Malaria transmission in two rural communities in the forest zone of Ghana.

Malaria transmission was assessed in two rural communities, Kona and Afamanaso in Sekyere South district, Ashanti Region, in the forest zone of Ghana to provide baseline data for ongoing clinical studies and the evaluation of the effect of interventions. Altogether, 3,479 Anopheles gambiae and 1,157 Anopheles funestus were caught by human landing catches. Sporozoite rates determined by either microscopy of salivary glands or enzyme-linked immunosorbent assay (ELISA) for Plasmodium falciparum in the two villages were 6.6% vs. 8.9% for the main vector A. gambiae and 3.2% vs. 6.3% for A. funestus. ELISA tests of dissected specimens compared to microscopy of salivary glands were 1.3 and 2.0 times more positive for A. gambiae and A. funestus, respectively. Plasmodium infections of 122 microscopically positive salivary glands of A. gambiae were identified by real-time PCR as 95 (77.9%) P. falciparum, 7 (5.7%) Plasmodium malariae, 7 (5.7%) Plasmodium ovale and 1 (0.8%) mixed infection of P. falciparum and P. malariae. Transmission in the area was found to be intense and perennial with some seasonal variations during the study period from Dec. 2003 to Aug. 2005. Although the two villages were only 10 km apart from each other, Annual Biting Rates (ABRs) and Annual Entomological Inoculation Rates (AEIRs) were much higher at Afamanaso (11,643 vs. 866) than at Kona (5,329 vs. 490). Most of the transmission (91.4%) occurred during bedtime hours from 21 to 6 h. It is important to note that there was still a substantial transmission before 21 h with AEIRs of 57.3 at Afamanso and 38.7 at Kona. The distribution of impregnated bednets alone, therefore, may not be sufficiently effective.

Onchocerciasis (river blindness) - more than a century of research and control.

This review summarises more than a century of research on onchocerciasis, also known as river blindness, and its control. River blindness is an infection caused by the tissue filaria Onchocerca volvulus affecting the skin, subcutaneous tissue and eyes and leading to blindness in a minority of infected persons. The parasite is transmitted by its intermediate hosts Simulium spp. which breed in rivers. Featured are history and milestones in onchocerciasis research and control, state-of-the-art data on the parasite, its endobacteria Wolbachia, on the vectors, previous and current prevalence of the infection, its diagnostics, the interaction between the parasite and its host, immune responses and the pathology of onchocerciasis. Detailed information is documented on the time course of control programmes in the afflicted countries in Africa and the Americas, a long road from previous programmes to current successes in control of the transmission of this infectious disease. By development, adjustment and optimization of the control measures, transmission by the vector has been interrupted in foci of countries in the Americas, in Uganda, in Sudan and elsewhere, followed by onchocerciasis eliminations. The current state and future perspectives for control, elimination and eradication within the next 20-30 years are described and discussed. This review contributes to a deeper comprehension of this disease by a tissue-dwelling filaria and it will be helpful in efforts to control and eliminate other filarial infections.

Protection of confined cattle against biting and nuisance flies (Muscidae: Diptera) with insecticide-treated nets in the Ghanaian forest zone at Kumasi.

Insecticide-treated nets for the protection of cattle against Muscinae and Stomoxyinae were evaluated using four identical pens in Kumasi, Ghana, 2005. Two pens served as controls: pen A as negative control and pen C as a positive control containing two zebus and no netting protection. Pens B and D had two zebus each: B was protected with an untreated net (1 m height) while D had the same but deltamethrin-treated net with a persistency attaining 9 months. Nuisance fly densities were weekly monitored using mono-conical traps outside each pen at distances of 20-30 m. No Glossinidae were detected in an otherwise suitable habitat and fewer than ten Tabanidae per catch were recorded. Insect attacks were counted twice per week with photos of selected body regions. Video footages of each animal allowed recordings of defensive movements during 30 s. For the first 3 weeks, mean outside catches were highest around B and C with, respectively, 9.0 and 8.0 insects per trap per day compared with catches outside A and D with 1.8 and 3.3 insects. Catches increased sharply around pens B and C with, respectively, 155.7 and 172.8 insects during week 4 and following, while outside pens A and D significantly fewer insects (11.8 and 7.3) were caught. Pictures of selected body regions showed significantly fewer attacking insects inside pen D, leading to significant nuisance reductions. Feed-uptake and resting was undisturbed, contrasting with relentless disturbance of animals in pens B and C. Protecting confined cattle with a treated net prevented attacks by nuisance insects and reduced their densities.

