Wolbachia and Asaia Distribution among Different Mosquito Vectors Is Affected by Tissue Localization and Host Species.

Microbial communities play an important role in the fitness of mosquito hosts. However, the factors shaping microbial communities in wild populations, with regard to interactions among microbial species, are still largely unknown. Previous research has demonstrated that two of the most studied mosquito symbionts, the bacteria Wolbachia and Asaia, seem to compete or not compete, depending on the genetic background of the reference mosquito host. The large diversity of Wolbachia-Asaia strain combinations that infect natural populations of mosquitoes may offer a relevant opportunity to select suitable phenotypes for the suppression of pathogen transmission and for the manipulation of host reproduction. We surveyed Wolbachia and Asaia in 44 mosquito populations belonging to 11 different species of the genera Anopheles, Aedes, and Culex using qualitative PCR. Through quantitative PCR, the amounts of both bacteria were assessed in different mosquito organs, and through metagenomics, we determined the microbiota compositions in some selected mosquito populations. We show that variation in microbial community structure is likely associated with the species/strain of mosquito, its geographical position, and tissue localization. Together, our results shed light on the interactions among different bacterial species in the microbial communities of mosquito vectors, and this can aid the development and/or improvement of methods for symbiotic control of insect vectors.

Diverse novel Wolbachia bacteria strains and genera-specific co-infections with Asaia bacteria in Culicine mosquitoes from ecologically diverse regions of Cameroon.

Background: The endosymbiotic bacterium Wolbachia infects numerous species of insects and Wolbachia transinfection of Aedes mosquito species is now being used for biocontrol programs as Wolbachia strains can both inhibit arboviruses and invade wild mosquito populations. The discovery of novel, resident Wolbachia strains in mosquito species warrants further investigation as potential candidate strains for biocontrol strategies. Methods: We obtained mosquito specimens from diverse Culicine mosquitoes from Cameroon including ecologically diverse locations in the Central and West Regions. Wolbachia prevalence rates were assessed in addition to the environmentally acquired bacterial species Asaia in major Culicine genera. PCR-based methods were also used with phylogenetic analysis to confirm identities of host mosquito species and Wolbachia strains were classified using multi-locus sequence typing (MLST). Results: We report high Wolbachia prevalence rates for Culicine species, including in a large cohort of Aedes africanus collected from west Cameroon in which 100% of mono-specific pools were infected. Furthermore, co-infections with Asaia bacteria were observed across multiple genera, demonstrating that these two bacteria can co-exist in wild mosquito populations.  Wolbachia strain MLST and phylogenetic analysis provided evidence for diverse Wolbachia strains in 13 different mosquito species across seven different genera.  Full or partial MLST profiles were generated from resident Wolbachia strains in six Culex species ( quinquefasciatus, watti, cinerus, nigripalpus, perexiguus and rima), two Aedes species (africanus and denderensis) and in Mansonia uniformis, Catageiomyia argenteopunctata, Lutzia tigripes, Eretmapodites chrysogaster and Uranotaenia bilineata. Conclusions: Our study provides further evidence that Wolbachia is widespread within wild mosquito populations of diverse Culicine species and provides further candidate strains that could be investigated as future options for Wolbachia-based biocontrol to inhibit arbovirus transmission.

Emergency department management of pediatric acute asthma: an evidence-based review.

Asthma is the most common chronic disease of childhood. Although home action plans and the use of maintenance medications have improved daily management and control of asthma, many children still require emergency department care at least once per year. Emergency clinicians must be able to manage patients with acute asthma exacerbations and determine their safe disposition. This issue reviews the current evidence-based emergency department management recommendations for moderate to severe acute asthma in pediatric patients. Timely use of bronchodilators and systemic corticosteroids, as well as adjunct modalities, are discussed. Current challenges in asthma management related to vaping and COVID-19 are also addressed.

High prevalence of asymptomatic Plasmodium falciparum malaria in Makenene, a locality in the forest-savannah transition zone, Centre Region of Cameroon.

