Anopheles bionomics in a malaria endemic area of southern Thailand

Abstract Background Ivermectin mass drug administration (MDA) could accelerate malaria elimination in the Greater Mekong Subregion. This study was performed to characterize the bionomics of Anopheles in Surat Thani province, Thailand. Methods Mosquitoes were collected via human landing collections between February and October 2019. Anopheles mosquitoes were morphologically identified to species. Primary Anopheles malaria vectors were dissected to assess parity status, and a subset were evaluated for molecular identification and Plasmodium detection. Results A total of 17,348 mosquitoes were collected during the study period; of these, 5777 were Anopheles mosquitoes. Morphological studies identified 15 Anopheles species, of which the most abundant were Anopheles minimus (s.l.) (87.16%, n = 5035), An. dirus s.l. (7.05%, n = 407) and An. barbirostris s.l. (2.86%, n = 165). Molecular identification confirmed that of the An. minimus s.l. mosquitoes collected, 99.80% were An. minimus (s.s.) (n = 484) and 0.2% were An. aconitus (n = 1), of the An. dirus (s.l.) collected, 100% were An. baimaii (n = 348), and of the An. maculatus (s.l.) collected, 93.62% were An. maculatus (s.s.) (n = 44) and 6.38% were An. sawadwongporni (n = 3). No Anopheles mosquito tested was Plasmodium positive (0/879). An average of 11.46 Anopheles were captured per collector per night. There were differences between species in hour of collection (Kruskal–Wallis H-test: χ2 = 80.89, P < 0.0001, n = 5666), with more An. barbirostris (s.l.) and An. maculatus (s.l.) caught earlier compared to An. minimus (s.l.) (P = 0.0001 and P < 0.0001, respectively) and An. dirus (s.l.) (P = 0.0082 and P < 0.001, respectively). The proportion of parous An. minimus (s.l.) captured by hour increased throughout the night (Wald Chi-square: χ2 = 17.31, P = 0.000, odds ratio = 1.0535, 95% confidence interval 1.0279–1.0796, n = 3400). Overall, An. minimus (s.l.) parity was 67.68% (2375/3509) with an intra-cluster correlation of 0.0378. A power calculation determined that an An. minimus (s.l.) parity reduction treatment effect size = 34%, with four clusters per treatment arm and a minimum of 300 mosquitoes dissected per cluster, at an α = 0.05, will provide 82% power to detect a significant difference following ivermectin MDA. Conclusions The study area in Surat Thani province is an ideal location to evaluate the impact of ivermectin MDA on An. minimus parity. Graphical abstract

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Anopheles Bionomics in a Malaria Endemic Area of Southern Thailand

10.21203/rs.3.rs-407027/v1 ◽

2021 ◽

Author(s):

Narenrit Wamaket ◽

Oranicha Khamprapa ◽

Sittinont Chainarin ◽

Panisa Thamsawet ◽

Ubolrat Ninsaeng ◽

...

Keyword(s):