After 70 years of fighting an age-old scourge, onchocerciasis in Uganda, the end is in sight.

Onchocerciasis causes severe itching, serious skin disease and ocular damage leading to visual impairment or permanent blindness. It is associated with hanging groin, epilepsy, Nakalanga dwarfism and, most recently, nodding disease. This disease affected communities in 17 transmission foci in 37 districts of Uganda, where about 6.7 million people are once at risk. The efforts against onchocerciasis in Uganda commenced in the late 1940s, when vector control was launched using dichlorodiphenyltrichloroethane; by 1973, Simulium damnosum had been eliminated in the Victoria focus. Success outside of the Victoria focus was short-lived due to changes in government priorities and the political upheavals of the 1970s and 1980s. With the return of political stability, annual treatment with ivermectin through mass drug administration was launched in the early 1990s. Control of the disease has been successful, but there has been failure in interrupting transmission after more than 15 years. In 2007 Uganda launched a nationwide transmission elimination policy based on twice-per-year treatment and vector control/elimination, with a goal of eliminating river blindness nationwide by 2020. By 2017, 1 157 303 people from six foci had been freed from river blindness. This is the largest population ever declared free under World Health Organization elimination guidelines, providing evidence that elimination of river blindness in Africa is possible.

Evaluation of onchocerciasis control in the Upper Denkyira East municipal in the forest area of Ghana: Responses of participants and distributors to the CDTI programme.

The African Programme for Onchocerciasis Control (APOC), which focused on annual mass treatment with ivermectin, was launched in 1995 and was replaced by the Expanded Special Project for Neglected Tropical Diseases (ESPEN) by the end of 2015. In Ghana, the Community Directed Treatment with Ivermectin (CDTI) was introduced in 1999. After a decade, biannual reinforcement was introduced during which the Ghana Health Service (GHS) recorded coverage rates through routine data collection. Transmission studies conducted in the Upper Denkyira East Municipal (UDEM) of the forest zone of Ghana in 2002 and 2006 had shown that annual treatments with ivermectin had hardly any effect on the transmission of Onchocerca volvulus by the vector Simulium sanctipauli. In order to establish whether or not this was due to an insufficient compliance to the CDTI programme, an additional questionnaire survey was carried out in 2013 following those conducted in 2002 and 2006. The repeat transmission survey conducted in 2013 in the same area revealed that the vector S. sanctipauli had apparently disappeared from the rivers Ofin and Pra due to gold mining activities. In 2006 and 2013, we conducted surveys using structured questionnaires to address issues related to compliance and to compare results on the effectiveness of CDTI. A total of 692 individuals from 7 villages and 447 individuals from 9 villages were interviewed in 2006 and 2013 respectively. Questions asked included whether or not they had taken the ivermectin and reasons for not doing so when that was the case. Results were compared with the previous investigations conducted in 2002. Whereas official reported coverage rates ranged from 59 to 85% in 2006 and from 88 to 97% in 2013, compliance rates decreased from 36% in 2006 to 21% in 2013. Factors affecting compliance included fear of unpleasant side effects (pruritus and oedema), which decreased from 36% to 21% for the same period. Lack of awareness of CDTI sharply increased from 12% to 46% for the same period. Participants believed that treatments were no longer necessary due to the absence of vectors observed in 2013. There seems to be a considerable difference between coverage and compliance rates in the study communities. The difference can be attributed to the performance of the Community-Directed Distributors (CDDs) and the absence of the vector population observed in 2013. Discussions with CDDs suggested that factors that led to non-compliance were mostly side effects, unawareness of the disease by immigrants and lack of financial motivation for the CDDs. Also included was the fact that they needed to complete distribution of the drugs in the entire village, covering all households within just one week irrespective of the size of the catchment area. This, they thought was too much work for a short period of time. We propose to intensify the training of CDDs by the national Neglected Tropical Diseases Programme (NTDP) and to include the Community-based Health and Planning Services (CHPS) concept into onchocerciasis control efforts for awareness creation while the vector population and the transmission should be further monitored. The population should be made aware that the side effects they experienced from previous treatments or had heard about had reduced significantly. They also should be in the known that vector flies may return and so the risk of transmission remains.

Ecological characteristics of Simulium breeding sites in West Africa.

