Knowledge among Drug Dispensers and Antimalarial Drug Prescribing Practices in Public Health Facilities in Dar es Salaam.

Irrational prescribing and dispensing of antimalarials has been identified as a contributing factor in the emergence of malaria parasites resistant to existing antimalarial drugs. Factors that contribute to such irrational prescribing and dispensing should therefore be identified to address this problem. The aim of this study was to assess irrational antimalarial drug dispensing and prescribing practices in public health facilities. A descriptive-retrospective cross-sectional study was conducted between January and June 2011 in order to assess prescribing and dispensing practices for antimalarial drugs in three public hospitals and nine health centers in Dar es Salaam, Tanzania. Thirty-two drug dispensers were interviewed using a structured questionnaire. A total of 4,320 prescriptions for the period January to December 2010 were collected and assessed for antimalarial drug prescribing patterns. The majority (84.6%) of drug dispensers had poor knowledge regarding the basic information required from patients before dispensing artemether-lumefantrine. Seventeen of 32 drug dispensers did not know the basic information that should be given to patients in order to increase absorption of artemether-lumefantrine after oral intake. Most drug dispensers also showed limited knowledge about the dosage and contraindications for artemether-lumefantrine. Eighty-seven percent of all prescriptions contained artemether-lumefantrine as the only antimalarial drug, 77.1% contained at least one analgesic, and 26.9% contained at least one antibiotic, indicating unnecessary use of analgesics and antibiotics with antimalarial drugs. A substantial number of prescriptions contained antimalarial drugs that have already been declared ineffective for the treatment of malaria in Tanzania, providing additional evidence of inadequate knowledge among health care workers concerning treatment policy. Despite the government's efforts to increase public awareness regarding use of artemether-lumefantrine as first-line treatment for uncomplicated malaria, there is still irrational prescribing, dispensing, and use of this combination. Based on the results of this study, it is proposed that regular on-the-job training and continuing education be provided to drug dispensers and prescribers in public health facilities

Evaluation of semiochemical based push-pull strategy for population suppression of ambrosia beetle vectors of laurel wilt disease in avocado.

Ambrosia beetles (Coleoptera: Curculionidae: Scolytinae and Platypodinae) bore into tree xylem to complete their life cycle, feeding on symbiotic fungi. Ambrosia beetles are a threat to avocado where they have been found to vector a symbiotic fungus, Raffaelea lauricola, the causal agent of the laurel wilt disease. We assessed the repellency of methyl salicylate and verbenone to two putative laurel wilt vectors in avocado, Xyleborus volvulus (Fabricius) and Xyleborus bispinatus (Eichhoff), under laboratory conditions. Then, we tested the same two chemicals released from SPLAT flowable matrix with and without low-dose ethanol dispensers for manipulation of ambrosia beetle populations occurring in commercial avocado. The potential active space of repellents was assessed by quantifying beetle catch on traps placed 'close' (~5-10 cm) and 'far' (~1-1.5 m) away from repellent dispensers. Ambrosia beetles collected on traps associated with all in-field treatments were identified to species to assess beetle diversity and community variation. Xyleborus volvulus was not repelled by methyl salicylate (MeSA) or verbenone in laboratory assays, while X. bispinatus was repelled by MeSA but not verbenone. Ambrosia beetle trap catches were reduced in the field more when plots were treated with verbenone dispensers (SPLAT) co-deployed with low-dose ethanol dispensers than when treated with verbenone alone. Beetle diversity was highest on traps deployed with low-dose ethanol lures. The repellent treatments and ethanol lures significantly altered the species composition of beetles captured in experiment plots. Our results indicate that verbenone co-deployed with ethanol lures holds potential for manipulating ambrosia beetle vectors via push-pull management in avocado. This tactic could discourage immigration and/or population establishment of ambrosia beetles in commercial avocado and function as an additional tool for management programs of laurel wilt

Comparison of Three Dispenser Distribution Patterns for Pheromone Mating Disruption of Paralobesia viteana (Lepidoptera: Tortricidae) in Vineyards

