Response to: Bouwman, H. et al. Hallogenated pollutants in terrestrial and aquatic bird eggs: converging patterns of pollutant profiles, and impacts and risks from higher levels Environ. Res. (2013) http://dx.doi.org/10.1016/j.envres.2013.06.003.

Bouwman and coauthors present data and analyses of DDT and other halogenated pollutants in environmental samples and based on their data and analyses thereof, argue against the use of DDT for malaria control. Regrettably, the analyses, presentations, and interpretations of data presented by Bouwman and coauthors are biased and erroneous.

International advocacy against DDT and other public health insecticides for malaria control.

A new international effort to control/eradicate malaria is accompanied by suggestions that malaria can be controlled without the use of dichloro-diphenyl-trichloroethane (DDT) and other insecticides. We review the underlying science of claims publicized by the Global Environment Facility (GEF), the United Nations Environment Programme, and the Stockholm Convention Secretariat (the Secretariat). Their claims stem from a $14 million GEF project that was conducted from 2003 to 2008 in Mexico and seven countries of Central America. Objectives, experimental design, analyses, and project accomplishments are described. So-called environmentally sound interventions (GEF interventions) that excluded insecticides were implemented in demonstration areas in eight countries. Efficacy of interventions was evaluated by comparing malaria rates in demonstration areas (n = 202) with those in control areas (n = 51), all in high malaria risk areas. There were no statistically significant reductions in malaria rates in demonstration areas compared with controls. This was true across all eight countries. Broad use of antimalarial drugs was the primary method of malaria suppression in the eight countries, but this method was not a GEF intervention. Ultimately statistics favoring efficacy of "environmentally sound" methods of malaria control were obtained by comparing malaria cases in demonstration areas for 2004 with cases in 2007, and we explain why these comparisons are not valid. In conclusion, claims that GEF interventions effectively reduced malaria in Mexico and seven countries of Central America are not supported by existing data or the results of epidemiological analyses. The claims are being used to justify the Secretariat's plan to eliminate DDT production by 2017. DDT is still needed for effective control of malaria, and its elimination could have significant consequences for people in malaria endemic countries.

Contact irritancy and spatial repellency behaviors in Anopheles albimanus Wiedemann (Diptera: Culicidae) collected in Orange Walk, Belize, C.A.

Anopheles albimanus Wiedemann is a vector of malaria in northern Belize. Previous studies have identified behavioral responses in this species when exposed to certain chemicals. We used a high throughput screening system to evaluate the contact irritant and spatial repellency responses exhibited by An. albimanus collected from Orange Walk, Belize, Central America. Anopheles albimanus behavior was significantly altered by a number of key public health insecticides. Significant irritant responses to alphacypermethrin, deltamethrin, permethrin, DDT, and propoxur were recorded, while spatial repellency responses were only elicited by DDT. Malathion resulted in neither a contact irritant or spatial repellency response. These results are in congruence with behavioral patterns previously observed for An. albimanus and for Aedes aegypti in the same system. This study produced baseline data on the behaviors of An. albimanus and confirms that the majority of compounds used as indoor residual sprays may induce premature exiting by An. albimanus in addition to killing the mosquito. This effect would decrease contact with humans and thus disrupt malaria transmission.

A mark release-recapture study to define the flight behaviors of Anopheles vestitipennis and Anopheles albimanus in Belize, Central America.

The recapture rates of wild-caught, unengorged Anopheles vestitipennis and Anopheles albimanus females were determined at 0, 400, and 800 m from a fixed release point in Belize, Central America. Three sampling trials, each consisting of two 12-hour collections, were performed at each distance during September-October 2003. A total of 1,621 An. vestitipennis and 1,326 An. albimanus were marked and released during the course of the study. The recapture rate of An. vestitipennis was greatest at 0 m (7.9%; 44/ 556) and declined from 3.0% (16/531) at 400 m to 0.2% (1/534) at 800 m. Anopheles albimanus females were recaptured only at the 0-m distance and in extremely low numbers (1.1%; 5/446). Biting patterns for the unmarked natural populations were similar to those previously described for Belize, and recaptures for both species occurred during these normal biting times. The overall recapture rates for An. vestitipennis (3.76%; 61/ 1,621) and An. albimanus (0.38%; 5/1,326) indicate that An. vestitipennis has a higher probability of being attracted to a human habitation.