Twenty-nine taxa of Simulium were identified amongst 527 collections of larvae and pupae from untreated rivers and streams in Liberia (362 collections in 1967-71 & 1989), Togo (125 in 1979-81), Benin (35 in 1979-81) and Ghana (5 in 1980-81). Presence or absence of associations between different taxa were used to group them into six clusters using Ward agglomerative hierarchical cluster analysis. Environmental data associated with the pre-imaginal habitats were then analysed in relation to the six clusters by one way ANOVA. The results revealed significant effects in determining the clusters of maximum river width (all P<0.001 unless stated otherwise), water temperature, dry bulb air temperature, relative humidity, altitude, type of water (on a range from trickle to large river), water level, slope, current, vegetation, light conditions, discharge, length of breeding area, environs, terrain, river bed type (P<0.01), and the supports to which the insects were attached (P<0.01). When four non-significant contributors (wet bulb temperature, river features, height of waterfall and depth) were excluded and the reduced data-set analysed by principal components analysis (PCA), the first two principal components (PCs) accounted for 87% of the variance, with geographical features dominant in PC1 and hydrological characteristics in PC2. The analyses also revealed the ecological characteristics of each taxon's pre-imaginal habitats, which are discussed with particular reference to members of the Simulium damnosum species complex, whose breeding site distributions were further analysed by canonical correspondence analysis (CCA), a method also applied to the data on non-vector species.

Detection and characterization of a novel rhabdovirus in Aedes cantans mosquitoes and evidence for a mosquito-associated new genus in the family Rhabdoviridae.

Thanks to recent advances in random amplification technologies, metagenomic surveillance expanded the number of novel, often unclassified viruses within the family Rhabdoviridae. Using a vector-enabled metagenomic (VEM) tool, we identified a novel rhabdovirus in Aedes cantans mosquitoes collected from Germany provisionally named Ohlsdorf virus (OHSDV). The OHSDV genome encodes the canonical rhabdovirus structural proteins (N, P, M, G and L) with alternative ORF in the P gene. Sequence analysis indicated that OHSDV exhibits a similar genome organization and characteristics compared to other mosquito-associated rhabdoviruses (Riverside virus, Tongilchon virus and North Creek virus). Complete L protein based phylogeny revealed that all four viruses share a common ancestor and form a deeply rooted and divergent monophyletic group within the dimarhabdovirus supergroup and define a new genus, tentatively named Ohlsdorfvirus. Although the Ohlsdorfvirus clade is basal within the dimarhabdovirus supergroup phylogeny that includes genera of arthropod-borne rhabdoviruses, it remains unknown if viruses in the proposed new genus are vector-borne pathogens. The observed spatiotemporal distribution in mosquitoes suggests that members of the proposed genus Ohlsdorfvirus are geographically restricted/separated. These findings increase the current knowledge of the genetic diversity, classification and evolution of this virus family. Further studies are needed to determine the host range, transmission route and the evolutionary relationships of these mosquito-associated viruses with those infecting vertebrates.

Host-feeding patterns of mosquito species in Germany.