Over two growing seasons, Isomate GBM-Plus tube-type dispensers releasing the major pheromone component of grape berry moth, Paralobesia viteana (Clemens) (Lepidoptera: Tortricidae), were evaluated in vineyards (Vitis spp.) in Michigan, New York, and Pennsylvania. Dispensers were deployed in three different density-arrangement treatments: 124 dispensers per ha, 494 dispensers per ha, and a combined treatment with 124 dispensers per ha in the vineyard interior and 988 dispensers per ha at the vineyard border, equivalent to an overall density of 494 dispensers per ha. Moth captures and cluster infestation levels were compared at the perimeter and interior of vineyards receiving these different pheromone treatments and in vineyards receiving no pheromone. Orientation of male moths to pheromone-baited traps positioned at the perimeter and interior of vineyards was reduced as a result of mating disruption treatments compared with the nontreated control. These findings were consistent over both years of the study. Disruption of male moth captures in traps varied from 93 to 100% in treated vineyards, with the 494 dispensers per ha application rates providing significantly higher level of disruption than the 124 dispensers per ha rate, but only in 2007. Measurements of percentage of cluster infestation indicated much higher infestation at perimeters than in the interior of the vineyards in all three regions, but in both sample positions there was no significant effect of dispenser density on cluster infestation levels in either year. The contrasting results of high disruption of moth orientation to traps in vineyards that also had low levels of crop protection from this pheromone treatment are discussed in the context of strategies to improve mating disruption of this tortricid pes

Opportunistic use of a wool-like artificial material as lining of Tit (Paridae) nests

The lining material is a key element of bird nests primarily serving as insulation for the adult, eggs and/or chicks but collection of such material will have an energetic cost. This study investigated the nest building effort of four species of tit (Paridae) in an English wood by determining the use of colored, wool-like artificial nest lining material over the period 2000-2010. The distances that birds carried the material from source to nest was recorded for each nest as an indirect measure of the energetic cost of collection of nest material by individual birds. Birds did not always use nest material from the nearest source to their nest and some birds collected material from 2, 3 or 4 well-separated sources. There was no detectable color preference in choice of material and few birds would travel more than 200 m to gather the material. Use of the material appeared to depend on the species. Within defined areas around material dispensers not all individual Great Tits (Parus major) used the artificial material and, for all species examined, the proportion of birds using the material declined with increasing distance between source and nest. Use of artificial material suggested that selection of nest materials was probably opportunistic but also reflected the preference of these species for a wool-like nest-lining

Application of Basic Pharmacology and Dispensing Practice of Antibiotics in Accredited Drug-Dispensing Outlets in Tanzania.

Provision of pharmaceutical services in accredited drug-dispensing outlets (ADDOs) in Tanzania has not been reported. This study compared the antibiotics dispensing practice between ADDOs and part II shops, or duka la dawa baridi (DLDBs), in Tanzania. This was a cross-sectional study that was conducted in ADDOs and DLDBs. A simulated client method for data collection was used, and a total of 85 ADDOs, located in Mvomero, Kilombero, and Morogoro rural districts, were compared with 60 DLDBs located in Kibaha district. The research assistants posed as simulated clients and requested to buy antibiotics from ADDOs and DLDBs after presenting a case scenario or disease condition. Among the diseases presented were those requiring antibiotics and those usually managed only by oral rehydration salt or analgesics. The simulated clients wanted to know the antibiotics that were available at the shop. The posed questions set a convincing ground to the dispenser either to dispense the antibiotic directly, request a prescription, or refer the patient to a health facility. Proportions were used to summarize categorical variables between ADDOs and DLDBs, and the chi-square test was used to test for statistical difference between the two drug-outlet types in terms of antibiotic-dispensing practice. As many as 40% of trained ADDO dispensers no longer worked at the ADDO shops, so some of the shops employed untrained staff. A larger proportion of ADDOs than DLDBs dispensed antibiotics without prescriptions (P = 0.004). The overall results indicate that there was no difference between the two types of shops in terms of adhering to regulations for dispensing antibiotics. However, in some circumstances, eg, antibiotic sale without prescription and no referral made, for complicated cases, ADDOs performed worse than DLDBs. As many as 30% of DLDBs and 35% of ADDOs dispensed incomplete doses of antibiotics. In both ADDOs and DLDBs, fortified procaine penicillin powder was dispensed as topical application for injuries. There was no statistical difference between ADDOs and DLDBs in the violation of dispensing practice and both ADDOs and DLDBs expressed poor knowledge of the basic pharmacology of antibiotics

Testing the Temporal Limits of Lures and Toxicants for Trapping Fruit Flies (Diptera: Tephritidae): Additional Weathering Studies of Solid Bactrocera and Zeugodacus Male Lures and Associated Insecticidal Strips

