Temperate Countries Research Articles

Hot and cold: Policy perspectives on overheating and cooling in United Kingdom homes

Under the current climate, overheating is already a problem in UK homes, causing discomfort, ill health, and mortality. As temperatures continue to increase due to climate change, the problem will worsen. Cooling offers a solution and its use in the domestic sector is expected to grow, but active cooling technologies can create emissions which contribute to climate change and can have wider social impacts. Policy needs to be developed to protect people from heat risks, whilst limiting the impacts from any cooling. These are emerging research and policy areas within the UK and other temperate countries, and this paper explores these challenges and opportunities using an avoid-improve-shift cooling decarbonisation framework, through semi-structured interviews with 74 policy actors. The results show the main challenge is the existing stock, that the market for domestic cooling is immature, and there are opportunities to support the adoption of passive measures, improve cooling products, and manage cooling within the energy system. Overall, the paper highlights the need for action to create homes that are fit for the future through the development of a balanced, integrated cooling policy. This can be achieved by acting quickly and comprehensively; seeking synergies with wider energy policies; supporting people to take low-carbon, climate resilient behaviours; making use of best practice; and through effective leadership.

Rôle du laboratoire dans le diagnostic d’une onychomycose : méthodes et interprétation

AbstractOnychomycosis does not represent more than 50% of all nail pathologies. Anthropophilic dermatophytes ( Trichophyton rubrum and T. interdigitale) are the main agents encountered on feet. Yeasts of the genus Trichosporon and Candida ( Candida albicans, Candida parapsilosis, etc.) predominate on fingernails where nail damage can be associated with perionyxis. Other filamentous species, called “pseudodermatophytes”, have a particular affinity for keratin, such as dermatophytes. These keratinophilic species belong to the genus Neoscytalidium from tropical and subtropical regions, and Arachnomyces nodosetosus from temperate or cold countries, mainly involved in onyxis on the feet of elderly people. Among the environmental molds that can sometimes parasitize nails, there are mainly species belonging to the genera Scopulariopsis, Aspergillus and Fusarium, their pathogenic power must however be clearly defined. The role of the Laboratory is precisely to identify the species in question, and to demonstrate that the fungus isolated from samples of a pathological nail is indeed the pathogen in question.

Health-Related Parameterization Evaluating Thermal Comfort in Urban Green Spaces: Data Sourced from a Global Database and Mapping at National Scale

Outdoor thermal comfort (OTC) is one of the most important issues for people exposed to urban green space (UGS). It is mainly evaluated by assessing equivalent meteorological factors that may combine and result in human responses of perceptions about comfortable vs. uncomfortable environments. The assessment of these responses is challenged by limits in a database that is powerful enough to support big-data analysis and an essential parameter that can evaluate health-related responses to OTC in urban forests. In this study, a meta-analysis was conducted by synthesizing studies of physiological and psychological health responses of green space (GS) visitors to meteorological factors in host cities on a global scale. A total of 15,000 numerical records about the psychological and physiological responses of UGS visitors were obtained from 105 papers across 68 global cities in 21 countries. A novel parameterization was developed to evaluate OTC by normalizing changes in health-related parameters and detecting their regressions against multiple meteorological factors. It was revealed that OTC resulted in more benefits in psychological health parameters than in physiological ones for UGS visitors worldwide. Globally, health-promoting OTC environments were more found in temperate countries than in countries subjected to other climates. People in Asian countries were indicated to live in environments with higher comfort that benefitted health states in cities at low latitudes. Thermal environments tended to be harsher and more challenging, mostly too chilling, in northern cities than in the south globally. A deep learning model using the ResNet algorithm was found to perform to an expected level with R2 as high as >70% and errors controlled generally lower than 0.01. Taking mainland China for instance, it was predicted that thermal environments in eastern cities of China highly challenged the psychological health of local UGS visitors across all seasons of the year. Northern cities of China were predicted to have satisfied thermal environments that benefited psychological and psychological health responses in spring. In summer, cities in West China were predicted to have comfortable thermal environments, and in winter, environments in the southwestern cities were more comfortable.