BACKGROUND: Mosquito-borne pathogens are of growing importance in many countries of Europe including Germany. At the same time, the transmission cycles of most mosquito-borne pathogens (e.g. viruses or filarial parasites) are not completely understood. There is especially a lack of knowledge about the vector capacity of the different mosquito species, which is strongly influenced by their host-feeding patterns. While this kind of information is important to identify the relevant vector species, e.g. to direct efficient control measures, studies about the host-feeding patterns of mosquito species in Germany are scarce and outdated. METHODS: Between 2012 and 2015, 775 blood-fed mosquito specimens were collected. Sampling was conducted with Heavy Duty Encephalitis Vector Survey traps, Biogents Sentinel traps, gravid traps, hand-held aspirators, sweep nets, and human-bait collection. The host species for each mosquito specimen was identified with polymerase chain reactions and subsequent Sanger sequencing of the cytochrome b gene. RESULTS: A total of 32 host species were identified for 23 mosquito species, covering 21 mammalian species (including humans) and eleven bird species. Three mosquito species accounted for nearly three quarters of all collected blood-fed mosquitoes: Aedes vexans (363 specimens, 46.8 % of all mosquito specimens), Culex pipiens pipiens form pipiens (100, 12.9 %) and Ochlerotatus cantans (99, 12.8 %). Non-human mammals dominated the host species (572 specimens, 73.8 % of all mosquito specimens), followed by humans (152, 19.6 %) and birds (51, 6.6 %). The most common host species were roe deer (Capreolus capreolus; 258 mosquito specimens, 33.3 % of all mosquito specimens, 65 % of all mosquito species), humans (Homo sapiens; 152, 19.6 %, 90 %), cattle (Bos taurus; 101, 13.0 %, 60 %), and wild boar (Sus scrofa; 116, 15.0 %, 50 %). There were no statistically significant differences in the spatial-temporal host-feeding patterns of the three most common mosquito species. CONCLUSIONS: Although the collected blood-fed mosquito species had a strong overlap of host species, two different host-feeding groups were identified with mosquito species feeding on (i) non-human mammals and humans or (ii) birds, non-human mammals, and humans, which make them potential vectors of pathogens only between mammals or between mammals and birds, respectively. Due to the combination of their host-feeding patterns and wide distribution in Germany, Cx. pipiens pipiens form pipiens and Cx. torrentium are potentially most important vectors for pathogens transmitted from birds to humans and the species Ae. vexans for pathogens transmitted from non-human mammals to humans. Finally, the presented study indicated a much broader host range compared to the classifications found in the literature for some of the species, which highlights the need for studies on the host-feeding patterns of mosquitoes to further assess their vector capacity and the disease ecology in Europe.

The Imaramagambo Onchocerciasis Focus in Southwestern Uganda: Interruption of Transmission After Disappearance of the Vector Simulium neavei and Its Associated Freshwater Crabs.

It was not until early 1990s that, when the Imaramagambo focus of southwest Uganda was mapped, mass treatment with a single annual dose of ivermectin for onchocerciaisis control commenced. However, comprehensive investigations on its transmission were launched after a nationwide policy for onchocerciasis elimination in 2007. Entomological surveys throughout the focus from 2007 to 2015 have yielded few or no freshwater crabs (Potamonautes aloysiisabaudiae), which serve as the obligate phoretic host of the larvae and pupae of the vector Simulium neavei No S. neavei flies have been observed or collected since 2007. Skin snips (microscopy) from 294 individuals in 2008 were negative for skin microfilariae, and of the 462 persons analyzed by polymerase chain reaction skin snip poolscreen in 2009, only five (1.08%) persons were indicated as infected with onchocerciasis. All five of the positive persons were at least 40 years old. Serosurvey results showed negative exposure among 3,332 children in 2012 and 3,108 children in 2015. Both were within the upper bound of the 95% confidence interval of the prevalence estimate of 0.06%, which confirmed the elimination of onchocerciasis. Treatment coverage in Imaramagambo was generally poor, and transmission interruption of onchocerciasis could not be attributed solely to annual mass treatment with ivermectin. There was sufficient evidence to believe that the possible disappearance of the S. neavei flies, presumed to have been the main vector, may have hastened the demise of onchocerciasis in this focus.

Palp ratio as a field identification tool for two members of the Anopheles gambiae complex in Ghana (A. melas and A. gambiae).

BACKGROUND: The Anopheles gambiae Giles complex is the most widely studied and the most important insect vector group. We explored the use of the palp ratio method as a field tool to identify A. melas and A. gambiae in Ghana. METHODS: Human landing catches were conducted to collect mosquitoes in the coastal area of Western Region of Ghana. Palps were removed and segments 3 and 4 + 5 measured using a compound microscope. DNA extraction and downstream PCR for species identification was carried out using the legs and wings. Known A. gambiae collected from the Ashanti Region of Ghana were used for comparison. RESULTS: A total of 2120 A. gambiae were collected. Lengths of segments 3 and 4 + 5 were significantly correlated in samples from both regions. Using a palp ratio of 0.81 as the cut-off value, 14.9% outliers (≥0.81) from our study area were confirmed by PCR as A. melas. PCR also confirmed outliers from the Ashanti Region with palp ratio < 0.81 (10.2%) as A. gambiae. CONCLUSION: The palp ratio method proved to be a useful tool to identify populations of salt and freshwater A. melas and A. gambiae.

Potential effects of warmer worms and vectors on onchocerciasis transmission in West Africa.