Molecular Identification ◽

Malaria Vectors ◽

Power Calculation ◽

Chi Square ◽

Anopheles Dirus ◽

Significant Difference ◽

Southern Thailand ◽

Human Landing ◽

Greater Mekong Subregion ◽

The Impact

Abstract Background: Ivermectin mass drug administration (MDA) could accelerate malaria elimination in the Greater Mekong Subregion. This study was performed to characterize the bionomics of Anopheles in Surat Thani province, Thailand.Methods: Mosquitoes were collected via human landing collections, February - October of 2019. Anopheles were morphologically identified to species. Primary Anopheles malaria vectors were dissected to assess parity status and a subset evaluated for molecular identification and Plasmodium detection.Results: A total of 17,348 mosquitoes were collected. Of 5,777 Anopheles mosquitoes, 15 species were identified morphologically. The most abundant Anopheles were Anopheles minimus s.l. (87.87%, n = 5,035), Anopheles dirus s.l. (7.05%, n = 407), and Anopheles barbirostris s.l. (2.86%, n = 165). Molecular identification confirmed that of An. minimus s.l., 99.80% were An. minimus s.s. (n=484) and 0.2% An. aconitus (n = 1), of An. dirus s.l., 100% were An. baimaii (n = 348), and of An. maculatus s.l., 93.62% were An. maculatus s.s. (n = 44) and 6.38% An. sawadwongporni (n = 3). No Anopheles were Plasmodium positive (n = 879). An average of 11.46 Anopheles were captured per collector per night. There were differences between species in hour of collection (Kruskal-Wallis = 80.89, P < 0.0001, n = 5,666), with more An. barbirostris s.l. and An. maculatus s.l. caught earlier compared to An. minimus s.l. (P = 0.0001, P < 0.0001, respectively) and An. dirus s.l. (P = 0.0082, P < 0.001, respectively). The proportion of parous An. minimus s.l. captured by hour increased throughout the night (Wald Chi-square = 17.31, P=0.000, odds ratio = 1.0535 [1.0279 – 1.0796] 95% CI (n = 3,400). Overall, An. minimus s.l. parity was 67.68% (2,375/3,509) with an intra cluster correlation of 0.0378. A power calculation determined that an An. minimus s.l. parity reduction treatment effect size = 34%, with four clusters per treatment arm, a minimum of 300 mosquitoes dissected per cluster at an α= 0.05 will provide 82% power to detect a significant difference following ivermectin MDA. Conclusions: The study area in Surat Thani province is an ideal location to evaluate the impact of ivermectin MDA on An. minimus parity.

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The Invisible Enemy that Stopped the World: The Impact of the COVID‑19 Pandemic on Psychiatric Hospitalizations in a Portuguese Department

Revista Portuguesa de Psiquiatria e Saúde Mental ◽

10.51338/rppsm.2021.v7.i2.207 ◽

2021 ◽

Vol 7 (2) ◽

pp. 50-56

Author(s):

Joana Freitas ◽

Mariana Marinho ◽

Liliana Castro ◽

Catarina Fonseca ◽

Marieta Osório

Keyword(s):

Mental Health ◽

Mental Health Problems ◽

Health Department ◽

International Classification Of Diseases ◽

World Health ◽

Chi Square ◽

Psychiatric Hospitalizations ◽

Significant Difference ◽

The World ◽

The Impact

Introduction: The World The World Health Organization declared the coronavirus outbreak a pandemic on March 11th 2020. Since then, the containment measures are leading to increasing mental health problems in the general population and worsening of some pre‑existing psychiatric conditions. To our knowledge, there are no studies characterizing the impact of the COVID‑19 pandemic on psychiatric hospitalizations across the world. We aim to compare the number and characteristics of the hospitalizations in the mental health department of a Portuguese psychiatric hospital from March 2nd 2019 to October 31st 2019 with those that occurred in the same period in 2020. Methods: We conducted a retrospective observational study including all patients admitted to hospital during these periods (n=805). Sociodemographic data, clinical characteristics and information about the context of hospitalization were collected. Statistical analysis was performed using t Student Test, Mann‑Whitney and Chi‑square. Results: In the pandemic period there was a marked reduction in the number of psychiatric hospitalizations. There was a statistically significant difference in the median length of stay and in the percentage of involuntary hospitalizations between the two periods. In 2019, the most frequent International Classification of Diseases (10th Revision) diagnostic categories were F30‑F39 (mood disorders) and in 2020 were F20‑F29 (schizophrenia, schizotypal and delusional disorders). Conclusion: The reorganization of services and the decrease in admissions through the emergency department may explain these results.

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Semi Field Evaluation of Freestanding Transfluthrin Passive Emanators and the BG Sentinel Trap as a “Push-Pull control Strategy” Against Aedes aegypti Mosquitoes

10.21203/rs.3.rs-26088/v1 ◽

2020 ◽

Author(s):

Mgeni Mohamed Tambwe ◽

Sarah Moore ◽

Hassan Chilumba ◽

Johnson Kyeba Swai ◽

Jason Moore ◽

...

