefied species richness, Chao1-bc and ACE-1. Mosquito habitat segregation along different land use types was measured with a partial canonical correspondence analysis (pCCA). Generalized linear mixed models (GLMM) were used to model the probability of occurrence of the most abundant species along an Urban-Forest gradient. ResultsA total of 13,462 adult mosquitoes from 10 genera and 41 species were collected. The most abundant species were Culex quinquefasciatus Say, 1823, Aedes aegypti (Linnaeus, 1762) and Aedes albopictus (Skuse, 1895). There was a significant association between rarefied species richness and landscape, with higher richness in the Rural landscape. The number of observed species was matched only in the Urban landscape. Most species showed segregation along an Urban-Forest gradient, and the great majority were associated with forested habitats. We were able to fit prediction models for six mosquito species. DiscussionThe paper discusses the impact of human activities on landscape and its effects on mosquito populations, focusing on the segregation of different known vector species and their proximity to human altered environments. Most of these species are known arbovirus vectors and knowledge of their distribution are key elements that health authorities should take into account when planning arbovirus surveillance and vector control activities.

Susceptibility to Insecticides and Natural Infection in Aedes aegypti: An Initiative to Improve the Mosquito Control Actions in Boyacá, Colombia.

Background:Integrated management strategies for dengue prevention and control have been the main way to decrease the transmission of arboviruses transmitted by A. aegypti in Colombia. However, the increase of chikungunya (CHIKV), Zika, and dengue (DENV) fever cases suggests deficiencies in vector control strategies in some regions from this country.Objective:This work aimed to establish a baseline susceptibility profile of A. aegypti to insecticides, determine the presence of kdr mutations associated with resistance to pyrethroids, and detect natural arbovirus infection in this vector from Moniquirá – Boyacá, one of the most endemic cities in Colombia.Methods:Mosquitos were collected in six neighborhoods, and colonies established in the laboratory. Susceptibility to malathion and lambda-cyhalothrin insecticides was evaluated, and we examined the point mutations present in portions of domains I, II, III, and IV of the sodium channel gene using a simple allele-specific PCR-based assay (AS-PCR).Findings:A. aegypti from Moniquirá showed decreased susceptibility to pyrethroid insecticides, and kdr mutations 419L, 1016I, and 1558C with allelic frequencies of 0.39, 0.40 and 0.95, respectively, were observed. The minimal infection rate (MIR) to DENV-1 was 44.1, while to CHIKV was 14.7.Conclusions:We establish a baseline insecticide resistance, kdr mutations, and arbovirus circulation, which contain the elements necessary for the consolidation of a local surveillance strategy with an early warning system and rational selection and rotation of insecticides.

Associations Between Ross River Virus Infection in Humans and Vector-Vertebrate Community Ecology in Brisbane, Australia.

Transmission of vector-borne pathogens can vary in complexity from single-vector, single-host systems through to multivector, multihost vertebrate systems. Understanding the dynamics of transmission is important for disease prevention efforts, but is dependent on disentangling complex interactions within coupled natural systems. Ross River virus (RRV) is a multivector multihost pathogen responsible for the greatest number of notified vector-borne pathogen infections in humans in Australia. Current evidence suggests that nonhuman vertebrates are critical for the maintenance and spillover of RRV into mosquito populations. Yet, there is a limited knowledge of which mosquito vector species and amplifying vertebrate host species are most important for transmission of RRV to humans. We conducted field surveys of nonhuman vertebrates and mosquitoes in the RRV endemic city of Brisbane, Australia, to assess the effect of vector and host community structure on human RRV notifications. Six suburbs were selected across a gradient of human disease notification rates. Differences in vertebrate and mosquito compositions were observed across all suburbs. Suburbs with higher RRV notification rates contained greater vertebrate biomass (dominated by the presence of horses) and higher mosquito abundances. This study suggests that horse-mosquito interactions should be considered in more detail and that vertebrate biomass and mosquito abundance be incorporated into future RRV modeling studies and considered in public health strategies for RRV management.

Molecular Characterization of Small and Medium Segments of Crimean-Congo Hemorrhagic Fever Virus in Turkey

Aim: The objective was to investigate the genotypic relationship of S and M segments in Crimean-Congo hemorrhagic fever virus (CCHFV) by phylogenetic analysis in 25 patients from seven endemic cities in Turkey. Materials &amp; methods: A total of 25 samples from patients with CCHF were included between 2012 and 2015. Phylogenetic tree analyses were inferred using MEGA version-6.0 and distances were calculated by Kimura’s 2-parameter. Results: Phylogenetic analysis showed that all isolated viruses (n = 25) were in the predicted clades such as clade V- Europe-1 regarding both S and M segments of the CCHFV. Conclusion: Further epidemiological, molecular and phylogenic studies should be performed in both reservoir animals/vectors and humans to determine the incidence of tick-borne infectious disease and to help to develop vaccines for prevention of the disease.