Development times of eggs, larvae and pupae of vectors of onchocerciasis (Simulium spp.) and of Onchocerca volvulus larvae within the adult females of the vectors decrease with increasing temperature. At and above 25°C, the parasite could reach its infective stage in less than 7 days when vectors could transmit after only two gonotrophic cycles. After incorporating exponential functions for vector development into a novel blackfly population model, it was predicted that fly numbers in Liberia and Ghana would peak at air temperatures of 29°C and 34°C, about 3°C and 7°C above current monthly averages, respectively; parous rates of forest flies (Liberia) would peak at 29°C and of savannah flies (Ghana) at 30°C. Small temperature increases (less than 2°C) might lead to changes in geographical distributions of different vector taxa. When the new model was linked to an existing framework for the population dynamics of onchocerciasis in humans and vectors, transmission rates and worm loads were projected to increase with temperature to at least 33°C. By contrast, analyses of field data on forest flies in Liberia and savannah flies in Ghana, in relation to regional climate change predictions, suggested, on the basis of simple regressions, that 13-41% decreases in fly numbers would be expected between the present and before 2040. Further research is needed to reconcile these conflicting conclusions.

Does irrigated urban agriculture influence the transmission of malaria in the city of Kumasi, Ghana?

To verify the possible impact of irrigated urban agriculture on malaria transmission in cities, we studied entomological parameters, self-reported malaria episodes, and household-level data in the city of Kumasi, Ghana. A comparison was made between city locations without irrigated agriculture, city locations with irrigated urban vegetable production, and peri-urban (PU) locations with rain-fed agriculture. In the rainy as well as dry seasons, larvae of Anopheles spp. were identified in the irrigation systems of the urban farms. Night catches revealed significantly higher adult anopheline densities in peri-urban and urban agricultural locations compared to non-agricultural urban locations. Polymerase chain reaction (PCR) analysis of Anopheles gambiae sensu lato revealed that all specimens processed were A. gambiae sensu stricto. The pattern observed in the night catches was consistent with household interviews because significantly more episodes of malaria and subsequent days lost due to illness were reported in peri-urban and urban agricultural locations than in non-agricultural urban locations. In Kumasi, urban agriculture is mainly practised in inland valleys, which might naturally produce more mosquitoes. Therefore more detailed studies, also in other cities with different water sources and irrigation systems, and a better spatial distribution of sites with and without urban agriculture than in Kumasi are needed.

The use of morphometric wing characters to discriminate female Culex pipiens and Culex torrentium.

The reliability of the length of wing radial vein r(2/3) as a character for the morphological discrimination of the two potential arbovirus vectors Culex pipiens s.s. and Cx. torrentium from Germany was reassessed, after this character had been neglected for more than 40 years. Additionally, multivariate morphometric analyses were applied to evaluate wing shape variation between both species. Although high-throughput molecular tools are now available to differentiate the two species, a simple, low-cost routine alternative may be useful in the absence of a molecular laboratory, such as under semi-field conditions. A thin-plate splines transformation confirmed that primarily the shrinkage of vein r(2/3) is responsible for the wing differences between the two species. In the bivariate analysis, the r(2/3)/r3 indices of Cx. pipiens s.s. and Cx. torrentium were 0.185 and 0.289, respectively, resulting in a correct classification of more than 91% of all tested specimens. Using the absolute length of vein r(2/3) alone still allowed for more than 90% accurate discrimination. Furthermore, classification accuracy of linear discriminant analysis exceeded 97%.

Field evaluation of four widely used mosquito traps in Central Europe.

BACKGROUND: To monitor adult mosquitoes several trapping devices are available. These are differently constructed and use various mechanisms for mosquito attraction, thus resulting in different trapping sensitivities and efficacies for the various species. Mosquito monitoring and surveillance programs in Europe use various types of mosquito traps, but only a few comparisons have been conducted so far. This study compared the performance of four commercial trapping devices, which are commonly used in Europe. METHODS: Four different traps, Biogents Sentinel trap (BG trap), Heavy Duty Encephalitis Vector Survey trap (EVS trap), Centres for Disease Control miniature light trap (CDC trap) and Mosquito Magnet Patriot Mosquito trap (MM trap) were compared in a 4 × 4 latin square study. In the years 2012 and 2013, more than seventy 24-hour trap comparisons were conducted at ten different locations in northern and southern Germany, representing urban, forest and floodplain biotopes. RESULTS: Per 24-hour trapping period, the BG trap caught the widest range of mosquito species, the highest number of individuals of the genus Culex as well as the highest number of individuals of the species Ochlerotatus cantans, Aedes cinereus/geminus, Oc. communis and Culex pipiens/torrentium. The CDC trap revealed best performance for Aedes vexans, whereas the MM trap was most efficient for mosquitoes of the genus Anopheles and the species Oc. geniculatus. The EVS trap did not catch more individuals of any genus or species compared to the other three trapping devices. The BG trap caught the highest number of individuals per trapping period in urban environments as well as in wet forest, while the CDC trap caught the highest number of individuals in the floodplain biotopes. Additionally, the BG trap was most efficient for the number of mosquito species in urban locations. CONCLUSION: The BG trap showed a significantly better or similar performance compared to the CDC, EVS or MM trap with regard to trapping efficacy for most common mosquito species in Germany, including diversity of mosquito species and number of mosquitoes per trapping period. Thus, the BG trap is probably the best solution for general monitoring or surveillance programs of adult mosquitoes in Central Europe.

