A systematic review investigating patient knowledge and awareness on the association between oral health and their systemic condition.

BACKGROUND: The prevalence of the oral-systemic relationship has accounted for potentially preventable chronic conditions and morbidity worldwide. Health literacy is a large contributing factor. This systematic review investigates the knowledge and awareness of patients with major systemic conditions, regarding the oral associations to their condition. METHODS: Electronic databases including Medline (Ovid), CINAHL, The Cochrane Library, Web of Science, Informit Health Databases and Scopus were searched. All articles from 2011 to 2020, investigating knowledge of the oral-systemic link, of adult patients with the following major system conditions were searched: diabetes mellitus (DM), respiratory disease, cardiovascular disease (CVD), pregnancy and bone disease. Two independent reviewers completed screening, data extraction and quality assessment. A synthesis without meta-analysis was conducted. Twenty-four studies, from 14 different countries, were included in the systematic review. RESULTS: Analysis showed that globally, patients with major systemic conditions have poor knowledge and awareness (< 50%) of the oral health associations to their condition. Improvements in health education are particularly necessary for patients with heart disease, bone disease and diabetes. Dentists and the media were the most common source of information. There were no relevant studies investigating the knowledge of patients with respiratory disease. CONCLUSION: To improve the global burden of preventable chronic conditions, it is essential to address inequalities in the dissemination of health education to at-risk populations. Improvements in patient education rely on an increase in patient-practitioner communication on the oral-systemic link, implementation of oral health educational programs and greater interdisciplinary collaboration.

Droplet Distribution in a University Dental Clinic Setting: The Importance of High-Volume Evacuation.

The purpose of this study is to compare droplet distribution during a piezoelectric ultrasonic debridement procedure using either high-volume or slow-volume evacuation. Droplet distribution during a crown preparation with slow-volume evacuation is also examined. Fluorescein dye is added to the water reservoir and the procedures are performed by a single operator for 15 min on a dental manikin with artificial upper and lower teeth. Placement of filter paper squares (10 cm × 10 cm) in radiating lines away from the oral cavity of the dental manikin allows for visualization of droplet dispersion. Results show minimal difference in the spread of the droplets between the two evacuators during the debridement procedure; however, the slow-volume evacuator produces a higher concentration of droplets than the high-volume evacuator. An even higher concentration of droplets in the vicinity of the dental chair is observed during the crown preparation procedure. This study recommends the use of a high-volume evacuator where possible during professional debridement and crown preparation to reduce contamination around the dental chair from potentially pathogenic microorganisms.

The development of predictive tools for pre-emptive dengue vector control: a study of Aedes aegypti abundance and meteorological variables in North Queensland, Australia.

SUMMARY OBJECTIVES: To describe the meteorological influences on adult dengue vector abundance in Australia for the development of predictive models to trigger pre-emptive control operation. METHODS: Multiple linear regression analyses were performed using meteorological data and female Aedes aegypti collection data from BG-Sentinel Mosquito traps placed at 11 monitoring sites in Cairns, north Queensland. RESULTS: Considerable regression coefficients (R(2) = 0.64 and 0.61) for longer- and shorter-term factor models respectively were derived. Longer-term factors significantly associated with abundance of adult vectors were mean minimum temperature (lagged 6 month) and mean daily temperature (lagged 4 month), explaining the predictable increase in abundance during the wet season. Factors explaining fluctuation in abundance in the shorter term were mean relative humidity over the previous 2 weeks and current daily average temperature. Rainfall variables were not found to be strong predictors of A. aegypti abundance in either longer- or shorter-term models. CONCLUSIONS: The implications of these findings for the development of useful predictive models for vector abundance risks are discussed. Such models can be used to guide the application of pre-emptive dengue vector control, and thereby enhance disease management.

Rapid estimation of Aedes aegypti population size using simulation modeling, with a novel approach to calibration and field validation.

New approaches for control of the dengue vector Aedes aegypti (L.) are being developed, including the potential introduction of life-shortening symbiont bacteria into field populations and the release of transgenic strains with reduced vector competency. With these new approaches comes the need for rapid estimations of existing field population size. Here, we describe the use of simulation modeling with container-inhabiting mosquito simulation (CIMSiM) for estimation of Ae. aegypti pupal crop size in north Queensland, Australia. CIMSiM was calibrated for local conditions by deploying "sentinel key containers" (tire, 2-liter plastic bucket, 0.6-liter pot plant base, and tarpaulin indentation) in which water flux and pupal productivity were studied for 72 d. Iterative adjustment of CIMSiM parameters was used to fit model outputs to match that of sentinel key containers. This calibrated model was then used in a blind field validation, in which breeding container and local meteorological data were used to populate CIMSiM, and model outputs were compared with a field pupal survey. Actual pupae per ha during two 10-d periods in 2007 fell within 95% confidence intervals of simulated pupal crop estimates made by 10 replicate simulations in CIMSiM, thus providing a successful field validation. Although the stochasticity of the field environment can never be wholly simulated, CIMSiM can provide field-validated estimates of pupal crop in a timely manner by using simple container surveys.