Keyword(s):

Aedes Aegypti ◽

Field Experiments ◽

Protective Efficacy ◽

Malaria Vectors ◽

Human Landing Catch ◽

Regular User ◽

Pull System ◽

Significant Difference ◽

Human Landing ◽

Bg Sentinel

Abstract Background The use of volatile pyrethroids and odor-baited traps in a push-pull system has been shown to reduce house entry and outdoor bites for malaria vectors. This technology has the potential to control other outdoor biting mosquitoes such as Aedes aegypti that transmit arboviral diseases. In this study, semi-field experiments were conducted to evaluate whether a push-pull system could be used to reduce bites from Aedes.Methods The push and pull under investigation consisted of two freestanding transfluthrin passive emanators (FTPE), and a BG sentinel trap (BGS) respectively. The FTPE contained hessian strips treated with 5.25 g of transfluthrin active ingredient. The efficacies of FTPE and BGS alone and in combination were evaluated by human landing catch in a large semi-field system in Tanzania. We also investigated the protection of FTPE over six months. The data was analyzed using generalized linear mixed models with binomial distribution.Results Two FTPE have a protective efficacy (PE) of 61% (95% Confidence interval (CI): 52.18–69.91) against human landing rate of Aedes aegypti. The BGS did not significantly reduce mosquito landings; the PE was 2.14% (95% CI: -2.87-7.16). The combination of FTPE and BGS (push-pull) provided the PE of 64.46% (95% CI: 59.06–69.85). However, there was no significant difference in the protective efficacy between the push-pull and the two FTPE against Ae. aegypti (p = 0.286). The FTPE offered significant protection against Ae. aegypti at month three, with a PE of 46.44% (95% CI: 41.12–51.76), but not at six months with a PE of 2.20% (95% CI: -9.00-14.02).Conclusions The protective efficacy of the FTPE and the full push-pull system are similar, indicative that bite prevention is primarily due to the activity of the FTPE. While these results are encouraging for the FTPE, further work is needed for a push-pull system to be recommended for Ae. aegypti control. The three-month protection provided by the FTPE against Ae. aegypti bites suggests it would be a useful additional personal protection tool during dengue outbreaks, that does not require regular user compliance.

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Host-seeking behavior and hourly biting rhythm of vectors in malaria endemic district of Arba Minch area, Southwest Ethiopia

10.21203/rs.2.20364/v1 ◽

2020 ◽

Author(s):

Melkam Abiye Zeru ◽

Simon Shibru ◽

Fekadu Massebo

Keyword(s):

Malaria Vector ◽

Negative Binomial ◽

Malaria Vectors ◽

Malaria Vector Control ◽

Southwest Ethiopia ◽

Anopheles Mosquitoes ◽

Host Seeking ◽

Human Landing ◽

Seeking Behavior ◽

The Impact

Abstract Background The early and outdoor biting behaviors of malaria vectors are among the key challenges in malaria control. Hence, understanding the host-seeking behavior and the peak biting time of malaria vectors is important in malaria vector control programs. This study assessed the host-seeking behavior and hourly biting activity of malaria mosquitoes in Chano Mille village in Arba Minch district, southwest Ethiopia. Methods The first trial was done by keeping cattle together with human that collects the entered mosquitoes in tent, while the other was done by keeping cattle outside a 1 m distance from human collector inside a tent. In both trials, mosquito collation was done inside tents baited by cattle and human using human landing catches (HLC) techniques. Four human volunteers’ were recruited and trained to collect mosquitoes in the four tents from 18:00-24:00 for three months. Two tents were selected randomly for human alone and two for cattle baited collections in the first night and then rotated to minimize the variation due to location of tents and collectors skill. The tent trial was done close to the shore of the Lake Abaya to minimize the interference of other animals on mosquito movement. The peak biting hour of malaria vectors was assessed within a Chano village from 18:00-6:00. Mosquito collation was done both indoor and outdoor by HLC. Morphological speciation of Anopheles mosquitoes was done. The sporozoite infectivity status of Anopheles pharoensis was examined using enzyme-linked immuno-sorbent assay technique. The data was analyzed using a Generalized Estimating Equations with a negative binomial distribution. Results An. pharoensis, An. gambiae complex and An. tenebrosus were the three species documented during the trial. Keeping cattle together with human collector inside the tent attracted 42% ( P < 0.001) more An. pharoensis compared to human alone tent. Also, keeping cattle outside near to a tent with human at 1 m distance, attracted the entering An. pharoensis into the tent inside with human by 46% ( P = 0.002) than human in a tent with no cattle outside the same tent. The impact was not significant for An. gambiae complex and An. tenebrosus. Anopheles pharoensis and An. gambiae complex showed early night biting activity with peak biting from 19.00-20:00 which was significant for both An. gambiae complex ( P < 0.001) and An. pharoensis ( P = 0.015). Anopheles gambiae complex was mainly biting humans outdoor in the village. Conclusions Finally, keeping cattle within and close to human dwellings could increase malaria vectors bite exposure particularly to the zoophilic malaria vector An. pharoensis and, hence deployment of cattle far from human residence could be recommended to reduce the human exposure. The outdoor and early hours biting behavior of the An. gambiae complex could be a threat for success of current indoor based interventions and hence, tools could be designed to reduce this threat.