Evaluation of the Level of Knowledge of the Population and Risk Factors Related to Leptospirosis in an Endemic City

Leptospirosis is an infectious-contagious zoonosis caused by gram-negative bacteria, a spirochete of the genus Leptospira. It is largely related to high rainfall levels, accumulation of litter, presence of rodents and lack of basic sanitation.

Investigation on current schistosomiasis cases in Sichuan Province

To understand the status of current schistosomiasis patients after the interruption of schistosomiasis transmission in Sichuan Province, so as to provide the reference for the development of specific rescue and treatment schemes and the implementation of dynamic management of the patients. The information of registered schistosomiasis patients in disease control and prevention institutions and medical institutions were reviewed in all schistosomiasis-endemic counties (districts) across Sichuan Province in 2018, and the data of all newly discovered schistosomiasis patients were collected and analyzed. A total of 1 558 current schistosomiasis cases were diagnosed in 11 endemic cities (prefectures) across Sichuan Province, and all were advanced cases. Megalosplenia and ascites were the predominant types of advanced schistosomiasis cases, and no age- (χ2 = 16.723, P > 0.05) or gender-specific difference (χ2 = 2.493, P > 0.05) was seen in the clinical types of current schistosomiasis cases. There were 9.3% of current schistosomiasis patients from poor households. There was a tendency towards a decline in the number of advanced schistosomiasis cases since 2012, and the number of schistosomiasis cases in 2018 reduced by 17.8% as compared to that in 2012. Currently, all current schistosomiasis patients are advanced cases in Sichuan Province. In the future, multidisciplinary collaboration should be implemented to search for a feasible financial subsidy pattern and establish an effective care system for advanced schistosomiasis patients.

Building an innovative Chagas disease program for primary care units, in an urban non- endemic city

BackgroundOn an absolute basis, Argentina is the country with the largest affected population with Chagas Disease (ChD). This constitutes a significant public health issue. As a consequence of Argentina’s migratory patterns, there has been a significant increase of affected population in urban centers. An innovative project for early diagnosis and timely treatment of ChD was designed for Municipal Primary Care Facilities of La Plata City, a non- endemic area, in line with a proposal from the Pan-American Health Organization. The project was a public –private intervention. The objectives of this study were to demonstrate the feasibility of the primary healthcare level for early diagnosis and timely treatment of ChD; to design and implement a tailor made program and to innovate in a public-private association.MethodsThe healthcare barriers for early diagnosis and timely treatment for the population with ChD of La Plata were analyzed. The four dimensions described by Peters et al. (Ann N Y Acad Sci 1136:161–71, 2008) were used. The baseline was measured during a previous pilot project and the same items were evaluated at the end of 2017. The model from Damschroder et al. (Implement Sci 4:50, 2009) was used during the implementation process.ResultsWith all the information gathered during this investigation, a “patient-centered” model was designed. During the program, 17,894 people were serologically tested for ChD, 1,394 were positive and 1,035 were treated. Additionally, 3,750 children from 46 public schools were evaluated for risk factors of ChD.ConclusionsThis project showed the feasibility of the primary healthcare level for early diagnosis and timely treatment of ChD. Tailor made programs and public-private associations should be considered for vulnerable populations in emerging economies in order to enhance efforts and obtain better results. This program may be replicated in other countries of Latin America were Chagas is a main public health issue and, with the corresponding adaptations, for other neglected diseases as well.

Spatial and Seasonal Distribution of Holochilus sciureus with Schistosoma mansoni Infection in an Endemic Area for Schistosomiasis in Brazil.

The occurrence of wild rodents in the Schistosoma mansoni life cycle may increase the transmission of schistosomiasis and understanding the spatial and seasonal distribution of the natural infection of these reservoirs is essential for the development of more effective control strategies. In this study, Holochilus sciureus rodents were captured from the flooded fields of São Bento city (an endemic area for schistosomiasis in Northeast Brazil), during the dry and rainy seasons. All these sites were georeferenced and the prevalence of S. mansoni was verified by the presence of adult worms in the mesenteric branches and livers of each animal. It was demonstrated that almost half of the animals collected were naturally infected with S. mansoni (45.45%) and this infection was not related to the distance from urban areas. Furthermore, the temperature, precipitation, sex, and weight did not interfere with the H. sciureus infection rates. Interestingly, we found, for the first time, the natural infection of H. sciureus in another endemic city of S. mansoni in Northeast Brazil. Therefore, the H. sciureus rodent shows a high natural infection rate for S. mansoni in the flooded fields of São Bento, regardless of the weather station, capture distance, and biological aspects. Additionally, we have demonstrated that H. sciureus naturally parasitized with S. mansoni may inhabit a much more extensive area that is currently described in the literature.

