Effect of Education and Regular Examination on the Prevalence of Head Louse Infestations in Adana

Objective: The current study provides training to parents and teachers about pediculosis in schools in three villages in Adana to measure their knowledge level by conducting surveys and to determine the prevalence of pediculosis in these foci. Methods: Pre- and post-questionnaires including 30 questions about pediculosis were handed to parents and teachers. The answers were analyzed with the Pearson correlation analysis. Overall, 418 school pupils s were examined for lice. The results of the head louse control were analyzed by the chi-square test and t-test. Results: We observed that the level of awareness increased in parents and teachers. Additionally, the gender of both teachers and parents was determined as the most important factor in increasing this awareness. Because of interventions for the control of head and lice, the prevalence of pediculosis decreased from 15.22% to 1.71%. Conclusion: It is very important that parents and teachers are aware of the health problems related to pediculosis, while regular combing of school children may be essential for the control of this common infestation.

TRsandflies: A Web-Based Software for the Morphometric Identification of Sand Flies in Turkey.

Sand flies are vector of several diseases, mostly cutaneous and visceral leishmaniasis (CL and VL). Also, 29 sand fly species have been identified in previous fauna studies carried out in 40 provinces of Turkey. Totally, 24 sand flies species belonging to Phlebotomus (Ph.) (Diptera: Psychodidae) genus have been proven or reported as possible vector species. This study aimed to develop a new software which could contribute to researchers' decision making about the identification of sand flies with obtained data from entomological surveys conducted before in Turkey. Developed software called TRsandflies included 35 textbox created with parameters obtained from caught sand flies specimens by the above-mentioned surveys. It also contained 130 photos and distribution maps related to 24 sand flies species. In addition, C# language and MYSQL database were used in the program. TRsandflies had three different forms (pages) allowing the user to compare the specimens and known species. In the species identification trials with three repetitions carried out in the program, except for the specimens belonging to the Transphlebotomus Artemiev & Neronov, 1984 subgenus, morphometric data of all previously collected sand fly species specimens were included. The process of running the morphometric measurement results of predetermined specimens in the program provided us with an accurate prediction rate of 86.66% in male specimens and 71.66% in female specimens. We concluded that the web-based software developed could play an important role in reducing the rate of possible errors that might be encountered by conventional identification methods.

Entomological Survey for the Detection of Sand Fly Fauna and Vector Species in the Cutaneous Leishmaniasis Endemic Area in East Mediterranean Region of Turkey, Mersin Province.

Cutaneous (CL) and visceral (VL) forms of leishmaniasis, transmitted by sand flies, are seen in all countries located in Mediterranean Basin including Turkey. In this study, we aimed to conduct an entomological survey for the detection of sand fly fauna and vector species in Mersin province, one of the important endemic areas for CL in Turkey. In total, 912 sand fly specimens were collected in 2010 and 2011 using CDC light traps. Nine Phlebotomus (Diptera: Psychodidae) and three Sergentomyia (Diptera: Psychodidae) species were detected. Of the collected Phlebotomus sand flies, P. sergenti Parrot, 1917 (30.1%) was the most dominant followed by P. alexandri Sinton, 1928 (18.2%), P. neglectus/syriacus Tonnoir Adler (12.0%), P. tobbi Adler & Theodor, 1930 (11.7%), and P. papatasi Scopoli, 1786 (10.2%), while S. minuta Rondani, 1843 (11.3%) was the dominant species among Sergentomyia. During the field work in 2011, female specimens (n = 81) were screened for the presence of Leishmania promastigotes by midgut dissection, and all were found negative. The rest of the collected female specimens (n = 334) were pooled according to species (P. alexandri, P. neglectus/syriacus, P. papatasi, P. sergenti, P. simici, and P. tobbi) and location (Mut, Silifke, and Anamur). In total, 29 pools were generated and real-time ITS1 PCR assay was performed to detect and identify natural Leishmania Ross, 1903 (Kinetoplastida: Trypanosomatida) infection. Two pools, both from Mut town, containing P. sergenti specimens were found positive and Leishmania tropica Ross, 1903 was identified as an infectious agent for both pools. In conclusion, the sand fly fauna was determined in an endemic area for CL. The detection of L. tropica DNA in P. sergenti specimens showed the possible vectorial role of this species in Mersin province.