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New insights into malaria vector bionomics in Lao PDR: a nationwide entomology survey

10.21203/rs.3.rs-35716/v3 ◽

2020 ◽

Author(s):

Sebastien Marcombe ◽

Santi Maithaviphet ◽

Julie Bobichon ◽

Nothasin Phommavan ◽

Simone Nambanya ◽

...

Keyword(s):

Molecular Identification ◽

Sibling Species ◽

Rural Areas ◽

Lao Pdr ◽

Malaria Vectors ◽

Human Landing Catch ◽

Morphological Identification ◽

Anopheles Mosquitoes ◽

Malaria Burden ◽

Human Landing

Abstract Background . In Laos, the malaria burden remains high despite a significant reduction of cases during the last decade. In the context of the disease elimination by 2030, a nationwide entomological survey was conducted to better understand the distribution, abundance and behavior of major malaria vectors ( Anopheles spp.) in the country. Methods . Mosquito collections were implemented in ten villages from ten provinces during the rainy and dry seasons of 2014 and 2015 by using human landing catch (HLC) and cow bait collection (CBC) methods. After morphological identification in the field, molecular identification of the sibling species of Anopheles mosquitoes from the Funestus, Leucosphyrus, and Maculatus groups were determined using PCR specific alleles. A screening of Plasmodium falciparum and P. vivax infections in the vectors was carried out by quantitative PCR assays. Results. A total of 14,146 adult mosquitoes representing 25 different Anopheles species were collected and morphologically identified. Molecular identification revealed the presence of 12 sibling species within the main primary vector groups including An. maculatus s.s., An. rampae , An. sawadwongporni , An. pseudowillmori , An. dravidicus , An. minimus s.s., An. aconitus , An. pampanai , An. harrisoni , An. dirus s.s., An. baimaii , An. nemophilous . Anopheles maculatus and An. minimus were predominant during both the dry and rainy seasons, but showed highly zoophilic preferences (Zoophilic index of 98% and 95%, respectively). Overall, 22% of the total malaria vectors were collected between 10:00 PM and 5:00 AM indoors when people are sleeping. Twenty-seven percent of primary and secondary vectors were collected outdoors before 10:00 PM or after 5:00 AM, times when people are usually awake and outdoors. Only two specimens were positive for P. falciparum , one An. aconitus from Phongsaly and one An. minimus from Vientiane Province Conclusions. The results indicate that people living in rural areas in Laos are constantly exposed to malaria vectors throughout the year and specifically outdoors. The use of LLINs/IRS remains important but innovative tools and new strategies are needed to address locally, the early and outdoor malaria transmission. Lack of expertise in general entomological methods may further exacerbate the situation.