11. A Clinic Based Survey of Urban Youth Knowledge of PrEP Use for HIV Prevention

Despite improved treatment for HIV disease and FDA approved pre-exposure prophylaxis (PrEP) for HIV prevention in 2012, Washington DC continues to be an endemic city with an overall prevalence of 1.9% and 41% of new infections occurring in youth; almost double the national rate. The interest and uptake of PrEP in youth has been relatively understudied to date. This study sought to document the current level of awareness about and willingness to take PrEP in a sample of urban youth from our patient community, as well as changes in awareness between 2012 and 2018.

Identifikasi Jenis Bahan Aktif dan Penggunaan Insektisida Antinyamuk serta Kerentanan Vektor DBD terhadap Organofosfat pada Tiga Kota Endemis DBD di Provinsi Banten

The increasing cases of Dengue Hemorrhagic Fever (DHF) in various places leads to increased efforts to control the Aedes aegypti mosquito populations using anti-mosquito insecticide. The use of insecticides continuously, the absence of insecticide rotation and errors in the application has been lead to insecticide resistance of dengue vector. The purpose of this study is (1) to identify active ingredients of insecticide; (2) used of anti-mosquito insecticide that has been used by households and programs, (3) as well as knowing the susceptibility status of Aedes aegypti to organophosphate insecticides (Malathion 0,8% and Temephos 0.02 ppm). Descriptive research with cross sectional approach conducted in three highest endemic cities in Banten province: Cilegon City, Serang City, and South Tangerang City. Identification of anti-mosquito insecticide has been done by interview, and identifying health centers and Health Service reports. The results showed that most respondents have been using anti-mosquito insecticide applied daily at night. Respondents prefer to use repellent which can be applied by swab. Based on the active ingredient, D-alethrin is a type of active ingredients which mentioned most often, followed by Pralethrin and Diethyltoluamide (DEET). Insecticides used by the program are Malathion and Pirimiphos-methyl, rotated by Cypermethrin. Susceptibility test results showed that Aedes aegypti is not susceptible to Malathion 0,8 % and Temephos 0.02 ppm.

Malaria preventive behaviors among housewives in suburbs of Bandar-Abbas City, south of Iran: interventional design based on PRECEDE model

ABSTRACTSuburban areas suffer from unfavorable conditions as a result of poor health standards, low income, illness, and slight levels of education. One of the most important components in malaria elimination programs is health education. Bandar-Abbas is a malaria endemic city. Therefore, this study aimed to promote malaria preventive behaviors among housewives in suburbs of Bandar-Abbas City, Iran, through a PRECEDE model-based intervention program. This quasi-experimental study was carried out on 172 housewives under the coverage of four healthcare centers in Bandar-Abbas in 2016. The participants were randomly divided into two experimental and control groups, based on the inclusion criteria. The data collection tools included ademographic questionnaire, aresearcher-made questionnaire based on the educational phase of the PRECEDE model and achecklist for assessing malaria preventive behaviors. After the pre-test, the educational intervention was implemented on the intervention group at the first stage and the same questionnaire was administered as the post-test for both groups two months after the intervention. In this study, after implementing the intervention using the PRECEDE educational program, asignificant difference was found between the intervention and control groups in the mean scores for predisposing factors (knowledge and attitude) (P< 0.001), enabling factors (P< 0.001) and reinforcing factors (P< 0.001), which contributed to the improvement of preventive behaviors (P< 0.001). The PRECEDE model-based health education was effective in increasing knowledge and attitude, enabling and reinforcing factors, and promoting malaria preventive behaviors in the studied endemic areas.

Detection of Mansonella ozzardi among blood donors from highly endemic interior cities of Amazonas state, northern Brazil.