Indices of onchocerciasis transmission by different members of the Simulium damnosum complex conflict with the paradigm of forest and savanna parasite strains.

Onchocerciasis in savanna zones is generally more severe than in the forest and pathologies also differ geographically, differences often ascribed to the existence of two or more strains and incompatibilities between vectors and strains. However, flies in the forest transmit more infective larvae than their savanna counterparts, even in sympatry, contradicting expectations based on the forest and savanna strains paradigm. We analysed data on the numbers of Onchocerca volvulus larvae of different stages found in 10 different taxonomic categories of the Simulium damnosum complex derived from more than 48,800 dissections of flies from Sierra Leone in the west of Africa to Uganda in the east. The samples were collected before widespread ivermectin distribution and thus provide a baseline for evaluating control measures. Savanna species contained fewer larvae per infected or per infective fly than the forest species, even when biting and parous rates were accounted for. The highest transmission indices were found in the forest-dwelling Pra form of Simulium sanctipauli (616 L3/1000 parous flies) and the lowest in the savanna-inhabiting species S. damnosum/S. sirbanum (135) and S. kilibanum (65). Frequency distributions of numbers of L1-2 and L3 larvae found in parous S. damnosum/S. sirbanum, S. kilibanum, S. squamosum, S. yahense, S. sanctipauli, S. leonense and S. soubrense all conformed to the negative binomial distribution, with the mainly savanna-dwelling species (S. damnosum/S. sirbanum) having less overdispersed distributions than the mainly forest-dwelling species. These infection patterns were maintained even when forest and savanna forms were sympatric and biting the same human population. Furthermore, for the first time, levels of blindness were positively correlated with infection intensities of the forest vector S. yahense, consistent with relations previously reported for savanna zones. Another novel result was that conversion rates of L1-2 larvae to L3s were equivalent for both forest and savanna vectors. We suggest that either a multiplicity of factors are contributing to the observed disease patterns or that many parasite strains exist within a continuum.

Malaria transmission intensity and dynamics of clinical malaria incidence in a mountainous forest region of Ghana.

Background: Malaria transmission is heterogeneous. Villages close to each other may have very different transmission characteristics. The presence and abundance of malaria vectors is governed by local ecology and microclimate. Knowledge of the dynamics of transmission is important for planning and evaluation of malaria control strategies. This study investigated the heterogeneity of malaria transmission in preparation for a vaccine trial and offers insights into dynamics of malaria incidence in the forest zone of Ghana. Methods: Malaria transmission was assessed in four villages with different micro-ecological features in the forest zone of the Akwapim-Mampong Range in Ghana, water shed with rivers flowing north to Lake Volta in the south. Human landing catches (HLC) of mosquitoes were conducted and Plasmodium falciparum circumsporozoite rates were assessed by ELISA. Sporozoite prevalence, annual biting rates (ABR) and entomological inoculation rates (EIR) from the four study sites were compared with climatological and ecological data. Regression analysis was used to compare transmission data and blood parasite prevalence, parasite density (PD) and malaria episodes from children in the study area. Additionally we examined trends in confirmed clinical malaria incidence from 2005 -2012. Results: In total 1307 Anopheles gambiae s.l. and 54 An. funestus females were caught by HLC from November 2003 to August 2005. Sporozoites in Anopheles vectors in four villages ranged from 4.0 to 10.2%, ABR from 371 to 1890 and EIR from 40 to 158. Linear regression on parasitological and clinical data of children from the villages revealed that the ABR significantly influenced the parasite density (PD) of P. falciparum. Conclusion: Malaria transmission was intense and heterogeneous and corresponded to the micro-ecological differences. Malaria transmission in the early evening hours before people went to sleep was enough to sustain stable malaria. Scaling up preventive measures to reduce exposure to vectors will be effective in reducing parasitemia in children. Variations in transmission intensity must be considered when evaluating impact of control strategies and interventions such as the vaccine trials.