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Transfluthrin eave-positioned targeted insecticide (EPTI) reduces human landing rate (HLR) of pyrethroid resistant and susceptible malaria vectors in a semi-field simulated peridomestic space

Malaria Journal ◽

10.1186/s12936-021-03880-2 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Mgeni M. Tambwe ◽

Sarah Moore ◽

Lorenz Hofer ◽

Ummi A. Kibondo ◽

Adam Saddler

Keyword(s):

Mixed Models ◽

Pyrethroid Resistance ◽

Malaria Vectors ◽

Mosquito Vectors ◽

Technical Grade ◽

Field System ◽

Kisumu Strain ◽

Human Landing ◽

The Impact ◽

Different Levels

Abstract Background Volatile pyrethroids (VPs) are proven to reduce human–vector contact for mosquito vectors. With increasing resistance to pyrethroids in mosquitoes, the efficacy of VPs, such as transfluthrin, may be compromised. Therefore, experiments were conducted to determine if the efficacy of transfluthrin eave-positioned targeted insecticide (EPTI) depends on the resistance status of malaria vectors. Methods Ribbons treated with 5.25 g transfluthrin or untreated controls were used around the eaves of an experimental hut as EPTI inside a semi-field system. Mosquito strains with different levels of pyrethroid resistance were released simultaneously, recaptured by means of human landing catches (HLCs) and monitored for 24-h mortality. Technical-grade (TG) transfluthrin was used, followed by emulsifiable concentrate (EC) transfluthrin and additional mosquito strains. Generalized linear mixed models with binomial distribution were used to determine the impact of transfluthrin and mosquito strain on mosquito landing rates and 24-h mortality. Results EPTI treated with 5.25 g of either TG or EC transfluthrin significantly reduced HLR of all susceptible and resistant Anopheles mosquitoes (Odds Ratio (OR) ranging from 0.14 (95% Confidence Interval (CI) [0.11–0.17], P < 0.001) to 0.57, (CI [0.42–0.78] P < 0.001). Both TG and EC EPTI had less impact on landing for the resistant Anopheles arabiensis (Mbita strain) compared to the susceptible Anopheles gambiae (Ifakara strain) (OR 1.50 [95% CI 1.18–1.91] P < 0.001) and (OR 1.67 [95% CI 1.29–2.17] P < 0.001), respectively. The EC EPTI also had less impact on the resistant An. arabiensis (Kingani strain) (OR 2.29 [95% CI 1.78–2.94] P < 0.001) compared to the control however the TG EPTI was equally effective against the resistant Kingani strain and susceptible Ifakara strain (OR 1.03 [95% CI 0.82–1.32] P = 0.75). Finally the EC EPTI was equally effective against the susceptible An. gambiae (Kisumu strain) and the resistant An. gambiae (Kisumu-kdr strain) (OR 0.98 [95% CI 0.74–1.30] P = 0.90). Conclusions Transfluthrin-treated EPTI could be useful in areas with pyrethroid-resistant mosquitoes, but it remains unclear whether stronger resistance to pyrethroids will undermine the efficacy of transfluthrin. At this dosage, transfluthrin EPTI cannot be used to kill exposed mosquitoes.

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Impact of sugarcane irrigation on malaria vector Anopheles mosquito fauna, abundance and seasonality in Arjo-Didessa, Ethiopia

10.21203/rs.3.rs-37850/v3 ◽

2020 ◽

Author(s):

Assalif Demissew Shifera ◽

Dawit Hawaria ◽

Solomon Kibret ◽

Abebe Animut ◽

Arega Tsegaye ◽

...

Keyword(s):