A new classification system for the actions of IRS chemicals traditionally used for malaria control.

Knowledge of how mosquitoes respond to insecticides is of paramount importance in understanding how an insecticide functions to prevent disease transmission. A suite of laboratory assays was used to quantitatively characterize mosquito responses to toxic, contact irritant, and non-contact spatial repellent actions of standard insecticides. Highly replicated tests of these compounds over a range of concentrations proved that all were toxic, some were contact irritants, and even fewer were non-contact repellents. Of many chemicals tested, three were selected for testing in experimental huts to confirm that chemical actions documented in laboratory tests are also expressed in the field. The laboratory tests showed the primary action of DDT is repellent, alphacypermethrin is irritant, and dieldrin is only toxic. These tests were followed with hut studies in Thailand against marked-released populations. DDT exhibited a highly protective level of repellency that kept mosquitoes outside of huts. Alphacypermethrin did not keep mosquitoes out, but its strong irritant action caused them to prematurely exit the treated house. Dieldrin was highly toxic but showed no irritant or repellent action. Based on the combination of laboratory and confirmatory field data, we propose a new paradigm for classifying chemicals used for vector control according to how the chemicals actually function to prevent disease transmission inside houses. The new classification scheme will characterize chemicals on the basis of spatial repellent, contact irritant and toxic actions.

Molecular epidemiology of Plasmodium vivax in the State of Amazonas, Brazil.

Over the past 2 decades, the Amazon region of Brazil has experienced reemergence of Plasmodium vivax malaria, with reported occurrence of severe disease. The frequency and manifestations of this severe disease are unlike previous clinical experience. The hypothesis has been raised that the occurrence of severe disease may relate to the emergence of a variant form of the parasite. To test this hypothesis, we conducted a retrospective cohort study of P. vivax strains in the State of Amazonas. We determined nucleic acid sequences of segments of three genes, the 18S SSUrRNA Type A gene, the circumsporozoite surface protein (CSP) gene and the MSP-1 gene. Sequences were determined for parasites infecting 11 hospitalized (Inpatients) and 21 non-hospitalized (Outpatients) patients. We observed two common polymorphisms in the 18S SSUrRNA Type A gene; a thymidine (T)/adenine (A) polymorphism at residue 117 was significantly more common in the Inpatient group (p<0.05). Types of variation in the CSP gene included the numbers of repeat nonapeptide segments, alanine/aspartic acid polymorphism at position 5 of the nonapeptide repeat, and sporadic mutations. Alanine was more common as the fifth residue of the nonapeptide repeat in Inpatients and in strains causing second infections (both, p<0.05). Synonymous substitutions of the common repeat sequence occurred frequently in codons 1, 2, and 7, while the mutations at codon 5 were always non-synonymous, indicating that variation at codon 5 reflected selective pressure. Among MSP-1 gene sequences, recombination among progenitor strains, related to the Salvador I and Belém strains, was the main source of diversity. Phylogenetic analyses that incorporated sequence data for all three genes tested did not reveal clustering of sequences from inpatients. Our data do not affirm that the hypothesis that severe P. vivax disease in Amazonas is related to emergence of a new variant, but do suggest that variation in the fifth position of the CSP gene nonapeptide repeat may relate to disease manifestations.

Malaria diagnosis and hospitalization trends, Brazil.

We focused on rates of malaria in the state of Amazonas and city of Manaus, Brazil. Plasmodium vivax accounted for an increased number and rate of hospital admissions, while P. falciparum cases decreased. Our observations on malaria epidemiology suggest that the increased hospitalization rate could be due to increased severity of P. vivax infections.