Temperate Soils Exposed to Drought—Key Processes, Impacts, Indicators, and Unknowns

The summer drought in the United Kingdom (UK) in 2022 produced significant speculation concerning how its termination may impact and interact with the soil resource. Whilst knowledge regarding soils and droughts exists in the scientific literature, a coherent understanding of the wider range of impacts on soil properties and functions has not been compiled for temperate soils. Here, we draw together knowledge from studies in the UK and other temperate countries to understand how soils respond to drought, and importantly what and where our knowledge gaps are. First, we define the different types of droughts and their frequency in the UK and provide a brief overview on the likely societal impacts that droughts place on the soil and related ecosystems. Our focus is on ‘agricultural and ecosystem drought’, as this is when soils experience dry periods affecting crops and ecosystem function, followed by rewetting. The behaviour of moisture in soils and the key processes that contribute to its storage and transport are examined. The principal changes in the physical, chemical, and biological properties of soils resulting from drought, and rewetting (i.e., drought termination) are discussed and their extensive interactions are demonstrated. Processes that are involved in the rewetting of soils are explored for soil and catchment-scale soil responses. Lastly, soils’ recovery after drought is considered, knowledge gaps are identified, and areas to improve understanding are highlighted.

A transgenerational study on the effect of granddam conception month on granddaughter test day records for milk production traits in Italian Simmental cattle

The consequences of climate change are becoming a relevant issue also for the livestock industry in temperate countries. Transgenerational studies outlined the effect of the ancestors’ calving season, considered as an indicator of the period during which pregnancy occurs, on their female progeny performance. The aim of this study was to evaluate the effect of great granddam (F0) calving month on their great granddaughters (F3) Test Day (TD) records for milk production. A total of 414,069 TD records of milk, fat, and protein yields from 27,224 Italian Simmental F3 cows was analysed with a mixed linear model with year of calving, parity, age at parity, F0 calving month, days in milk class, the interactions between DIM and F0 calving month and between parity and F0 calving month, F3 calving date and the random effects of herd-test date and animal. The F0 calving month significantly influenced F3 performance for the three considered traits; largest F3 TD records were obtained for F0 calvings occurring in October, smallest for February. The largest milk production of F3 cows were observed when their F1 conceptions occurred in winter. Results were confirmed by a further analysis considering the calving seasons of F0, F1 and F2. The effect of F0 calving month (associated with the conception of F1) on milk production decreased as F3 parity increased. Results of this study suggest that the period of ancestor pregnancy and conception affects milk production traits of further generations also in temperate climates.

Waterproofing integrity and water tightness of buildings in the tropic

For tropical countries in Southeast Asia, frequent heavy rains and the local habit of using lots of water in wet areas such as toilets and bathrooms within dwelling units are the major reasons that waterproofing designs fail to prevent the water ingress into buildings. Unfortunately, not many studies on the effectiveness of waterproofing system for such climatic conditions and social habits have been reported. Results of studies conducted on various categories of defects related to water ingress and water tightness for public housing projects and others buildings in Singapore are reported. Examination of waterproofing failures in Singapore and other Southeast Asia countries showed the cause of the failure was because the waterproofing designs adopted were mainly copied from developed temperate countries in the earlier years. Based on the causes of waterproofing failures, revised details are proposed for tropical countries with frequent heavy rains and similar social habits to eliminate these failures in an integrated approach, that is, design, construction, and maintenance, to achieve efficiency, durability, ease of construction and maintenance, overall quality assurance, and cost effectiveness for the waterproofing system. Revised details adopted to achieve waterproofing integrity and water tightness of conventional and prefabricated buildings in the tropic are presented.

Genome characterization of Shewanella algae in Hainan Province, China.

Shewanella algae is an emerging marine zoonotic pathogen. In this study, we first reported the Shewanella algae infections in patients and animals in Hainan Province, China. Currently, there is still relatively little known about the whole-genome characteristics of Shewanella algae in most tropical regions, including in southern China. Here, we sequenced the 62 Shewanella algae strains isolated from Hainan Province and combined with the whole genomes sequences of 144 Shewanella algae genomes from public databases to analyze genomic features. Phylogenetic analysis revealed that Shewanella algae is widely distributed in the marine environments of both temperate and tropical countries, exhibiting close phylogenetic relationships with genomes isolated from patients, animals, and plants. Thereby confirming that exposure to marine environments is a risk factor for Shewanella algae infections. Average nucleotide identity analysis indicated that the clonally identical genomes could be isolated from patients with different sample types at different times. Pan-genome analysis identified a total of 21,909 genes, including 1,563 core genes, 8,292 strain-specific genes, and 12,054 accessory genes. Multiple putative virulence-associated genes were identified, encompassing 14 categories and 16 subcategories, with 171 distinct virulence factors. Three different plasmid replicon types were detected in 33 genomes. Eleven classes of antibiotic resistance genes and 352 integrons were identified. Antimicrobial susceptibility testing revealed a high resistance rate to imipenem and colistin among the strains studied, with 5 strains exhibiting multidrug resistance. However, they were all sensitive to amikacin, minocycline, and tigecycline. Our findings clarify the genomic characteristics and population structure of Shewanella algae in Hainan Province. The results offer insights into the genetic basis of pathogenicity in Shewanella algae and enhance our understanding of its global phylogeography.