Modeling the Ecological Niche: A Case Study on Bioclimatic Factors Related to the Distribution of Phlebotomus tobbi Adler & Theodor (Diptera: Psychodidae) in Two Endemic Foci of Adana.

Cutaneous leishmaniasis (CL) is a zoonotic infectious disease caused mainly by Leishmania infantum Nicolle, 1908 (Kinetoplastida: Trypanosomatida) transmitted by dominant species Phlebotomus tobbi Adler & Theodor (Diptera: Psychodidae) in Adana, Turkey. CL has been reported to be detected commonly in low-socioeconomic status population scattered in rural areas. The environmental determinants are relatively poorly understood, especially in Adana despite the fact that Adana is endemic foci of CL. The subject of this study was the current and future probability model of P. tobbi in the study areas, and to determine the underlying factors affecting its distribution. Sticky papers and CDC light traps were used for capturing the sand fly specimens. The current and future presence of P. tobbi was modeled using maximum entropy (MaxEnt) techniques. The predictive model indicated the presence of P. tobbi in the southeast and south part of the selected study area with 0.816 area under the curve (AUC) value. The model also implied that its survival could tend to expand with suitable climatic conditions in future (2070) with 0.798 AUC value. In addition, aspect, digital elevation model, BIO3, BIO 10, BIO12, and BIO14 were determined as the most influential variables for current and projected future. ArcGIS and MaxEnt software were used for the ecological niche model analysis to explore the ecological conditions of the disease. I suggest that produced models contribute to better understanding of epidemiology and controlling of vector-borne diseases.

Prediction of Cutaneous Leishmaniasis Epidemiology in Mersin Using Ecological Niche Modeling.

OBJECTIVE: In our study, we aimed to develop an ecological niche model showing current distribution of cutaneous leishmaniasis (CL) by using location information on 630 cases of CL reported in the Mersin province between 2005 and 2015 and bioclimatic and environmental variables. METHODS: The ecological niche model was based on interpretation of patient locations and climatic data entered in geographical information systems and maximum entropy databases. RESULTS: In the model produced for the Mersin province, the area under the curve was calculated as 0.918. Also, the mean temperature of the driest quarter (BIO9), mean temperature of the warmest quarter (BIO10), and maximum temperature of the warmest month (BIO5) were determined as climatic factors that are most effective for CL distribution. CONCLUSION: There is a relationship between distribution of CL and climatic factors in the Mersin province. The developed model will contribute to better understanding of epidemiology and control of vector-borne diseases by authorities in the ministry of health.

Phlebotomus halepensis (Diptera: Psychodidae) Vectorial Capacity in Afyon and Nigde Province, Turkey.

Leishmaniasis is a one of the vector-borne diseases and has two clinical forms in Turkey: cutaneous and visceral. The aim of this study was to determine the sand fly fauna in Afyon and Nigde provinces where endemic foci of cutaneous leishmaniasis (CL) in Turkey. In Afyon, 2,259 sand flies were collected in 73 locations in August 2009 and August 2010, using CDC light traps. In total, eight Phlebotomus species were identified; Phlebotomus halepensis (47.41%), Phlebotomus papatasi (31.42%), Phlebotomus neglectus/syriacus (9.38%), Phlebotomus balcanicus (7.48%), Phlebotomus simici (2.12%), Phlebotomus perfiliewi (1.90%), Phlebotomus sergenti (0.08%), Phlebotomus similis (0.13%), and Sergentomyia dentata (0.04%). A total of 418 sand fly specimens were caught by CDC light traps in 40 stations in Nigde in September 2009 and September 2010. In total, seven Phlebotomus species were identified; P. halepensis (74.16%), P. simici (13.87%), P. papatasi (3.82%), P. neglectus/syriacus (2.87%), P. balcanicus (2.63%), P. sergenti (2.39%), and Phlebotomus tobbi (0.23%). Collected sand flies were examined by microscope, and no promastigotes were found in their midguts. We categorized and pooled female specimens (1,031 females, 73 pools of 2-33 individuals). Leishmania species-specific ITS1 real-time PCR assay was performed for detection and identification of parasites. We detected 6 of the 73 pools with Leishmania tropica (Ross, 1903), (Trypanosomatidae). In conclusion, P. halepensis was found to be dominant species in both areas. We are in opinion that our findings support P. halepensis vectorial role for L. tropica in nature and it could be responsible for the transmission of L. tropica in these endemic areas.