A mark-release-recapture study to define the flight behaviors of Anopheles vestitipennis and Anopheles albimanus in Belize, Central America

The recapture rates of wild-caught, unengorged Anopheles vestitipennis and Anopheles albimanus females were determined at 0, 400, and 800 m from a fixed release point in Belize, Central America. Three sampling trials, each consisting of two 12-hour collections, were performed at each distance during September­October 2003. A total of 1,621 An. vestitipennis and 1,326 An. albimanus were marked and released during the course of the study. The recapture rate of An. vestitipennis was greatest at 0 m (7.9%; 44/ 556) and declined from 3.0% (16/531) at 400 m to 0.2% (1/534) at 800 m. Anopheles albimanus females were recaptured only at the 0-m distance and in extremely low numbers (1.1%; 5/446). Biting patterns for the unmarked natural populations were similar to those previously described for Belize, and recaptures for both species occurred during these normal biting times. The overall recapture rates for An. vestitipennis (3.76%; 61/ 1,621) and An. albimanus (0.38%; 5/1,326) indicate that An. vestitipennis has a higher probability of being attracted to a human habitation.

A delayed release mechanism for mark-release-recapture studies.

A delayed release mechanism was designed for a mark-recapture study that evaluated the flight behavior of anopheline mosquitoes in Belize, Central America. The design prevents marked mosquitoes from being released until after a set time. The time lag allows researchers to return to collecting posts before release and reduces the potential of marked females tracking an odor plume generated during the release procedure. This is especially important in study designs evaluating temporal host-seeking behavior patterns. Detailed descriptions of the design are presented.

Inhibition of kinesin motor proteins by adociasulfate-2.

Kinesin motor proteins are involved in cell division and intracellular transport of vesicles and organelles, and as such, they play a role in neurological disease, cancer, and developmental disorders. Inhibitors of kinesin would be valuable as probes of cell physiology and as potential therapeutics. Adociasulfate-2 (AS-2) is the only known natural product inhibitor of kinesins, but its mechanism of action is unknown. We utilized kinetic studies, dynamic light scattering, and transmission electron microscopy to investigate the inhibitory action of AS-2. Our data suggest that AS-2 is not a classical 1:1 inhibitor. Instead, a rodlike aggregate that mimics microtubules is complexed with kinesin and inhibits its ATPase activity. An intriguing implication of this hypothesis is that aggregates of a chiral natural product can have interesting and biologically relevant properties. This mode of action might represent one way in which a small molecule can disrupt a protein-protein interaction.

Biting patterns and seasonal densities of Anopheles mosquitoes in the Cayo District, Belize, Central America with emphasis on Anopheles darlingi.

The present study utilized an experimental hut to conduct human-baited landing collections for characterizing the all-night biting patterns and seasonal densities of adult Anopheles darlingi in the centrally located Cayo District of Belize, Central America. A total of 25 all-night collections (i.e., sunset to sunrise) were conducted from January 2002 to May 2003, capturing a total of 18,878 An. darlingi females. Anopheles darlingi exhibited a bimodal nightly biting pattern with one predominate peak occurring three h after sunset and a smaller peak occurring one h prior to sunrise. Biting females were collected throughout the night in higher densities indoors (9,611) than outside (9,267) the experimental hut (O:I=1.00:1.04). Seasonal adult collections show An. darlingi densities were highest during the transitional months between the end of the wet and beginning of the dry season (January) and the end of the dry season and beginning of the wet season (May). A total of 2,010 An. darlingi females was captured in 31 two-h, human-baited landing collections performed from January to October 2002. Anopheles darlingi monthly population densities were found to have no significant associations with high or low temperatures, precipitation, or river level. However, qualitative data examination indicates an inverse relationship between river level and An. darlingi adult collections suggesting a disturbance of larval habitats. All-night biting and seasonal distribution patterns for other anopheline species are also described. None of the adult specimens collected throughout the entire study tested positive for Plasmodium spp. infection using the VecTest rapid diagnostic kit.