Malaria transmission and prevalence is still not well documented across Cameroon particularly in medium-sized cities or localities representing high transit zone. Different risk factors could be associated with persistence malaria transmission such as population movement from high to low transmission settings. A cross-sectional community-based study was carried out to determine malaria prevalence and risk factors in Makenene, a small city in a forest-savannah which is a crossroads between different parts of the country where travellers usually stop-over day and night to rest. Using malaria diagnostic test (mRDTs from SD-BIOLINE) and microscopy (thin and thick blood smears), 406 participants from 237 households were tested for malaria infection. The prevalence of malaria was high irrespective of the detection method: mRDT (41.87%) or microscopy (38.42%). At household level, 46.41% of households had at least one case of malaria with an average of 1.41 infected individuals per household. Parasite density was also high with the majority of infected individuals (64.74%) bearing more than 500 parasites/µl. Only Plasmodium falciparum was found. The chances of being infected with malaria parasites was almost the same for all participants irrespective of the sleeping behavior, bednet usage, house type and environmental factors. The study supports high malaria transmission in the locality and the need for additional studies on vectors bionomics and transmission patterns.

Aedes Mosquito Surveillance Using Ovitraps, Sweep Nets, and Biogent Traps in the City of Yaoundé, Cameroon.

Arbovirus diseases represent a significant public health problem in Cameroon and vector surveillance is a key component of prevention strategies. However, there is still not enough evidence of the efficacy of different sampling methods used to monitor Aedes mosquito population dynamic in different epidemiological settings. The present study provides data on the evaluation of ovitraps and different adult sampling methods in the city of Yaoundé and its close vicinity. Entomological surveys were carried out from February 2020 to March 2021 in two urban (Obili, Mvan), two peri-urban (Simbock, Ahala), and two rural (Lendom, Elig-essomballa) sites in the city of Yaoundé. The efficacy of three sampling methods, namely ovitraps, Biogent Sentinel trap, and sweep nets, was evaluated. Different ovitrap indices were used to assess the infestation levels across study sites; a general linear model was used to determine if there are statistical differences between positive ovitraps across ecological zones. A total of 16,264 Aedes mosquitoes were collected during entomological surveys. Ovitraps provided the highest mosquito abundance (15,323; 91.14%) and the highest species diversity. Of the five Aedes species collected, Aedes albopictus (59.74%) was the most commonly recorded in both urban and rural settings. Different Aedes species were collected in the same ovitrap. The ovitrap positivity index was high in all sites and varied from 58.3% in Obili in the urban area to 86.08% in Lendom in the rural area. The egg density index varied from 6.42 in Mvan (urban site) to 13.70 in Lendom (rural area). Adult sampling methods recorded mostly Aedes albopictus. The present study supports high infestation of Aedes species in the city of Yaoundé. Ovitraps were highly efficient in detecting Aedes distribution across study sites. The situation calls for regular surveillance and control of Aedes population to prevent sudden occurrence of outbreaks.

Population knowledge, attitudes and practices towards malaria prevention in the locality of Makenene, Centre-Cameroon.

BACKGROUND: To contribute to the mission of the National Malaria Control Programme (NMCP) and guide future interventions in Cameroon in general, and in Makenene in particular, this study assessed the knowledge, attitudes and practices of the population of Makenene towards the fight against malaria. METHODS: Using a semi-structured questionnaire, a descriptive cross-sectional household community survey was carried out in randomly selected households in Makenene, a locality situated between forest and savannah ecotypes. RESULTS: Out of the 413 households surveyed, all (100%) claimed to have heard of malaria with over 94% (n = 391) associating disease transmission with mosquito bites. The main mosquito control tools used in the area were mosquito nets (92.25%). The majority of participants had good knowledge (55.93%; n = 231), good practices (71.67%, n = 296) but moderate attitudes (47.94%; n = 198) towards malaria control and fight. Good knowledge and practices were recorded mostly in educated persons including public servants and students. Good attitudes were adopted mostly by public servants and students of secondary and higher levels of education. CONCLUSION: In Makenene, the population exhibits good knowledge and practices towards malaria and its control. However, despite high LLINs ownership and use, people still complain about malaria in the area. Control tools should be monitored, repaired or replaced when necessary to support the achievement of the NMCP mission.

Efficacy of Trapping Methods in the Collection of Eretmapodites (Diptera: Culicidae) Mosquitoes in an Afrotropical Rainforest Region, South western Cameroon.