The effect of deltamethrin-treated net fencing around cattle enclosures on outdoor-biting mosquitoes in Kumasi, Ghana.

Classic vector control strategies target mosquitoes indoors as the main transmitters of malaria are indoor-biting and -resting mosquitoes. However, the intensive use of insecticide-treated bed-nets (ITNs) and indoor residual spraying have put selective pressure on mosquitoes to adapt in order to obtain human blood meals. Thus, early-evening and outdoor vector activity is becoming an increasing concern. This study assessed the effect of a deltamethrin-treated net (100 mg/m(2)) attached to a one-meter high fence around outdoor cattle enclosures on the number of mosquitoes landing on humans. Mosquitoes were collected from four cattle enclosures: Pen A - with cattle and no net; B - with cattle and protected by an untreated net; C - with cattle and protected by a deltamethrin-treated net; D - no cattle and no net. A total of 3217 culicines and 1017 anophelines were collected, of which 388 were Anopheles gambiae and 629 An. ziemanni. In the absence of cattle nearly 3 times more An. gambiae (p<0.0001) landed on humans. The deltamethrin-treated net significantly reduced (nearly three-fold, p<0.0001) culicine landings inside enclosures. The sporozoite rate of the zoophilic An. ziemanni, known to be a secondary malaria vector, was as high as that of the most competent vector An. gambiae; raising the potential of zoophilic species as secondary malaria vectors. After deployment of the ITNs a deltamethrin persistence of 9 months was observed despite exposure to African weather conditions. The outdoor use of ITNs resulted in a significant reduction of host-seeking culicines inside enclosures. Further studies investigating the effectiveness and spatial repellence of ITNs around other outdoor sites, such as bars and cooking areas, as well as their direct effect on vector-borne disease transmission are needed to evaluate its potential as an appropriate outdoor vector control tool for rural Africa.

The impact of ivermectin treatment alone and when in parallel with Simulium neavei elimination on onchocerciasis in Uganda.

The study was conducted in August 2002 in Kigoyera parish in Kyenjojo district, where ivermectin treatment had been the strategy to control onchocerciasis since 1991 and was later supplemented with Simulium neavei control in 1995 and subsequent elimination; and in July 2003 in Kicece parish in Kamwenge district, where ivermectin treatment alone had been the strategy used to control onchocerciasis since 1991. Our objective was to examine and compare the impact of ivermectin treatment alone and when in parallel with S. neavei elimination on nodule and microfilariae carrier rates and on onchocercal dermatitis to provide baseline data that could be used to monitor the trends of microfilariae carrier rates for decision-making on when to discontinue ivermectin treatment. The combined interventions had significantly reduced onchocercal dermatitis from 34% pre-control to 2.9% (P < 0.001), microfilariae carrier rate from 88 to 7.5% (P < 0.001) and nodule prevalence from 49 to 19.2% (P < 0.001). Ivermectin treatment alone had also reduced onchocercal dermatitis prevalence from 34.2% pre-control to 9.5% (P < 0.001), the microfilariae carrier rate from 78 to 27.8% (P < 0.001) and nodule prevalence from 49.1 to 14.2% (P < 0.001). None of the children under 10 years were nodule or microfilariae carriers in both study areas. Histological examination of eight nodules extirpated from patients in Kigoyera identified five male and 12 female adult worms that were all old and alive. Five live and one dead female worms and one live male worm were identified from nodules extirpated from patients in Kicece. There was no female worm with embryogenesis from the nodules obtained from Kigoyera while two female worms from five nodules obtained from Kicece still showed a few embryos. Two female worms in each of the study area had sperms in uteri indicating that male worms were still active. Ivermectin treatment in parallel with vector elimination had a greater impact on onchocercal dermatitis and microfilariae carrier rates than ivermectin treatment alone. It would be worthwhile considering supplementation of ivermectin treatment with vector elimination in all isolated foci with S. neavei transmission to hasten the elimination of onchocerciasis as a public health and socio-economic problem in those foci.