Investigation of the spatial distribution of sandfly species and cutaneous leishmaniasis risk factors by using geographical information system technologies in Karaisali district of Adana province, Turkey.

BACKGROUND & OBJECTIVES: Cutaneous leishmaniasis displays two epidemiological routes of transmission, zoonotic cutaneous leishmaniasis (ZCL) which includes animal reservoir hosts in the transmission cycle and anthroponotic cutaneous leishmaniasis (ACL), where human is the sole source of infection for the vector sandflies. About 10-13% of CL cases are reported each year from Adana province in Turkey. The aim of this study was to develop a predictive model for determining the spatial risk level of cutaneous leishmaniasis in the Adana province, southern part of Turkey, in relation to environmental factors. METHODS: Entomological survey was carried out between June 2015 and September 2016. Sandflies were collected from Karaisali district of the Adana province using light-traps and sticky papers. Sandfly fauna results were compared with environmental data obtained from field-survey, and examined with univariate and binary logistic regression in PASW statistical software. The ArcMap application of ArcGIS10.0. software was used for geographical adjustments to create maps and establish a risk model. RESULTS: In total five sandfly species were identified in the study area, and three of them (Phlebotomus tobbi, P. neglectus/syriacus and P. perfiliewi) were detected as potential vectors of cutaneous leishmaniasis. The results showed that enhanced vegetation index (EVI) and emissivity band 31 (EMIS31) values are related to the distribution of these three species. INTERPRETATION & CONCLUSION: The created risk maps may provide useful information to guide the control programme interventions and prevent the economic loses in the future insecticide applications. They could be used to better understand the distribution of vectors, and determine the epidemiology and risk level of the CL.

Geographical Information Systems in Determination of Cutaneous Leishmaniasis Spatial Risk Level Based on Distribution of Vector Species in Imamoglu Province, Adana.

The Imamoglu district located in the southeast of Adana province in Turkey is an endemic focus of cutaneous leishmaniasis (CL) owing to dominancy of Phlebotomus tobbi, which is a probable vector of Leishmania infantum. About 11.26% of CL cases reported each year are from Imamoglu, Adana, and between 2008 and 2015, 223 cases of CL were reported. Leishmania infantum, which may be transmitted by P. tobbi, Phlebotomus neglectus/syriacus, and Phlebotomus perfiliewi, is referred as leishmaniasis factor in Adana. Thus, the aim of this study was to map the risk areas for each sand fly species using remote sensing images based on environmental factors and geographical characteristics. Two field works in two consecutive years (2013 and 2014) were conducted and six sand fly species were caught, four of which were identified as probable vector species. Field work results were compared with environmental data obtained from satellite images by univariate and binary logistic regression in PASW. ARCMAP 10.2 software was used for geographical adjustments, creating a database and estimating a risk model by using previous risk value formulas. The results showed that the distribution of three probable leishmaniasis vectors (P. tobbi, P. neglectus/syriacus, and P. perfiliewi) was associated with normalized difference vegetation index (NDVI), digital elevation model (DEM), night-time land surface temperature (LSTNIGHT), and emissivity (EMIS31) values, which were related to the local authorities, who take these findings into account when deciding on high risk areas for CL.

[The effects of chitin synthesis inhibitor, diflubenzuron on the larvae of Culex pipiens (L.) and Culiseta longiareolata (Macquart) (Diptera: Culicidae)]. / Kitin sentez inhibitörü diflubenzuron'un Culex pipiens (L.) ve Culiseta longiareolata (Macquart)'nin (Diptera: Culicidae) larvalari üzerine etkileri.