Species Composition ◽

Malaria Vector ◽

Mosquito Species ◽

Malaria Vectors ◽

Anopheline Mosquito ◽

Chi Square ◽

Anopheles Species ◽

Mosquito Abundance ◽

Anopheles Mosquitoes ◽

The Impact

Abstract Background: Although irrigation activities are increasing in Ethiopia, limited studies evaluated their impact on malaria vector mosquito composition, abundance and seasonality. This study aimed at evaluating the impact of sugarcane irrigation on species composition, abundance and seasonality of malaria vectors. Methods : Adult Anopheles mosquitoes were collected using CDC light traps from three irrigated and three non-irrigated clusters in and around Arjo-Didessa sugarcane irrigation scheme in southwestern Ethiopia. Mosquito collections were conducted in four seasons: two wet and two dry, in 2018 and 2019. Mosquito species composition, abundance and seasonality were compared between irrigated and non-irrigated clusters. Anopheles mosquitoes were identified to species using morphological keys and An. gambiae s.l to sibling species using PCR. Chi-square was used to analyze the association between Anopheles species occurrence and environmental and seasonal parameters. Results: Overall, 2,108 female Anopheles mosquitoes comprising of six species were collected. Of these, 92.7% (n=1954) were from irrigated clusters and 7.3% (n=154) from the non-irrigated. An. gambiae s.l was the most abundant (67.3%) followed by An. coustani complex (25.3 %) and An. pharoensis (5.7%). PCR based identification revealed that 74.7% (n=168) of the An. gambiae s.l were An. arabiensis and 22.7% (n=51) An. amharicus . Density of An. gambiae s.l. (both indoor and outdoor) was higher in irrigated than non-irrigated clusters. The overall anopheline mosquito abundance during the wet seasons (87.2%; n=1837) was higher than the dry seasons (12.8%; n=271). Conclusion : The ongoing sugarcane irrigation activities in Arjo-Didessa created conditions suitable for increased malaria transmitting Anopheles species diversity and abundance. This in turn could drive malaria transmission in Arjo-Didessa and its environs in both dry and wet seasons. Thus, currently practiced malaria vector interventions need to be strengthened and consider larval source management to reduce vector abundance in the irrigated areas. Key Words: Malaria, Irrigation, Anopheles mosquitoes, vector density, An. amharicus , Ethiopia

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Impact of sugarcane irrigation on malaria vector Anopheles mosquito fauna, abundance and seasonality in Arjo-Didessa, Ethiopia

Malaria Journal ◽

10.1186/s12936-020-03416-0 ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Assalif Demissew ◽

Dawit Hawaria ◽

Solomon Kibret ◽

Abebe Animut ◽

Arega Tsegaye ◽

...

Keyword(s):

Species Composition ◽

Malaria Vector ◽

Mosquito Species ◽

Molecular Techniques ◽

Malaria Vectors ◽

Anopheline Mosquito ◽

Chi Square ◽

Mosquito Abundance ◽

Southwestern Ethiopia ◽

The Impact

Abstract Background Despite extensive irrigation development in Ethiopia, limited studies assessed the impact of irrigation on malaria vector mosquito composition, abundance and seasonality. This study aimed to evaluate the impact of sugarcane irrigation on species composition, abundance and seasonality of malaria vectors. Methods Adult Anopheles mosquitoes were collected using CDC light traps from three irrigated and three non-irrigated clusters in and around Arjo-Didessa sugarcane irrigation scheme in southwestern Ethiopia. Mosquitoes were surveyed in four seasons: two wet and two dry, in 2018 and 2019. Mosquito species composition, abundance and seasonality were compared between irrigated and non-irrigated clusters. Anopheles mosquitoes were sorted out to species using morphological keys and molecular techniques. Chi square was used to test the relationships between Anopheles species occurrence, and environmental and seasonal parameters. Results Overall, 2108 female Anopheles mosquitoes comprising of six species were collected. Of these, 92.7% (n = 1954) were from irrigated clusters and 7.3% (n = 154) from the non-irrigated. The Anopheles gambiae complex was the most abundant (67.3%) followed by Anopheles coustani complex (25.3%) and Anopheles pharoensis (5.7%). PCR-based identification revealed that 74.7% (n = 168) of the An. gambiae complex were Anopheles arabiensis and 22.7% (n = 51) Anopheles amharicus. The density of An. gambiae complex (both indoor and outdoor) was higher in irrigated than non-irrigated clusters. The overall anopheline mosquito abundance during the wet seasons (87.2%; n = 1837) was higher than the dry seasons (12.8%; n = 271). Conclusion The ongoing sugarcane irrigation activities in Arjo-Didessa created conditions suitable for malaria transmitting Anopheles species diversity and abundance. This could drive malaria transmission in Arjo-Didessa and its environs in both dry and wet seasons. Currently practiced malaria vector interventions need to be strengthened by including larval source management to reduce vector abundance in the irrigated areas.

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New insights into malaria vector bionomics in Lao PDR: a nationwide entomology survey

Malaria Journal ◽

10.1186/s12936-020-03453-9 ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Sébastien Marcombe ◽

Santi Maithaviphet ◽

Julie Bobichon ◽

Nothasin Phommavan ◽

Simone Nambanya ◽

...