A biodegradable lethal ovitrap for control of container-breeding Aedes.

Lethal ovitraps (LO) have been successfully deployed in dengue control operations in north Queensland, Australia since 2004. However, the current plastic-bucket LO must be retrieved before the pesticide-treated strip degrades and the trap begins producing mosquitoes. The logistics involved with trap retrieval are considerable and include recording trap location and retrieval date onto a database, locating and retrieving each trap, and examining lethal ovitraps for eggs. Collectively, these necessary activities greatly reduce the efficiency of dengue control. In response, we have developed a biodegradable lethal ovitrap (BLO) that does not need to be retrieved for the control of container-breeding Aedes, particularly Aedes aegypti. The BLOs were made by injection molding with the use of 2 proprietary blends of thermoplastic starch (TPS) polymer based on plasticised amylose maize polymers. In field trials, Ae. aegypti readily oviposited in BLOs, with those dyed black with the use of carbon black preferred. Water loss was higher in BLOs than in standard plastic LO because of weeping from the walls, although none of the BLOs failed in the 5 wk of the trial. The occurrence and rate of Ae. aegypti oviposition in both BLOs and the LO was comparable. In an accelerated standard composting trial (ISO16929:2002E), both BLOs fragmented within 4 wk, and no BLO particles were visible after 12 wk. Large numbers of BLOs could be deployed in a "set it and forget it" strategy to control Ae. aegypti and to stop dengue transmission, and could be used in a community participation program to maximize coverage.

Impact of a bifenthrin-treated lethal ovitrap on Aedes aegypti oviposition and mortality in north Queensland, Australia.

Lethal ovitraps (LOs) containing an insecticide-treated ovistrip are used as a lure-and-kill device for the container-breeding dengue vector, Aedes aegypti (L.). We aimed to affirm that the pyrethroid bifenthrin could be used effectively in LOs against Ae. aegypti in north Queensland, Australia, by quantifying oviposition in and mortality caused by LOs. Small cage experiments in which individual gravid Ae. aegypti were given a choice of LOs and untreated ovitraps revealed that although LOs were less acceptable for oviposition, they provided an average 64.6% adjusted mortality. Although 92% of mosquitoes ovipositing in LOs died, 61.8% of mosquitoes that visited but did not oviposit in an LO also died, demonstrating that lethal contact occurred without egg laying. The bifenthrin content of strips (approximately 0.1 mg/cm2; 7 mg/strip) did not decrease significantly after 4 wk of field exposure nor did the toxic effect of the LOs. Large cage trials with groups of 10 Ae. aegypti confirmed that bifenthrin-treated LOs provided consistent control (average adjusted mortality 79.7%). Four-week field trials in north Queensland showed that although LOs were acceptable to ovipositing Ae. aegypti (mean time to first egg 10.9 d; mean eggs 47.3), insecticide-free ovitraps were oviposited in more readily (6.8 d, 199 eggs). The number of eggs laid per mosquito in laboratory LOs allowed calculation of the number of Ae. aegypti killed in field-deployed LOs; rapid estimates can be made by simply dividing the number of eggs on the strip by 2.84. Overall, the studies demonstrated that bifenthrin-treated LOs have potential for use as a lure-and-kill device against Ae. aegypti and that they should be effective in the field for at least 4 wk. Given that untreated ovitraps were more acceptable for Ae. aegypti oviposition, the removal of alternative oviposition sites before deployment of LOs in the field should maximize their effectiveness.

Aedes aegypti population sampling using BG-Sentinel traps in north Queensland Australia: statistical considerations for trap deployment and sampling strategy.

BG-Sentinel mosquito traps were trialed as a tool for the rapid assessment (24-h collections) and routine monitoring (72-h collections) of adult Aedes aegypti L. populations in north Queensland. Analysis of Ae. aegypti collections using BG-Sentinels set in suburban Cairns for 24 h permitted the calculation of sample size for a range of precision levels. Clusters of houses with BG-Sentinels operating continuously for 15 d, with collections every 72 h, also permitted required sample size calculation. Evidence of Ae. aegypti spatial clustering at the house scale was revealed, with statistically significant effects detected for all collection days. Less variation was detected at each trap location, with only nine of 32 trap locations revealing significant clustering over time. Trap-out effects through continuous BG-Sentinel operation at a fixed location were absent. The findings support fixed position sampling at 72-h intervals for routine monitoring ofAe. aegypti populations in Cairns. Despite the relationship between collections of adult vectors and the incidence of disease remaining unknown, BG-Sentinel collections provide an alternative and less labor-intensive abundance measure for assessing risk of dengue virus transmission and success of dengue vector control programs.