Experimental evaluation of overhanging bamboo in Anopheles darlingi larval habitat selection in Belize, Central America.

Previous studies in Belize have shown the preferred breeding habitats of the malaria vector Anopheles darlingi were floating detritus patches within riverine systems that were associated with overhanging bamboo. The present study focused on an experimental evaluation of overhanging bamboo in An. darlingi habitat selection using larval counts as an indicator of attractiveness. Four sets of 1-m2 floating screened enclosures were placed at a location with a documented presence of both larval and adult An. darlingi populations. Each enclosure set comprised a control (i.e., open water) and three other experimental treatments consisting of: 1) detritus, 2) detritus with overhanging bamboo, and 3) overhanging bamboo alone. Larvae were sampled from all treatments on Day 5, Day 11, and Day 17 post-setup. A total of 2,461 An. darlingi larvae were collected and identified from three trials conducted from March-May 2002. Of these, 1,997 larvae were sampled from detritus treatments, 256 from enclosures with bamboo and detritus, 139 from bamboo treatments, and 69 from control enclosures. The detritus treatment had a significantly higher average count of An. darlingi larvae than the other treatments (P<0.01), and no difference existed between the control treatment and the treatment containing overhanging bamboo alone (P=0.423). More importantly, enclosures containing the overhanging bamboo with detritus treatments did not have greater larval populations than the enclosures with only detritus. These data suggest that bamboo does not contribute to An. darlingi larval habitat attractiveness but may function as a barrier to surface water flow causing the lodging of debris, the preferred habitat, that will then attract gravid females for oviposition.

Use of remote sensing and geographic information systems to predict locations of Anopheles darlingi-positive breeding sites within the Sibun River in Belize, Central America.

Previous studies have identified several anopheline species integral to the transmission of malaria in Belize. The highly efficient vector, Anopheles darlingi Root, is currently considered the most important. The preferred larval habitat of An. darlingi has been described as floating detritus patches, which are commonly associated with overhanging spiny bamboo, Guadua longifolia (E. Fourn.), along river margins. The objectives of this study were to use remote sensing and geographic information system (GIS) tools to 1) define the landscape features (i.e., river curvature, land cover, and house locations) associated with An. darlingi-positive breeding habitats and 2) determine the association between cleared land cover and the growth of spiny bamboo. A systematic survey was conducted in which all detritus patches of at least 1 m2 were sampled, mapped using GPS, and characterized by cause of habitat lodging. Bamboo stretches growing along the river margins also were mapped. Spatial analyses of satellite imagery found no associations between river characteristics or land cover with positive An. darlingi habitats. In addition, there was no significant difference in cleared versus forested land cover in relation to the presence or absence of bamboo. Results indicate that the average distance from homes to negative habitats was significantly greater than from positive detritus mats. Based on the land cover and river characteristics used, our results do not support the use of remote sensing as a predictive tool to locate specific areas within rivers positive for An. darlingi habitats.

Comparative susceptibility of three species of Anopheles from Belize, Central America, to Plasmodium falciparum (NF-54).