Keyword(s):

Molecular Identification ◽

Sibling Species ◽

Rural Areas ◽

Lao Pdr ◽

Malaria Vectors ◽

Human Landing Catch ◽

Morphological Identification ◽

Anopheles Dirus ◽

Malaria Burden ◽

Human Landing

Abstract Background In Laos, the malaria burden remains high despite a significant reduction of cases during the last decade. In the context of the disease elimination by 2030, a nationwide entomological survey was conducted to better understand the distribution, abundance and behaviour of major malaria vectors (Anopheles spp.) in the country. Methods Mosquito collections were implemented in ten villages from ten provinces during the rainy and dry seasons of 2014 and 2015 by using human landing catch (HLC) and cow bait collection (CBC) methods. After morphological identification in the field, molecular identification of the sibling species of Anopheles mosquitoes from the Funestus, Leucosphyrus, and Maculatus groups were determined using PCR specific alleles. A screening of Plasmodium falciparum and Plasmodium vivax infections in the vectors was carried out by quantitative PCR assays. Results A total of 14,146 adult mosquitoes representing 25 different Anopheles species were collected and morphologically identified. Molecular identification revealed the presence of 12 sibling species within the main primary vector groups, including Anopheles maculatus, Anopheles rampae, Anopheles sawadwongporni, Anopheles pseudowillmori, Anopheles dravidicus, Anopheles minimus, Anopheles aconitus, Anopheles pampanai, Anopheles harrisoni, Anopheles dirus, Anopheles baimaii, Anopheles nemophilous. Anopheles maculatus and An. minimus were predominant during both the dry and rainy seasons, but showed highly zoophilic preferences (Zoophilic index of 98% and 95%, respectively). Overall, 22% of the total malaria vectors were collected between 10:00 PM and 5:00 AM indoors when people are sleeping. Twenty-seven percent of primary and secondary vectors were collected outdoors before 10:00 PM or after 5:00 AM, times when people are usually awake and outdoors. Only two specimens were positive for P. falciparum, one An. aconitus from Phongsaly and one An. minimus from Vientiane Province Conclusions The results indicate that people living in rural areas in Laos are constantly exposed to malaria vectors throughout the year and specifically outdoors. The use of LLINs/IRS remains important but innovative tools and new strategies are needed to address locally, the early and outdoor malaria transmission. Lack of expertise in general entomological methods may further exacerbate the situation.

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Impact of Delayed Admission to the Intensive Care Unit from the Emergency Department upon Sepsis Outcomes and Sepsis Protocol Compliance

Critical Care Research and Practice ◽

10.1155/2017/9616545 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Michael Agustin ◽

Lori Lyn Price ◽

Augustine Andoh-Duku ◽

Peter LaCamera

Keyword(s):

Emergency Department ◽

Hospital Mortality ◽

Statistical Significance ◽

Tertiary Care ◽

Included Study ◽

Chi Square ◽

Significant Difference ◽

Protocol Compliance ◽

Sepsis And Septic Shock ◽

The Impact

Rationale. The impact of emergency department length of stay (EDLOS) upon sepsis outcomes needs clarification. We sought to better understand the relationship between EDLOS and both outcomes and protocol compliance in sepsis. Methods. We performed a retrospective observational study of septic patients admitted to the ICU from the ED between January 2012 and December 2015 in a single tertiary care teaching hospital. 287 patients with severe sepsis and septic shock were included. Study population was divided into patients with EDLOS < 6 hrs (early admission) versus ≥6 hours (delayed admission). We assessed the impact of EDLOS on hospital mortality, compliance with sepsis protocol, and resuscitation. Statistical significance was determined by chi-square test. Results. Of the 287 septic ED patients, 137 (47%) were admitted to the ICU in <6 hours. There was no significant in-hospital mortality difference between early and delayed admissions (p=0.68). Both groups have similar compliance with the 3-hour protocol (p=0.77). There was no significant difference in achieving optimal resuscitation within 12 hours (p=0.35). Conclusion. We found that clinical outcomes were not significantly different between early and delayed ICU admissions. Additionally, EDLOS did not impact compliance with the sepsis protocol with the exception of repeat lactate draw.

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