Very little data exist on the biology of an afrotropical rainforest mosquito Eretmapodites (Er.) in a world undergoing dramatic changes due to deforestation. The aim was to assess the efficacy of different trapping methods in the collection of Er. mosquito in forested area. This was a longitudinal study involving collection of mosquitoes for over two years. Multiple collection methods (grouped into two categories), were used; i) net baited and un-baited traps to collect adults, ii) techniques that target immature stages subsequently reared to adults. All males were identified by genitalia dissection. Five thousand seven hundred and four mosquitoes representing 11 genera among which 2,334 Er. were identified. Mosquito abundance was highest in the net traps (n = 1276 (56.4%)) and sweep nets (n = 393(17.4%)) respectively. The abundance was highest in green colored net traps (435(34.09%)) with significant value of χ2= 40.000, P < 0.001 and in pigeons baited traps (473 (37.06%)) with significant value of χ2= 42.000, P = 0.003. The diversity ranges from H' = 2.65; DS = 0.84; SR = 24; ACE = 24.77 in sweep net to H' = 0; DS = 0; SR = 1; ACE = 1 in rock pool among males mosquitoes. While for females, H = 1.14; DS = 0.71; SR = 5; ACE = 5.16, in sweep net to H = 0; DS = 0; SR = 1; ACE = 1 in rock pool, tarpaulin, resting cage. Net traps, bamboo pot, and sweep netting are efficient in collecting high abundance of forest mosquitoes in the Talanagaye rainforest.

Wolbachia Detection in Field-Collected Mosquitoes from Cameroon.

Wolbachia spp., known to be maternally inherited intracellular bacteria, are widespread among arthropods, including mosquitoes. Our study assessed the presence and prevalence of Wolbachia infection in wild mosquitoes collected in Cameroon, using the combination of 23s rRNA Anaplasmatacea and 16s rRNA Wolbachia genes. Mosquitoes that were positive for Wolbachia were sequenced for subsequent phylogenetic analysis. Out of a total of 1740 individual mosquitoes belonging to 22 species and five genera screened, 33 mosquitoes (1.87%) belonging to eight species (namely, Aedes albopictus, A. contigus, Culex quinquefasciatus, C. perfuscus, C. wigglesworthi, C. duttoni, Anopheles paludis and Coquillettidia sp.) were found to be positive for Wolbachia infections. Wolbachia spp. were absent in A. gambiae and A. aegypti, the main vectors of malaria and dengue, respectively. Phylogenetic analysis of the 16S RNA sequences showed they belong mainly to two distinct subgroups (A and B). This study reports the presence of Wolbachia in about eight species of mosquitoes in Cameroon and suggests that future characterisation of the strains is needed.

An update on the mosquito fauna and mosquito-borne diseases distribution in Cameroon.

The expansion of mosquito-borne diseases such as dengue, yellow fever, and chikungunya in the past 15 years has ignited the need for active surveillance of common and neglected mosquito-borne infectious diseases. The surveillance should be designed to detect diseases and to provide relevant field-based data for developing and implementing effective control measures to prevent outbreaks before significant public health consequences can occur. Mosquitoes are important vectors of human and animal pathogens, and knowledge on their biodiversity and distribution in the Afrotropical region is needed for the development of evidence-based vector control strategies. Following a comprehensive literature search, an inventory of the diversity and distribution of mosquitoes as well as the different mosquito-borne diseases found in Cameroon was made. A total of 290 publications/reports and the mosquito catalogue website were consulted for the review. To date, about 307 species, four subspecies and one putative new species of Culicidae, comprising 60 species and one putative new species of Anopheles, 67 species and two subspecies of Culex, 77 species and one subspecies of Aedes, 31 species and one subspecies of Eretmapodites, two Mansonia, eight Coquillettidia, and 62 species with unknown medical and veterinary importance (Toxorhynchites, Uranotaenia, Mimomyia, Malaya, Hodgesia, Ficalbia, Orthopodomyia, Aedeomyia, and Culiseta and Lutzia) have been collected in Cameroon. Multiple mosquito species implicated in the transmission of pathogens within Anopheles, Culex, Aedes, Eretmapodites, Mansonia, and Coquillettidia have been reported in Cameroon. Furthermore, the presence of 26 human and zoonotic arboviral diseases, one helminthic disease, and two protozoal diseases has been reported. Information on the bionomics, taxonomy, and distribution of mosquito species will be useful for the development of integrated vector management programmes for the surveillance and elimination of mosquito-borne diseases in Cameroon.