Defense Molecules of the Invasive Plant Species Ageratum conyzoides

Ageratum conyzoides L. is native to Tropical America, and it has naturalized in many other tropical, subtropical, and temperate countries in South America, Central and Southern Africa, South and East Asia, Eastern Austria, and Europe. The population of the species has increased dramatically as an invasive alien species, and it causes significant problems in agriculture and natural ecosystems. The life history traits of Ageratum conyzoides, such as its short life cycle, early reproductive maturity, prolific seed production, and high adaptive ability to various environmental conditions, may contribute to its naturalization and increasing population. Possible evidence of the molecules involved in the defense of Ageratum conyzoides against its natural enemies, such as herbivore insects and fungal pathogens, and the allelochemicals involved in its competitive ability against neighboring plant species has been accumulated in the literature. The volatiles, essential oils, extracts, residues, and/or rhizosphere soil of Ageratum conyzoides show insecticidal, fungicidal, nematocidal, and allelopathic activity. The pyrrolizidine alkaloids lycopsamine and echinatine, found in the species, are highly toxic and show insecticidal activity. Benzopyran derivatives precocenes I and II show inhibitory activity against insect juvenile hormone biosynthesis and trichothecene mycotoxin biosynthesis. A mixture of volatiles emitted from Ageratum conyzoides, such as β-caryophyllene, β-bisabolene, and β-farnesene, may work as herbivore-induced plant volatiles, which are involved in the indirect defense function against herbivore insects. Flavonoids, such as nobiletin, eupalestin, 5′-methoxynobiletin, 5,6,7,3′,4′,5′-hexamethoxyflavone, and 5,6,8,3,4′,5′-hexamethoxyflavone, show inhibitory activity against the spore germination of pathogenic fungi. The benzoic acid and cinnamic acid derivatives found in the species, such as protocatechuic acid, gallic acid, p-coumaric acid, p-hydroxybenzoic acid, and ferulic acid, may act as allelopathic agents, causing the germination and growth inhibition of competitive plant species. These molecules produced by Ageratum conyzoides may act as defense molecules against its natural enemies and as allelochemicals against neighboring plant species, and they may contribute to the naturalization of the increasing population of Ageratum conyzoides in new habitats as an invasive plant species. This article presents the first review focusing on the defense function and allelopathy of Ageratum conyzoides.

Comparison of different parts of tangerine (Citrus tangerina) for DNA extraction

The tangerine, a citrus fruit, is grown commercially worldwide in tropical, semitropical, and warm temperate countries, including the Mediterranean region. Tangerine cultivation and production are crucial for the economy of many countries, where genomic DNA plays a critical role in genetic diversity and molecular analysis of this tree. Therefore, this study was conducted in 2022 at Limpopo University to compare DNA extraction from three different parts of the tangerine tree: fresh leaves, stems, and fruit. The Chelex method was used to extract DNA from three samples of C. tangerine from South Africa. The quantity and purity of DNA were measured using a spectrophotometer. PCR amplification with 28S primers was used to confirm and evaluate the extracted DNA. The results from the spectrophotometer showed that the highest quantity of nucleic acid was extracted from the stem (98.18± 12 mg/mL), with a 260/280 ratio for DNA quality (1.85 ± 0.01). The fruit showed a high level of protein (5.8 ± 1.8 mg/mL), but the DNA concentration was lower. In conclusion the amplification of the samples indicated that the stem had high purity and concentration of DNA, which can be suitable for PCR amplification.

Unraveling the Role of Viral Interference in Disrupting Biennial RSV Epidemics in Northern Stockholm.