In the Brazilian Amazon, the filarial nematode Mansonella ozzardi co-exists with malaria parasites and thick blood smear microscopy is considered the diagnostic gold standard. Transfusion of M. ozzardi microfilariae does not establish new infections, however microfilariae can survive approximately 2 years in blood-recipients with unknown risk of pathology. Data on transfusion-transmitted filariasis are lacking. This study investigated M. ozzardi parasitemias in blood donors from decentralized centers of "Fundação Hematologia e Hemoterapia do Estado do Amazonas/HEMOAM," Northern Brazil. Cross-sectional investigation employing blood smear microscopy (n = 356) and qualitative nested-M. ozzardi-PCR (227 out of 356) in donor candidates from 19 hemocenters in interior/rural municipalities of Amazonas state. Participants were mostly young males. Positivity by microscopy was 7.9% (28 out of 356) and 23.8% by M. ozzardi-PCR (54 out of 227). Parasitaemias were found in 16 out of 19 municipalities. In 54 M. ozzardi-positives, 24 were ineligible; among 30 that donated, 27 were interdicted by seropositivity (22 anti-HBc, 3 anti-HBc + HBsAg, 1 Chagas+malaria, 1 VDRL). Seropositivty was higher in M. ozzardi-PCR-positives vs M. ozzardi-PCR-negatives (OR = 15.8, 95% CI 4.5-56.1, p < 0.0001). Three M. ozzardi contaminated blood units were transfused, but no follow-up information on the recipients is available. Our study provides important baseline data on M. ozzardi among blood donors from the Brazilian Amazon. Further investigations in endemic areas are necessary to clarify possible association between M. ozzardi and other infections and also to elucidate whether there is any significant clinical effect upon transfusion of contaminated blood.

Correlates of Climate Variability and Dengue Fever in Two Metropolitan Cities in Bangladesh.

Dengue fever is a major public health concern in Bangladesh with increased incidence during monsoon. We aimed to assess the correlation of temperature, humidity, and rainfall on dengue fever in two dengue endemic cities in Bangladesh. It was a time series analysis of climate factors and dengue occurrence data in Dhaka and Chittagong cities from 1 January 2000 to 31 December 2009. Daily mean temperature, rainfall, and humidity data were obtained from the Bangladesh meteorological department and daily dengue cases data were obtained from the directorate general of health services (DGHS) of Bangladesh. The mean dengue incidence was 31.62 (SD 28.7) per 100,000 in Dhaka whereas it was 5.76 (SD 11.7) per 100,000 population in Chittagong. The incidence of dengue cases was found significantly associated with the monthly mean temperature, total rainfall, and mean humidity in Dhaka, though in Chittagong, the significantly associated factors​ ​​​​​​were monthly total rainfall and mean humidity. The autoregressive integrated moving average (ARIMA) model identified monthly mean humidity and total rainfall as the most significant contributing factors for dengue cases in Dhaka and Chittagong, respectively. Our study reinforces the relationship of climate parameters with dengue fever, which will support policy-makers in developing a climate-based early warning system for dengue in Bangladesh.

GIS based software technology assistance for effective control of malaria in Mangaluru, India

Background: Mangaluru is malaria endemic costal city with Annual Parasitic incidence (API) ranging between 32/1000 population (2006) to 18 (2014). In spite of implementation of control programme and efforts, the disease is far from controlled. Breaking transmission cycle is crucial in controlling malarial disease.A web based android software for surveillance/program implementation was designed and implemented for aiding control of malaria in Mangaluru. An inter professional project of medical and technology architects,Malaria Control System(MCS) is a specialized GIS based software platform for implementation, monitoring and evaluation of malaria control activities. MCSinstantaneously connects people in malaria control with transfer of information towards treatment compliance, surveillance, anti-mosquito measures and evaluation. Web-based application is for hospitals and laboratories to log on and report incidences soon after diagnosis. GIS based data is captured transferred to multipurpose workers (MPW) for house visits within 48 hrs for actions within defined time frame. Methods & Materials: MCS Software was introduced in existing health system in October 2015 and is operational for past 24 months. Real-time digital data was analyzed to study impact during 1st and 2nd year after implementation and compared with that of previous year(PY). Reporting of cases, number of house visits, and closure of cases after confirming parasite clearance, numbers of sources identified/sources closed or eliminated were analyzed to assess implementation of control measures. API, annual blood examination rate (ABER) &; slide positivity rates (SPR) were analyzed and compared to assess disease control. Results: Reporting of cases within 72 hrs from point of diagnosis was 80%. House visits were incidence centric (as against random visits previously) and complete treatment with evidence of parasite clearance was documented in 89 % and 93%(1st & 2ndyr). Breeding was identified in 11,337 visits out of 1, 95,009 visits by MPW (1st year); 10545.visits out of 1,76,398visits(2ndyear) with photo-evidences, followed by elimination in over 92% in both years. Number of cases reported decreased from 12614 (1styr) to 7181 2ndyr). Progressive reduction in API (16/18/8 in previous year/1st/2ndyr); SPR (10.3/8.2/3.7in PY/1st/2ndyr) was documented. Conclusion: By using software technology, instantaneous transfer of information, and networking ensure’s effective implementation of malaria control program to break local transmission cycle.