Aedes Mosquito Distribution along a Transect from Rural to Urban Settings in Yaoundé, Cameroon.

INTRODUCTION: The surveillance of mosquito vectors is important for the control of arboviruses diseases worldwide. Detailed information on the bionomics and distribution of their main vectors, Aedes aegypti and Aedes albopictus, is essential for assessing disease transmission risk and for better planning of control interventions. METHODS: Entomological surveys were carried out from November 2019 to November 2020 in six localities of Yaoundé city following a transect from urban to rural settings: two urban (Obili, Mvan), two peri-urban (Simbock, Ahala) and two rural areas (Lendom, Elig-essomballa)-during rainy and dry seasons. All water containers were inspected. Aedes mosquito abundance, species distribution and seasonal distribution patterns were compared using generalized linear models. Stegomyia indexes were estimated to determine the risk of arbovirus transmission. RESULTS: A total of 6332 mosquitoes larvae were collected (2342 in urban areas, 1694 in peri-urban areas and 2296 in rural sites). Aedes species recorded included Ae. albopictus, Ae. aegytpi, Ae. simpsoni and Aedes spp. High mosquito abundance was registered in the rainy season (4706) compared to the dry season (1626) (p < 0.0001). Ae. albopictus was the most abundant Aedes species in urban (96.89%) and peri-urban (95.09%) sites whereas Ae. aegypti was more prevalent in rural sites (68.56%) (p < 0.0001). Both species were found together in 71 larval habitats. Ae. albopictus was mostly found in discarded tires (42.51%), whereas Ae. aegypti was more prevalent in plastic containers used for storing water (65.87%). The majority of Aedes mosquitoes' breeding places were situated close to human dwellings (0-10 m). CONCLUSION: Uncontrolled urbanization seems to greatly favour the presence of Aedes mosquito species around human dwellings in Yaoundé. Controlling Aedes mosquito distribution is becoming urgent to reduce the risk of arbovirus outbreaks in the city of Yaoundé.

Knowledge, Attitude, and Practices (KAP) of Human Populations towards Malaria Control in Four Ecoepidemiological Settings in Cameroon.

Malaria remains a major public health problem in Cameroon. Critical steps to improve disease control include assessing human population adherence to vector control interventions, especially in areas with different cultural backgrounds. The present study seeks to assess the knowledge, attitude, and practices (KAP) of populations towards malaria prevention in four ecoepidemiological settings in Cameroon. A cross-sectional malaria KAP survey was conducted from August to September 2019 in households of the localities of Kaélé, Tibati, Bertoua, and Santchou. A semistructured questionnaire was administered to randomly selected households in the localities. Data recorded were analysed using SPSS v. 20 and MedCalc v14.8.1. A total of 739 households were surveyed. The majority of participants had a secondary level of education (48.71%). A substantial number of participants (over 90%) in all the localities were able to make an accurate association between malaria and mosquito bites. The main sources of information for community members were television sets in Santchou and Tibati and interpersonal conversations in Bertoua and Kaélé. Mosquito nets were the most commonly used protective measure against malaria, and the majority of nets in households came from the free-of-charge mass distribution campaigns organized by the government. Participants with secondary and higher levels of education were more aware of good practices towards malaria control compared to those with a primary level of education. The study revealed that populations' KAP differed according to localities and culture. More sensitization and education need to be done to improve adherence to prevention programs.

Emergency department assessment and management of pediatric acute mild traumatic brain injury and concussion.

Mild traumatic brain injury (mTBI) and concussion, a subtype of mTBI, commonly present to the emergency department (ED) and may present with symptoms identical to those associated with more severe TBI. The development and use of clinical decision rules, increased awareness of the risk of radiation associated with head computed tomography, and the potential for patient observation has allowed emergency clinicians to make well-informed decisions regarding the need for imaging for patients who present with mTBI. For patients who present to the ED with concussion, appropriate diagnosis, management, and education are critical for optimal recovery. This issue reviews the most recent literature on concussion and mTBI and provides recommendations for the evaluation, diagnosis, and treatment of mTBI and concussion in the acute setting.