Respiratory syncytial virus (RSV) primarily impacts infants and older adults, with seasonal winter outbreaks in temperate countries. Biennial cycles of RSV activity have also been identified in Northern Europe and some states in the United States. Delayed RSV activity was reported worldwide during the 2009 influenza pandemic, and a disrupted biennial pattern of RSV activity was observed in northern Stockholm following the pandemic. Biennial patterns shifted to early/large outbreaks in even-numbered years and late/small outbreaks in odd-numbered years. However, the mechanisms underpinning this change in pattern remain unknown. In this work, we constructed an age-stratified mechanistic model to explicitly test three factors that could lead to the change in RSV transmission dynamics: 1) birth rates, 2) temperatures, and 3) viral interference. By fitting the model to weekly RSV admission data over a 20-year period and comparing different models, we found that viral interference from influenza was the only mechanism that explained the shifted biennial pattern. Our work demonstrates the complex interplay between different respiratory viruses, providing evidence that supports the presence of interactions between the H1N1 pandemic influenza virus and RSV at the population level, with implications for future public health interventions.

Overwintering potential of the Mediterranean fruit fly (Diptera: Tephritidae) in Austria.

The Mediterranean fruit fly (medfly), Ceratitis capitata (Wiedemann), one of the most important invasive pests of fresh fruits and vegetables from the coastal Mediterranean habitats, is expanding its current geographic distribution to cooler more temperate areas of Europe. Every year since 2010 the fly is detected in the area of Vienna, Austria. However, whether it can establish permanent populations is not known. In this current paper, the capacity of C. capitata to overwinter in Vienna, Austria (48.1° northern latitude) was studied over 2 consecutive winter seasons (2020-2022). Overwintering trials with different life stages (larva, pupa, and adult) of C. capitata were performed in the open field and in the protected environment of a basement without a heating system. Control flies were kept under constant conditions in a climate chamber (25 °C, 60% RH, 14:10 L:D). Our data showed that no life stage of the Mediterranean fruit fly was able to survive the Austrian winter in the open field. However, in the protected environment C. capitata outlived the winter months in all studied life stages at least in small numbers and several surviving females were able to lay eggs at the time of the following fruiting season. Implications of these findings for the ongoing geographic range expansion of the pest in temperate European countries are discussed.

Study of the ascorbic acid accumulation in Thymus L. genus species of Ukraine flora

The Thymus L. genus species are extremely widespread in temperate countries and number up to 200 main wild plants, of which up to 50 have been identified in the modern Ukraine flora. Extracts from the official species of the Thymus L. genus are part of effective herbal preparations with pronounced anti-inflammatory, antimicrobial, and antioxidant activities. A promising direction of modern phytochemical research is the determination of the presence and accumulation of biologically active ascorbic acid in the herbs of widespread wild and cultivated species of the Thymus L. genus. The aim of the work is to determine the presence and accumulation of biologically active L-ascorbic acid in the herbs of four widespread wild and cultivated species of the Thymus L. genus of Ukraine flora using thin layer chromatography (TLC) and spectrophotometry methods during vegetation season. Materials and methods. The research used herbs of four widespread wild and cultivated species of the Thymus L. genus of Ukraine flora during the growing season (June – August 2023). The presence and quantitative content of ascorbic acid were determined by TLC on a “Biostep” CD 60 densitometer (Germany) and spectrophotometry on a “Lambda 365’ device (USA). Results. TLC and spectrophotometry methods were used to determine the presence and quantitative content of ascorbic acid in the herbs of four widespread Thymus L. genus species of Ukraine flora during the growing season. Accumulation of the compound was higher during flowering of cultivated species than wild plants. For the herbs Thymus vulgaris L. up to 39.10 ± 3.88 mg%; Th. x citriodorus (Pers.) Schreb. var. “Silver Queen” up to 36.19 ± 3.59 mg%. Conclusions. Considering the results obtained by TLC and spectrophotometry methods, it can be concluded that the determination of ascorbic acid presence and content in the Thymus L. species genus herbs is appropriate for obtaining cosmetology preparations with pronounced anti-inflammatory, antioxidant, and regenerating activity for normal and problem skin.

An overview of swine production and marketing in Africa - Mini review

Pigs are the oldest domesticated animals, though their ancestry is still uncertain because of a lack of archaeological and genetic evidence. Pigs serve a vital role in reducing the demand for livestock and livestock products in most parts of the world. Especially in the African continent, pigs serve as mobile cash implying how easily they can be converted into cash to sort pressing family needs. Pig production in Africa is different from advanced systems of production in temperate countries, however, it has similarities with most of the tropical low and middle-income nations. Pig production in Africa requires attention to enable it to contribute effectively to the growing African population. However, it has been orchestrated with a myriad of challenges including market access. This mini-review is designed in a manner to provide an overview of pig production contribution to livelihoods in Africa and associated challenges with possible appropriate solutions.

