The dominant Anopheles vectors of human malaria in the Asia-Pacific region: occurrence data, distribution maps and bionomic précis

<p>Abstract</p> <p>Background</p> <p>The final article in a series of three publications examining the global distribution of 41 dominant vector species (DVS) of malaria is presented here. The first publication examined the DVS from the Americas, with the second covering those species present in Africa, Europe and the Middle East. Here we discuss the 19 DVS of the Asian-Pacific region. This region experiences a high diversity of vector species, many occurring sympatrically, which, combined with the occurrence of a high number of species complexes and suspected species complexes, and behavioural plasticity of many of these major vectors, adds a level of entomological complexity not comparable elsewhere globally. To try and untangle the intricacy of the vectors of this region and to increase the effectiveness of vector control interventions, an understanding of the contemporary distribution of each species, combined with a synthesis of the current knowledge of their behaviour and ecology is needed.</p> <p>Results</p> <p>Expert opinion (EO) range maps, created with the most up-to-date expert knowledge of each DVS distribution, were combined with a contemporary database of occurrence data and a suite of open access, environmental and climatic variables. Using the Boosted Regression Tree (BRT) modelling method, distribution maps of each DVS were produced. The occurrence data were abstracted from the formal, published literature, plus other relevant sources, resulting in the collation of DVS occurrence at 10116 locations across 31 countries, of which 8853 were successfully geo-referenced and 7430 were resolved to spatial areas that could be included in the BRT model. A detailed summary of the information on the bionomics of each species and species complex is also presented.</p> <p>Conclusions</p> <p>This article concludes a project aimed to establish the contemporary global distribution of the DVS of malaria. The three articles produced are intended as a detailed reference for scientists continuing research into the aspects of taxonomy, biology and ecology relevant to species-specific vector control. This research is particularly relevant to help unravel the complicated taxonomic status, ecology and epidemiology of the vectors of the Asia-Pacific region. All the occurrence data, predictive maps and EO-shape files generated during the production of these publications will be made available in the public domain. We hope that this will encourage data sharing to improve future iterations of the distribution maps.</p

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Conocimiento sobre consentimiento informado para atención médica en unidades de primer y segundo nivel de atención

Introduction. With the rise of bioethics, in the 70s, there was a new way of doing medicine, a different relationship between the patient and health professional, whose primary characteristic we noted the most appropriate way to address today this encounter is through participation and joint deliberation. Material and Methods. A descriptive study, observational and prospective, with 120 qualified doctors and nurses in direct contact with patients in the first and second level of care, we applied a 32-item structured questionnaire based on national and international articles about informed consent, we used descriptive and inferential statistics SPSS v.19®. Results. There were 120 participants: with an average age of 46.4±10.8 and 46±8.6, schooling of 17.4±3.0 and 19.4±4.4, and years as a health professional 20.2±10.1 and 21.6±8.2 for the first and second level of care respectively. From the questions about informed consent the 37.7% were answered correctly by the first level and the 40.1% by the second level, the 98.7% and 97.5% reported interest in training in bioethics issues. Conclusions. The results indicate deficiencies in aspects regarding informed consent in both levels of health care and indicate the need for training on these issues due to the high interest in health professionals.Introducción. Con el nacimiento de la bioética, en la década de los setenta, surgió un nuevo estilo de hacer medicina, una relación diferente entre el enfermo y profesional de la salud, cuya característica primordial podemos destacar que, la manera más adecuada de abordar hoy este encuentro es a través de la participación y la deliberación conjunta. Material y Métodos. Estudio descriptivo, observacional y prospectivo, en 120 médicos(as) y enfermeros(as) titulados en contacto directo con pacientes del primer y segundo nivel de atención, se aplicó un cuestionario estructurado de 32 ítems con base en artículos nacionales e internacionales sobre consentimiento informado, se utilizó estadística descriptiva e inferencial en el paquete estadístico SPSS v.19®. Resultados. Fueron 120 participantes: con una media en años de 46.4±10.8 y 46±8.6, escolaridad de 17.4±3.0 y 19.4±4.4 y años como profesional de salud 20.2±10.1 y 21.6±8.2 para el primer y segundo nivel de atención respectivamente. De los reactivos de conocimiento sobre consentimiento informado el 37.7% fueron contestados correctamente por el primer nivel y el 40.1% por el segundo nivel, el 98.7% y 97.5% refiere interés en capacitarse en aspectos bioéticos. Conclusiones. Los resultados indican deficiencias en aspectos sobre consentimiento informado en ambos niveles de atención a la salud e indican la necesidad de realizar capacitaciones sobre estos aspectos debido al alto interés por los profesionales de la salud