In August of 2000, a comparative susceptibility study was conducted using 3 species of Anopheles mosquitoes from Belize, Central America, and a standard species used in laboratory infection studies, Anopheles stephensi. Test populations were fed human blood infected with cultured Plasmodium falciparum (NF-54 strain) parasites via a membrane feeder. The control species, An. stephensi, exhibited the highest infections, with 73.8% of dissected specimens positive for sporozoites in the salivary glands. The control species also showed heavier sporozoite loads; 74.0% of positive glands having greater than 200 sporozoites. Of species from Belize, Anopheles darlingi was the most susceptibile, e.g., 41.0% of salivary glands were positive, with more than 200 sporozoites per gland. Anopheles vestitipennis had a low salivary gland infection rate (9.3%) and a moderate number of sporozoites in glands (i.e., 85.7% containing 50-250 sporozoites). Anopheles albimanus was the least susceptible species to infection. No specimens of An. albimanus from the Golden Stream population developed sporozoites in the salivary glands, yet 20.7% of dissected specimens had positive midgut infections. The An. albimanus Buena Vista population showed similar results with only a 2.2% salivary gland infection rate and a 21.5% midgut infection rate. Oocysts in An. stephensi increased in size by 20% after day 10. Development peaked at day 12, with a mean oocyst diameter of 58 microm at onset of oocyst differentiation. Oocysts developed more slowly in An. vestitipennis until day 10. After day 10, there was a 53% increase in oocyst development over the previous 10 days. Oocyst differentiation was not observed until day 13 postfeed. As with An. vestitipennis, both populations of An. albimanus showed similar slow rates of oocyst development; however, no dramatic growth increase occurred after day 10. The oocysts in the Golden Stream population exhibited a cessation of growth after day 10, peaking at a mean of 30 microm. The Buena Vista population did not exhibit the same level of reduced oocyst development. A gradual increase in growth continued until days 13 and 14 (36.7 and 35.7 microm, respectively).

Plasmodium-infected Anopheles mosquitoes collected in Virginia and Maryland following local transmission of Plasmodium vivax malaria in Loudoun County, Virginia.

Two recent outbreaks of locally acquired, mosquito-transmitted malaria in Virginia in 1998 and 2002 demonstrate the continued risk of endemic mosquito-transmitted malaria in heavily populated areas of the eastern United States. Increasing immigration, growth in global travel, and the presence of competent anopheline vectors throughout the eastern United States contribute to the increasing risk of malaria importation and transmission. On August 23 and 25, 2002, Plasmodium vivax malaria was diagnosed in 2 teenagers in Loudoun County, Virginia. The Centers for Disease Control and Prevention (CDC) deemed these cases to be locally acquired because of the lack of risk factors for malaria, such as international travel, blood transfusion, organ transplantation, or needle sharing. The patients lived approximately 0.5 mi apart; however, 1 patient reported numerous visits to friends who lived directly across the street from the other patient. Two Anopheles quadrimaculatus s.l. female pools collected in Loudoun County, Virginia, and 1 An. punctipennis female pool collected in Fairfax County, Virginia, tested positive for P. vivax 210 with the VecTest panel assay and enzyme-linked immunosorbent assay (ELISA). In addition, 2 An. quadrimaculatus s.l. female pools collected in Montgomery, Maryland, tested positive for P. vivax 210. The CDC confirmed these initial results with the circumsporozoite ELISA. The authors believe that this is the 1st demonstration of Plasmodium-infected mosquitoes collected in association with locally acquired human malaria in the United States since the current national malaria surveillance system began in 1957.

A mark-release-recapture study using a novel portable hut design to define the flight behavior of Anopheles darlingi in Belize, Central America.

Knowledge of the flight behavior of local vectors is of paramount importance in mosquito control programs. The following study defined the recapture rate of wild-caught, unengorged Anopheles darlingi females at 0, 400, and 800 m from a fixed release point in Belize, Central America, using a newly designed portable experimental hut. Three sampling trials, each consisting of 2 12-h collections, were performed at all distances from July 2002 to June 2003. A total of 1,185 An. darlingi were marked and released during the course of the study. The recapture rate was greatest at 0 m (29.0%; 124/428) and declined from 11.6% (37/318) at 400 m to 5.8% (21/361) at the 800-m site. There was no difference between the average number of marked mosquitoes recaptured inside the experimental hut versus outside the hut at any distance location. Recapture rates of each trial were highest during the first night's collection at all locations. Further examination of the first night data revealed a variation in the peak time of recapture by distances from the release point. The peak in nightly recapture at both the 0- and 400-m sites occurred within the first 2 h after sunset, and the peak recapture at the 800-m site occurred during the 7th h after sunset. Information from the present study is the first to describe the flight behavior of An. darlingi in Belize and will benefit in the development of adult-density risk assessments at the house level based on distances from potential vector breeding sites.