Detection of pestiferous fruit flies (Diptera: Tephritidae) relies largely on traps baited with male-specific attractants. Surveillance programs in Florida and California use liquid methyl eugenol (ME, attractive to males of Bactrocera dorsalis (Hendel)) and liquid cue-lure (CL, attractive to males of Zeugodacus cucurbitae (Coquillett)) mixed with the toxicant naled to bait detection traps. However, this practice requires considerable time and may subject personnel to health risks. Recent work indicates that solid male lures deployed with a separate insecticidal (DDVP) strip are as effective as the standard liquid formulations. Specifically, solid ME and CL dispensers and DDVP strips were weathered for 6 or 12 weeks under summer conditions in AZ and FL and subsequently field tested in Hawaii. Results showed that (i) solid ME dispensers weathered for 6 weeks, but not 12 weeks, were as attractive as fresh liquid ME, and (ii) solid CL dispensers and the insecticidal strips were as effective as fresh liquid formulation for at least 12 weeks. The present study expands upon these earlier findings and addresses two specific questions: Could solid ME dispensers be deployed for 8 or 10 weeks without loss of effectiveness? Could solid CL dispensers and insecticidal strips be deployed for intervals even longer than 12 weeks? Adopting the same protocol noted above, the present study indicates that effective field longevities are 10 weeks for solid ME dispensers, at least 20 weeks for solid CL dispensers, and 12 weeks for the DDVP strips. Comparisons are drawn with related studies, and implications for tephritid surveillance programs are discussed

Characterization of Alkali Metal Dispensers and Non-Evaporable Getter Pumps in Ultra-High Vacuum Systems for Cold Atomic Sensors

A glass ultrahigh vacuum chamber with rubidium alkali metal dispensers and non-evaporable getter pumps has been developed and used to create a cold atomic sample in a chamber that operates with only passive vacuum pumps. The ion-mass spectrum of evaporated gases from the alkali metal dispenser has been recorded as a function of dispenser current. The efficacy of the non-evaporable getter pumps in promoting and maintaining vacuum has been characterized by observation of the Rb vapor optical absorption on the D2 transition at 780 nm and vacuum chamber pressure rate of rise tests. We have demonstrated a sample of laser-cooled Rb atoms in this chamber when isolated and operating without active vacuum pumps

Primacy of effective communication and its influence on adherence to artemether-lumefantrine treatment for children under five years of age: a qualitative study.

BACKGROUND\ud \ud Prompt access to artemesinin-combination therapy (ACT) is not adequate unless the drug is taken according to treatment guidelines. Adherence to the treatment schedule is important to preserve efficacy of the drug. Although some community based studies have reported fairly high levels of adherence, data on factors influencing adherence to artemether-lumefantrine (AL) treatment schedule remain inadequate. This study was carried-out to explore the provider's instructions to caretakers, caretakers' understanding of the instructions and how that understanding was likely to influence their practice with regard to adhering to AL treatment schedule.\ud \ud METHODS\ud \ud A qualitative study was conducted in five villages in Kilosa district, Tanzania. In-depth interviews were held with providers that included prescribers and dispensers; and caretakers whose children had just received AL treatment. Information was collected on providers' instructions to caretakers regarding dose timing and how to administer AL; and caretakers' understanding of providers' instructions.\ud \ud RESULTS\ud \ud Mismatch was found on providers' instructions as regards to dose timing. Some providers' (dogmatists) instructions were based on strict hourly schedule (conventional) which was likely to lead to administering some doses in awkward hours and completing treatment several hours before the scheduled time. Other providers (pragmatists) based their instruction on the existing circumstances (contextual) which was likely to lead to delays in administering the initial dose with serious treatment outcomes. Findings suggest that, the national treatment guidelines do not provide explicit information on how to address the various scenarios found in the field. A communication gap was also noted in which some important instructions on how to administer the doses were sometimes not provided or were given with false reasons.\ud \ud CONCLUSIONS\ud \ud There is need for a review of the national malaria treatment guidelines to address local context. In the review, emphasis should be put on on-the-job training to address practical problems faced by providers in the course of their work. Further research is needed to determine the implication of completing AL treatment prior to scheduled time

Versatile Cold Atom Source for Multi-Species Experiments

We present a dual-species oven and Zeeman slower setup capable of producing slow, high-flux atomic beams for loading magneto-optical traps. Our compact and versatile system is based on electronic switching between different magnetic field profiles and is applicable to a wide range of multi-species experiments. We give details of the vacuum setup, coils and simple electronic circuitry. In addition, we demonstrate the performance of our system by optimized, sequential loading of magneto-optical traps of lithium-6 and cesium-133.Comment: 7 pages, 10 figure