Optimizing ovitrap use for Aedes aegypti in Cairns, Queensland, Australia: effects of some abiotic factors on field efficacy.

Insecticide-treated lethal ovitraps are used for control of the dengue vector Aedes aegypti in north Queensland, Australia. In an effort to optimize their use, the influence of deployment height, premise shading, and protection from wind on trap efficacy was assessed in field experiments. Sticky ovitraps were used as a proxy for lethal ovitraps because they provide a direct measure of adult visitation rates. Sticky ovitraps deployed at ground level for 1 wk captured significantly more female Ae. aegypti (mean +/- SE, 1.7 +/- 0.4) than those set at 1.75-m elevation (1.0 +/- 0.3). Setting traps on the leeward side of houses significantly improved collections during a dry season experiment but not in the wet season. Traps set at lightly or heavily shaded premises performed equally well. To determine the optimum number of ovitraps to set per premise, five treatments making up different numbers of traps (1, 2, 4, 6, or 8) were trialled in a Latin square experimental design. Female Ae. aegypti collections increased as more traps were deployed, although mean collections by using 4 (2.6 +/- 0.6), 6 (2.4 +/- 0.5), or 8 traps (4.8 +/- 1.3) could not be separated statistically, suggesting that 4 traps was the optimum number for routine deployment.

Field efficacy of the BG-Sentinel compared with CDC Backpack Aspirators and CO2-baited EVS traps for collection of adult Aedes aegypti in Cairns, Queensland, Australia.

In this study, we compared the efficacy of the newly available BG-Sentinel with an established "gold standard,", the CDC Backpack Aspirator, and a CO2-baited EVS trap for the collection of Aedes aegypti (L.) in Cairns, Australia. BG-Sentinels collected significantly more (P = 0.017) female Ae. aegypti (mean per collection, 1.92 +/- 0.39) than both the CDC Backpack Aspirator (1.00 +/- 0.35) and the EVS trap (0.71 +/- 0.27). Male-only and combined male-female Ae. aegypti collections for th BG-Sentinel and the CDC Backpack Aspirator were also greater than EVS trap collections. The CDC Backpack Aspirator and the BG-Sentinel captured proportionally fewer females compared with the EVS trap. The BG-Sentinel was the most Ae. aegypti specific collection method. The CDC Backpack Aspirator collected proportionally more bloodfed Ae. aegypti than the other methods, which collected a greater proportion of nullipars. The data presented here will aid researchers in deciding what Ae. aegypti sampling device best suits their needs. BG-Sentinels and CDC Backpack Aspirators should be considered as alternatives to human-bait collections for Ae. aegypti sampling.

Lethal ovitrap deployment for Aedes aegypti control: potential implications for non-target organisms.

In Australia, dengue control combines source reduction with lethal ovitraps to reduce Aedes aegypti populations during outbreaks. Lethal ovitraps are considered a sustainable and environmentally friendly method of controlling container-inhabiting mosquitoes, however, to-date, this claim has not been quantified. This study assesses the potential impact of lethal ovitraps on non-target organisms when used to control Ae. aegypti in tropical Australia. For retention of specimens, we substituted standard sticky ovitraps for lethal ovitraps. We collected 988 Ae. aegypti and 44,132 non-target specimens over 13 months from 16 sites. Although Ae. aegypti comprised only 2.2% of the total collection, they were were the eighth most dominant taxa collected, on the 93(rd) percentile. Of the non-target organisms, Collembola were the dominant taxa, 44.2%, with 36.8% and 10.5% Diptera and Hymenoptera, respectively. Of the Dipterans, 61% were family Phoridae. Lethal ovitraps were visited by 90 insect or invertebrate families in total. Ovitraps are attractive to Collembola, Phoridae, Sciaridae, Formicidae, and Culicidae, with minimal attraction by Apidae and other commonly monitored non-target organisms. For container-inhabiting mosquitoes, LOs are cost effective operationally, requiring minimal staff resources for placement and retrieval.

Entomological investigations in a focus of dengue transmission in Cairns, Queensland, Australia, by using the sticky ovitraps.