Performance assessment of a widely used rapid diagnostic test CareStart™ compared to microscopy for the detection of Plasmodium in asymptomatic patients in the Western region of Cameroon.

While malaria remains a serious public health concern, its rapid or prompt diagnosis in remote areas is important in the fight against the disease. The study aimed to evaluate the performance of widely used Rapid Diagnostic Test (RDT) kits for routinely detection of Plasmodium asymptomatic patients. A total of 400 asymptomatic participants of both sexes aged between 1-89 years from Menoua Division (Santchou and Dschang) were tested for malaria infection using both microscopy and CareStart™ RDT. The prevalence of malaria was higher when using the standard gold tool (Microscopy) (26.0%) compared to RDT (21.8%) with a significant difference (P < 0.05). However, a strong agreement was observed between both tests (kappa = 0.883; P < 0.0001). RDT CareStart™ sensitivity and specificity were 83.65% and 100% respectively while the positive predictive value and negative predictive value were 100% and 95.57% respectively. RDT sensitivity increased with parasite density while false negative (40.4%; n = 17) were observed only when parasite density was low (<500 parasites per microliter of blood). RDT kits appear to be good tools in areas where malaria diagnosis through microscopy is not feasible. However, the low sensibility observed when parasite density is low could be a concern.

New species of Culex (Culiciomyia) (Diptera: Culicidae) from Talangaye Forest in Cameroon and descriptions and identification keys for males of the Afrotropical species of the subgenus.

Species of Culex (Diptera: Culicidae) belonging to the subgenus Culiciomyia were collected in partially logged areas and in surrounding pristine forest (Talangaye Forest) in the Nguti Subdivision in the South-West Region of Cameroon. Mosquitoes were collected mainly by sweep netting through forest floor vegetation. Morphological species identification of African Culiciomyia relies almost exclusively on the structure of the male genitalia and the shapes of comb scales on the maxillary palpi of males. Other features of males and the habitus of females are largely indistinguishable between the species of this subgenus. In total, seven currently described species and three new species were collected in the forest. The males of the three new species are described and named as Culex apicopilosus Cornel Mayi, sp. n., Culex lanzaroi Cornel Mayi, sp. n. and Culex pseudosubaequalis Cornel Mayi, sp. n. More detailed descriptions of males of the other currently known species that were collected in the Talangaye Forest and pictorial keys to the males of all Afrotropical species of Culiciomyia, including the new species, are provided.

Causes of hospital readmissions within 7 days from the neurosurgical service of a quaternary referral hospital.

BACKGROUND: Evaluation of readmission rates as a proxy metric of health-care quality in neurological surgery has grown to become a prevalent area of investigation in the last several years. Significant attention has been paid to 30-day readmission rates due to the financial incentive to health-care providers following the enforcement of the penalties created by the Affordable Care Act. However, relatively little attention has been paid to patients readmitted within 7 days of discharge to large quaternary neurological surgery services. This study was conducted to examine the causes and unique characteristics of 7-day readmission rates from a neurosurgical service at a large quaternary referral hospital. METHODS: A retrospective observational analysis of all 7-day readmissions to the neurosurgical surgery service of the University of Pittsburgh Medical Center, Presbyterian Hospital from August 2017 to June 2019, was performed. Patients were organized into seven categories based on their primary reason for readmission: scheduled surgeries, infection, pain, altered mental status or seizures, general postoperative complications, complications directly resulting from a neurosurgical intervention, and unrelated reasons. Demographic information, the time between initial discharge and subsequent readmission, and discharge disposition were also recorded. RESULTS: Of 5274 discharges, 258 patients (4.9%) were readmitted within 7 days (55.0% male; mean age 60 years of age). Two-thirds of patients readmitted initially underwent care for cranial pathologies (57% of 258 patients) as opposed to a third for spine pathologies (33% of 258 patients). Complications that directly arose from the neurosurgical intervention (e.g., shunt infection or misplacement, and hardware misplacement) represented 18.9% of total readmission, while general postoperative complications (e.g., urinary tract infection) accounted for 15.1% of total readmission, in which all together were slightly greater than a third of readmissions. Seizures or altered mental status led to less than a fifth of readmissions (17.0%), followed by readmissions from unrelated diagnosis or miscellaneous reasons (17.0%) and scheduled surgeries (13.1%). Taken together, surgical site infections (9.7%) and postoperative pain (9.3%) accounted for 9.7% and 9.3 % of readmissions, respectively. CONCLUSION: Approximately 5% of patients discharged in a single year from our quaternary referral center were readmitted within 7-days. Approximately 90% of all 7-day readmissions were unplanned, with one-third resulting directly from perioperative complications. Further investigation to better understand this acutely vulnerable yet previously overlooked population may guide focused efforts to increase the quality of neurosurgical patient care.