OBJECTIVE: The aim of the present study was to detect effects of diflubenzuron on Culex pipiens and Culiseta longiareolata larvae, and determine the weekly mortality rate and most effective dose of diflubenzuron during the study. METHODS: The lower and higher doses (0.016, 0.032, and 0.064 mg(ai)/cm(2)) than 0.05 mg(ai)/cm(2) which are brecommended for granular formulation of diflubenzuron by WHO (World Health Organization) was applied against 1st, 2nd, 3rd and 4th instars under laboratory conditions and mortality was recorded. RESULTS: According to our data, diflubenzuron was more effective against early instars, and it was found most effective in the 4th and 3(th) week post-treatment in the application for Culex pipiens and Culiseta longiareolata larvae respectively. In addition, the most effective dose of diflubenzuron was obtained as 0.064 mg(ai)/cm(2) (LC50 > 4640 ppm, LC90 = 0.0034 ppm). Furthermore Culiseta longiareolata was more sensitive than Culex pipiens larvae. CONCLUSION: Knowing the specific mortality rate of diflubenzuron in different mosquitoe species and larvae stages, plays an important role in determining the resistance against diflubenzuron.

Treatment of head lice with dimeticone 4% lotion: comparison of two formulations in a randomised controlled trial in rural Turkey.

BACKGROUND: Dimeticone 4% lotion was shown to be an effective treatment for head louse infestation in two randomised controlled trials in England. It is not affected by insecticide resistance but efficacy obtained (70-75%) was lower than expected. This study was designed to evaluate efficacy of dimeticone 4% lotion in a geographically, socially, and culturally different setting, in rural Turkey and, in order to achieve blinding, it was compared with a potential alternative formulation. METHODS: Children from two village schools were screened for head lice by detection combing. All infested students and family members could participate, giving access to treatment for the whole community. Two investigator applied treatments were given 7 days apart. Outcome was assessed by detection combing three times between treatments and twice the week following second treatment. RESULTS: In the intention to treat group 35/36 treated using dimeticone 4% had no lice after the second treatment but there were two protocol violators giving 91.7% treatment success. The alternative product gave 30/36 (83.3%) treatment success, a difference of 8.4% (95% CI -9.8% to 26.2%). The cure rates per-protocol were 33/34 (97.1%) and 30/35 (85.7%) respectively. We were unable to find any newly emerged louse nymphs on 77.8% of dimeticone 4% treated participants or on 66.7% of those treated with the alternative formulation. No adverse events were identified. CONCLUSION: Our results confirm the efficacy of dimeticone 4% lotion against lice and eggs and we found no detectable difference between this product and dimeticone 4% lotion with nerolidol 2% added. We believe that the high cure rate was related to the lower intensity of infestation in Turkey, together with the level of community engagement, compared with previous studies in the UK. TRIAL REGISTRATION: Current Controlled Trials ISRCTN10431107.

Comparison of two combs in the detection of head lice in school children.

The diagnostic efficacies of two metal pin lice combs having different spacing between their teeth were compared in two cohorts of school children, aged between 7 and 15 years, from different villages of Manisa, Turkey. Head lice infestation was evaluated with comb A (0.18 mm of distance between the teeth) in 95 children in Cavusoglu village, and with comb B (0.15 mm of distance between the teeth) in 146 children in Yesilköy village, compared to visual inspection. Five of 95 (5.3%) children in Cavusoglu village and 5 of 146 (3.4%) children in Yesilköy village were found to harbor live head lice with combing, while none was detected during the visual inspection. The difference between the infestation rates of two cohorts was statistically insignificant (p > 0.05). With visual screening, 15 and 16 children with louse eggs were identified in Cavusoglu and Yesilköy villages, respectively. With combing in these villages, 5 and 8 children, respectively, with louse eggs were identified and 3 and 5 children, respectively, were detected only with combing, not with visual screening. In conclusion, combing is more effective than visual inspection in head lice detection, but there were no significant difference between the two combs either in lice detection or in usage.