Season, size, and sex: factors influencing monogenean prevalence and intensity on Gambusia affinis in New Zealand

A number of studies have been conducted on monogenean seasonality, though primarily in continental regions with wide annual temperatures ranges. We investigated seasonal changes in the prevalence and intensity of Salsuginus seculus infesting sexually dimorphic western mosquitofish (Gambusia affinis) in New Zealand. This represents the first examination of seasonality for this species globally, and the first seasonal assessment of any monogenean population in New Zealand, a temperate country with a mild oceanic climate. Prevalence and intensity of S. seculus with respect to fish size and sex was also examined. Prevalence of S. seculus changed temporally, peaking in summer, and was strongly positively correlated with algal concentrations. This relationship may be associated with increasing food levels, leading to an increase in fish courting and mating, resulting in high numbers and close physical associations of G. affinis individuals, facilitating transmission of the monogeneans. Thus, biotic factors may be important in determining temporal changes in S. seculus prevalence in New Zealand. Female G. affinis had a significantly higher prevalence and mean intensity of S. seculus than males. Longer fish had a higher mean intensity and prevalence of S. seculus. Female G. affinis likely host disproportionately more monogeneans as they are larger than males. Alternatively, females may have a compromised immune response during reproductive periods. Overall, seasonal change was observed in S. seculus prevalence and intensity under New Zealand’s mild climatic conditions, and the larger female G. affinis in this dimorphic species supported a greater prevalence and intensity of infestation than males.

The Swelling–Shrinkage Properties of Intact and Disturbed Clayey and Marly Soils: The Density Effect

Expansive soils commonly encountered beneath foundations often lead to structural issues inducing expensive repairs. With the increase of the frequency of dry summers and irregular rainfall patterns, the clayey and marly soils become more and more sensitive to shrinking and swelling phenomena. So to find solutions and improve the knowledge on such phenomena especially in temperate countries where the saturation state is considered as the usual soil state, the impact of the soil density on shrinkage was studied by varying the compaction mode and introducing a swelling step before shrinkage. As expected, dynamically or statically compacted clayey or marly soils exhibited high shrinkage deformation when the soil had a low density. The swelling before shrinkage impacted the soil structure but ultimately had a low effect on shrinkage deformation. Swelling deformation was also influenced by density; the denser the soil, the more sensitive the compacted soil became to swelling. Furthermore, compaction modes induced differences in swelling or shrinkage amplitude that couldn’t be explained by microstructural observations. Finally, results demonstrated that intact soil behavior after shrinkage could be extrapolated from swelling–shrinkage tests conducted on remolded soil samples, thus decreasing the cost of field investigations.

Clinical Characteristics and Management of Children and Adolescents Hospitalized With Pyomyositis.

Pyomyositis, a bacterial muscle infection, is an important differential diagnosis in children and adolescents with musculoskeletal pain. In contrast to tropical regions, it is rarely recognized in temperate countries, but incidence is increasing and major studies are missing. This retrospective multicenter study included patients <18 years of age hospitalized with pyomyositis in 11 Swiss children's hospitals between January 2010 and December 2022. Cases were identified by ICD-10 code (Myositis; M60-M60.9), and data was extracted from electronic hospital records. Of 331 patients identified, 102 fulfilled the case definition. Patient age at presentation ranged from 2 weeks to 17 years (median 8 years). The majority had no underlying illness and all presented with fever and localized pain. At the respective site of pyomyositis, 100 (98%) had impaired movement and 39 (38%) presented with local swelling. Pelvic (57%) and leg (28%) muscles were mostly affected. Blood or tissue cultures were obtained in 94 (92%) and 59 (57%) patients, respectively. Of those, 55 (58%) blood and 52 (88%) tissue cultures were positive, mainly for Staphylococcus aureus (35 and 19, respectively) and Streptococcus pyogene s (12 and 15, respectively). All patients received antibiotic treatment during hospitalization for a median of 10 days (interquartile range: 7-17), followed by outpatient treatment for a further median of 16 days (interquartile range: 11-22) in 95 (93%) patients. Fifty-nine (57%) patients required surgery. Pyomyositis is a challenging diagnosis that requires a high level of awareness. Blood and/or tissue cultures revealed S. aureus and S. pyogenes as the predominant causative agents.