Sticky ovitraps (patent pending) were used to sample female Aedes aegypti (L.) weekly in a focus of dengue activity in Cairns, Queensland, Australia. In February 2003, transmission of dengue virus serotype 2 began in the suburb of Parramatta Park, peaking in mid-March 2003. This suburb features many older, unscreened houses with high populations of Ae. aegypti. Highest densities (2-3.5 females per trap per week) were obtained during peak dengue transmission (January and February) before mosquito control was initiated. Beginning in late March, female Ae. aegypti collected in sticky ovitraps were tested for dengue viral RNA by using a TaqMan reverse transcription-polymerase chain reaction assay. Dengue viral RNA was detected in six pools of Ae. aegypti collected in late March. The highest minimum infection rate was 116/1000 mosquitoes. After the initiation of larval control (containers treated with S-methoprene or lambda-cyhalothrin) and adult control (interior harborage sites sprayed with lambda-cyhalothrin) in early March, trap collections dropped to <0.5 per trap per week, and no virus was detected in trapped mosquitoes. Human cases subsequently dropped from a high of seven cases per day in mid-March to only sporadic cases in late April, with the final reported onset of 7 May. Sticky ovitraps have potential as a monitoring device for gravid Ae. aegypti and can be used to assess control efficacy and dengue virus activity. A sticky ovitrap index (mean number of female Ae. Aegypti per trap per week) could be useful in gauging the risk of dengue transmission.

Does S-methoprene affect oviposition by Aedes aegypti in an ovitrap?

We conducted a field study to test if the addition of a pellet of S-methoprene (Altosid pellets) to an ovitrap would affect oviposition by Aedes aegypti or Ochlerotatus notoscriptus. In 2 trials conducted near Cairns, Queensland, Australia, no significant difference (P > 0.05) was found in the number of eggs of Ae. aegypti or Oc. notoscriptus laid in ovitraps with or without a methoprene pellet. These results suggest the addition of an S-methoprene pellet to ovitraps or sentinel tires could be employed to eliminate the risk of mosquito production by ovitrap surveys.

Efficacy of methyl bromide fumigation and insecticidal dips against Aedes eggs on lucky bamboo.

Importation of lucky bamboo (Dracaena sp.) stalk clusters has led to the accidental importation of Aedes albopictus in some countries. Current methods of fumigation using methyl bromide are harmful to live plants and thus are not acceptable. We exposed Aedes aegypti eggs to methyl bromide at rates of 32 g/m3 for 2 and 3 h and 48 g/m3 for 3 h, achieving complete control in 0/5, 1/5, and 5/5 replicates, respectively. Submersion for 1 min in aqueous solutions of 0.04% active ingredient (AI) lambda-cyhalothrin, 0.04% AI bifenthrin and carbaryl + malathion (both 0.1% AI) + petroleum oil (1% AI) provided 100% control of Ae. aegypti eggs laid on Dracaena stalk clusters. These methods, apparently harmless to plants, would have application in preventing the importation of exotic Aedes eggs on lucky bamboo shipments.

An adulticidal sticky ovitrap for sampling container-breeding mosquitoes.

The efficacy of a standard ovitrap and an ovitrap featuring an internal wall covered by a polybutylene adhesive was compared in field studies in Cairns, Australia. The sticky ovitrap was as effective as the standard ovitrap in detecting Aedes aegypti, with 67.5% and 64% of traps positive for Ae. aegypti, respectively. Significantly higher numbers of Ae. aegypti were collected by traps set outside rather than inside premises. Sticky ovitraps also readily collected Ochlerotatus notoscriptus and, especially, Culex quinquefasciatus. With a 10X hand lens, mosquitoes of these species could readily be identified in traps set for 3 and 7 days. The sticky ovitraps were comparable in cost and as time efficient as standard ovitraps. The greatest advantage of the sticky ovitrap is the collection of adult female mosquitoes, negating the need to rear larvae for identification and providing a faster, more direct measure of the effectiveness of ovipositional attractants than egg counts. Finally, we demonstrated that sticky ovitraps, being adulticidal, have potential as a supplementary control measure, especially for quarantine programs designed to prevent the import and export of container-breeding vector mosquitoes at sea- and airports.

Subsoil drain sumps are a key container for Aedes aegypti in Cairns, Australia.

The contribution of subterranean drain sumps to pupal and adult populations of Aedes aegypti is reported for the 1st time in Cairns, Australia. Pupal surveys were used to quantify the relative contribution of drain sumps to the total population of Ae. aegypti by concurrent survey of sump and water-bearing containers in yards of inner-city premises. A total of 854 mosquito pupae were collected, predominantly Ae. aegypti and Culex quinquefasciatus (26.3 and 69.8%, respectively). Drain sumps provided a relatively uncommon (n = 4) but productive source for pupal Ae. aegypti, producing 14.7% of the combined yard and drain sump population. Drain sumps in inner-city Cairns most commonly occurred in parking lots (52.6%). Subsequently, a sticky emergent adult trap (SEAT) was developed to provide a pragmatic method to assess production of Ae. aegypti by drain sumps. A total of 866 adult mosquitoes were trapped from 162 drain sumps over a 48-h exposure period, comprising Ae. aegypti and Cx. quinquefasciatus (21 and 79%, respectively). Advantages of the SEAT are an ability to rapidly count, identify, and sex mosquitoes and to provide specimens for molecular analysis where necessary. The treatment of water-bearing drain sumps is a critical element of control campaigns against Ae. aegypti.