A novel high-throughput screening system to evaluate the behavioral response of adult mosquitoes to chemicals.

A modular and novel assay system for rapid mass screening of chemical compounds for contact irritant and spatial repellent actions against adult mosquitoes is described. The responses of Aedes aegypti to various concentrations of 3 topical repellents, deet, Bayrepel, and SS220, were evaluated. At treatment concentrations > or = 25 nmol/cm2 of SS220, mosquitoes exhibited significant contact irritant (escape) and spatial repellent (movement away from the chemical source) responses, whereas, a 10-fold increase in the treatment concentration of deet and Bayrepel was required to produce similar responses. The novel bioassay system detected contact irritancy and spatial repellency activity with reproducible results and provided baseline data for determining minimum effective concentrations for other chemicals. The system is compact in size, easy to decontaminate, and requires only a minute quantity of chemical compound.

Evaluation of habitat management strategies for the reduction of malaria vectors in northern Belize.

Mowing and burning of emergent vegetation were evaluated as potential management strategies for the control of the malaria vector, Anopheles vestitipennis, in northern Belize, Central America. The primary aim was reduction of tall dense macrophytes (dominated by Typha domingensis) as preferred larval habitat for An. vestitipennis. Nine experimental plots were established in a Typha marsh in Orange Walk District, Belize. Three plots were burned, three were treated by subaquatic mowing, and three were unaltered controls. After treatment, Typha height was most dramatically affected by the mow treatment. Plant heights at 21 and 95 days post-treatment reflected an 89% and 48% decrease, respectively, compared to pretreatment conditions. The Typha height in the burn plots was not as severely affected. Heights at 21 days post-treatment were 39% lower than those of pre-treatment vegetation, with a return to near pre-test heights by 95 days post-treatment. Both treatments resulted in a significant reduction in the number of An. vestitipennis larvae collected as compared to control plots. Conversely, the treatments resulted in increased larval densities of several other vector and pest mosquito species. Larval population densities ofAn. albimanus, Ochlerotatus taeniorhynchus, and Culex coronator were significantly higher in burn plots. In mow plots, there were significant increases in An. albimanus and Oc. taeniorhynchus larval populations. Non-target invertebrate species affected by the treatments were adult Tropisternus collaris, larval Corythrella, and adult Parapleapuella.

A mark-release-recapture study using a novel portable hut design to define the flight behavior of Anopheles darlingi in Belize, Central America

Knowledge of the flight behavior of local vectors is of paramount importance in mosquito control programs. The following study defined the recapture rate of wild-caught, unengorged Anopheles darlingi females at 0, 400, and 800 m from a fixed release point in Belize, Central America, using a newly designed portable experimental hut. Three sampling trials, each consisting of 2 12-h collections, were performed at all distances from July 2002 to June 2003. A total of 1,185 An. darlingi were marked and released during the course of the study. The recapture rate was greatest at 0 m (29.0%; 124/428) and declined from 11.6% (37/318) at 400 m to 5.8% (21/361) at the 800-m site. There was no difference between the average number of marked mosquitoes recaptured inside the experimental hut versus outside the hut at any distance location. Recapture rates of each trial were highest during the first night's collection at all locations. Further examination of the first night data revealed a variation in the peak time of recapture by distances from the release point. The peak in nightly recapture at both the 0- and 400-m sites occurred within the first 2 h after sunset, and the peak recapture at the 800-m site occurred during the 7th h after sunset. Information from the present study is the first to describe the flight behavior of An. darlingi in Belize and will benefit in the development of adult-density risk assessments at the house level based on distances from potential vector breeding sites.