Habitat and Seasonality Affect Mosquito Community Composition in the West Region of Cameroon.

To identify potential sylvatic, urban and bridge-vectors that can be involved in current or future virus spillover from wild to more urbanised areas, entomological field surveys were conducted in rural, peri-urban and urban areas spanning the rainy and dry seasons in western Cameroon. A total of 2650 mosquitoes belonging to 37 species and eight genera were collected. Mosquito species richness was significantly influenced by the specific combination of the habitat type and the season. The highest species richness was found in the peri-urban area (S = 30, Chao1 = 121 ± 50.63, ACE = 51.97 ± 3.88) during the dry season (S = 28, Chao1 = 64 ± 25.7, ACE = 38.33 ± 3.1). Aedes (Ae.) africanus and Culex (Cx.) moucheti were only found in the rural and peri-urban areas, while Cx. pipiens s.l. and Ae. aegypti were only found in the urban area. Cx. (Culiciomyia) spp., Cx. duttoni and Ae. albopictus were caught in the three habitat types. Importantly, approximately 52% of the mosquito species collected in this study have been implicated in the transmission of diverse arboviruses. This entomological survey provides a catalogue of the different mosquito species that may be involved in the transmission of arboviruses. Further investigations are needed to study the vectorial capacity of each mosquito species in arbovirus transmission.

Effect of deforestation on prevalence of avian haemosporidian parasites and mosquito abundance in a tropical rainforest of Cameroon.

Habitat change caused by deforestation can modify the interactions of many biotic and abiotic factors, and in turn influence patterns of diseases in wild birds. Whether deforestation directly or indirectly affects the prevalence of avian haemosporidian parasites through their hosts and/or vectors is still not well understood. We sampled understory bird communities (insectivorous, frugivorous, granivorous and nectarivorous birds) and mosquitoes in three habitats showing a gradient of deforestation (pristine forest, fragmented forest, and young palm oil plantation), to assess the effects of habitat changes on avian haemosporidian (Plasmodium and Haemoproteus) prevalence and its relationship to bird feeding guilds and mosquito abundance. Blood samples of 845 individual birds belonging to 85 species and 27 families were collected in the three habitat types and screened using microscopy and PCR. Plasmodium infections were detected in 136 individuals (16.09%) and varied significantly among habitat types while Haemoproteus infections were detected in 98 individuals (11.60%) and did not vary significantly among habitat types. However, the prevalence of Plasmodium and Haemoproteus in bird feeding groups varied significantly among habitats. Nectarivorous and granivorous birds had the highest Plasmodium and Haemoproteus prevalence, respectively. The abundance of mosquitoes varied significantly among habitat types and the prevalence of Plasmodium significantly and positively correlated with mosquito abundance in fragmented forest. This study highlights the importance of host and mosquito determinants in the transmission dynamics of avian Plasmodium and Haemoproteus infections following habitat changes. Selective logging favored an increase in the prevalence of Plasmodium in insectivores, the prevalence of Haemoproteus in nectarivores and the abundance of female mosquitoes while, the establishment of the palm oil plantation favored an increase in the prevalence of Plasmodium in granivores and Haemoproteus in nectarivores. Species feeding behavior is also an important determinant to consider for a better understanding of patterns of parasite infections in a changing environment.