Potential Role and Mechanism of Mulberry Extract in Immune Modulation: Focus on Chemical Compositions, Mechanistic Insights, and Extraction Techniques.

Mulberry is a rapidly growing plant that thrives in diverse climatic, topographical, and soil types, spanning temperature and temperate countries. Mulberry plants are valued as functional foods for their abundant chemical composition, serving as a significant reservoir of bioactive compounds like proteins, polysaccharides, phenolics, and flavonoids. Moreover, these compounds displayed potent antioxidant activity by scavenging free radicals, inhibiting reactive oxygen species generation, and restoring elevated nitric oxide production induced by LPS stimulation through the downregulation of inducible NO synthase expression. Active components like oxyresveratrol found in Morus demonstrated anti-inflammatory effects by inhibiting leukocyte migration through the MEK/ERK signaling pathway. Gallic and chlorogenic acids in mulberry leaves (ML) powder-modulated TNF, IL-6, and IRS1 proteins, improving various inflammatory conditions by immune system modulation. As we delve deeper into understanding its anti-inflammatory potential and how it works therapeutically, it is crucial to refine the extraction process to enhance the effectiveness of its bioactive elements. Recent advancements in extraction techniques, such as solid-liquid extraction, pressurized liquid extraction, superficial fluid extraction, microwave-assisted extraction, and ultrasonic-assisted extraction, are being explored. Among the extraction methods tested, including Soxhlet extraction, maceration, and ultrasound-assisted extraction (UAE), UAE demonstrated superior efficiency in extracting bioactive compounds from mulberry leaves. Overall, this comprehensive review sheds light on the potential of mulberry as a natural immunomodulatory agent and provides insights into its mechanisms of action for future research and therapeutic applications.

A relational approach to characterizing householder perceptions of disruption in heat transitions

Heat decarbonization threatens substantial disruptions in temperate countries. However, the concept of disruption carries diverse meanings, potentially relating to cost, material space and everyday heating practices. Here, using interpretive risk theory, this article elucidates a relational understanding of how disruption is experienced and takes on meaning in everyday life. We deploy this framework to examine perceptions of four low-carbon heating technologies—heat pumps, hydrogen, hybrid heating and heat networks—alongside associated upgrades to distribution network infrastructure. Drawing on data from six, 1-day workshops representing a diversity of geographic and housing contexts across the United Kingdom, we address how existing relationships shape hopes, fears and expectations for heat decarbonization. Our findings help clarify the role of affective relationships, feelings of precarity, security and pressure in distinguishing material inconveniences from more fundamental disruptions to valued ways of life, and may be particularly relevant in other gas-dependent countries and regions.

Lyme borreliosis in a French expatriate in India.

Lyme borreliosis is known to be endemic in temperate countries of the Northern hemisphere but is rarely reported in other regions of the world. Here, we describe a rare diagnosis in a traveller returning from India, who presented with two erythema migrans.

Mass Relapse Prevention to Reduce Transmission of Plasmodium vivax- A Systematic Review.

Several temperate countries have used mass chemoprevention interventions with medicines of the 8-aminoquinoline class that prevent relapses from Plasmodium vivax before peak transmission to reduce transmission of malaria. The WHO commissioned a systematic review of the literature and evidence synthesis to inform development of recommendations regarding this intervention referred to as "mass relapse prevention" (MRP). Electronic databases were searched, 866 articles screened, and 25 assessed for eligibility after a full-text review. Two nonrandomized studies were included, one from the Democratic People's Republic of Korea (391,357 participants) and the second from the Azerbaijan Soviet Socialist Republic (∼30,000 participants). The two studies administered a single round of primaquine over 14 days (0.25 mg/kg per day). From 1 to 3 months after the treatment round, the incidence of P. vivax infections was significantly lower in areas that received MRP than those that did not (pooled rate ratio [RR] 0.08, 95% CI 0.07-0.08). At 4 to 12 months after the treatment round, the prevalence of P. vivax infection was significantly lower in MRP villages than non-MRP villages (odds ratio 0.12, 95% CI 0.03-0.52). No severe adverse events were found. The certainty of evidence for all outcomes was very low and no conclusions as to the effectiveness or safety of MRP could be drawn. However, it is not likely that this intervention will be needed in the future as most temperate countries where P. vivax is transmitted are nearing or have already eliminated malaria.