Impact of deforestation on the abundance, diversity, and richness of Culex mosquitoes in a southwest Cameroon tropical rainforest.

Deforestation is a major threat to biodiversity but little data exist on how deforestation in real-time affects the overall mosquito species community despite its known role in the transmission of diseases. We compared the abundance and diversity of Culex mosquitoes before and after deforestation along a gradient of three different anthropogenic disturbance levels in a tropical rainforest in southwestern Cameroon. The collections were conducted in unlogged forest (January, 2016), selectively logged forest (January, 2017), and within a young palm plantation (October, 2017) using net traps, sweep nets, resting traps, and dipping for immature stages in water bodies. Mosquitoes were morphologically identified to subspecies, groups, and species. A total of 2,556 mosquitoes was collected of which 1,663 (65.06%) belong to the genus Culex, (n=427 (25.68%) in the unlogged forest; n=900 (54.12%) in the selectively logged forest; and n=336 (20.2%) in the young palm plantation) with a significant difference among the habitats. Diversity and richness of mosquitoes varied significantly among habitats with the highest values found in the selectively logged forest (H=2.4; DS=0.87; S=33) and the lowest value in the unlogged forest (H=1.37; DS=0.68; S=13). The results of this study showed that deforestation affects the abundance and diversity of Culex mosquitoes and favors the invasion of anthropophilic mosquitoes. Higher mosquito abundance and diversity in the selectively logged forest than in the pristine forest is notable and some explanations for these differences are discussed.

Impact of a Child Life and Music Therapy Procedural Support Intervention on Parental Perception of Their Child's Distress During Intravenous Placement.

OBJECTIVES: Child life specialists and music therapists have a unique and integral role in providing psychosocial care to pediatric patients and families. These professionals are trained to provide clinical interventions that support coping and adjustment and reduce the risk of psychological trauma related to hospital visits and health care encounters. The researchers devised a multimodal approach using a combined child life and music therapy intervention to address procedure-related distress in patients receiving intravenous (IV) placement in the pediatric emergency department. The aim of this study was to investigate the efficacy of this collaborative intervention by evaluating parental perception of their child's distress. METHODS: This study was a prospective analysis investigating the impact of a child life and music therapy intervention on children aged 4 to 11 years old receiving an IV placement in the pediatric emergency department. Efficacy was evaluated by comparing scores between a 4-question pretest and subsequent 4-question posttest that asked the child's parent to evaluate how they anticipated their child would respond to the procedure, and then to evaluate how they perceived their child to have responded after the procedure. Qualitative data were collected in the form of open-ended comments, which were accommodated at the end of the posttest. Data were analyzed by the Cochran-Mantel-Haenszel method for testing repeated ordinal responses and the PROC GENMOD procedure in the SAS system software. RESULTS: A total of 41 participants were enrolled in this study. Results of the statistical analysis revealed significant differences between all pre- and posttest scores (P < 0.05), and significant likelihood that the patient would improve relative to the 4 questions, as a result of the child life and music therapy intervention. CONCLUSIONS: Improvement was demonstrated across all 4 questions, suggesting that the child life and music therapy intervention supported healthy, adaptive coping and helped to minimize distress experienced by patients during IV placement. These results underscore the importance and potential clinical impact of child life psychological preparation and psychotherapy-based music therapy interventions in reducing distress in pediatric patients during common medical procedures.

Consensus Statement on Urgent Care Centers and Retail Clinics in Acute Care of Children.

This article provides recommendations for pediatric readiness, scope of services, competencies, staffing, emergency preparedness, and transfer of care coordination for urgent care centers (UCCs) and retail clinics that provide pediatric care. It also provides general recommendations for the use of telemedicine in these establishments. With continuing increases in wait times and overcrowding in the nation's emergency departments and the mounting challenges in obtaining timely access to primary care providers, a new trend is gaining momentum for the treatment of minor illness and injuries in the form of UCCs and retail clinics. As pediatric visits to these establishments increase, considerations should be made for the type of injury or illnesses that can be safely treated, the required level training and credentials of personnel needed, the proper equipment and resources to specifically care for children, and procedures for safe transfer to a higher level of care, when needed. When used appropriately, UCCs and retail clinics can be valuable and convenient patient care resources.