Effects of co-habitation between Anopheles gambiae s.s. and Culex quinquefasciatus aquatic stages on life history traits

<p>Abstract</p> <p>Background</p> <p>The effective measures for the control of malaria and filariasis vectors can be achieved by targeting immature stages of anopheline and culicine mosquitoes in productive habitat. To design this strategy, the mechanisms (like biotic interactions with conspecifc and heterospecific larvae) regulating mosquito aquatic stages survivorship, development time and the size of emerging adults should be understood. This study explored the effect of co-habitation between <it>An. gambiae </it>s.s. and <it>Cx. quinquefasciatus </it>on different life history traits of both species under different densities and constant food supply in the habitats of the same size under semi-natural conditions.</p> <p>Methods</p> <p>Experiments were set up with three combinations; <it>Cx. quinquefasciatus </it>alone (single species treatment), <it>An. gambiae </it>s.s. alone (single species treatment); and <it>An. gambiae </it>s.s. with <it>Cx. quiquefasciatus </it>(co-habitation treatment) in different densities in semi field situation.</p> <p>Results</p> <p>The effect of co-habitation of <it>An. gambiae </it>s.s. and <it>Cx. quinquefasciatus </it>was found to principally affect three parameters. The wing-lengths (a proxy measure of body size) of <it>An. gambiae </it>s.s. in co-habitation treatments were significantly shorter in both females and males than in <it>An. gambiae </it>s.s single species treatments. In <it>Cx. quinquefasciatus</it>, no significant differences in wing-length were observed between the single species and co-habitation treatments. Daily survival rates were not significantly different between co-habitation and single species treatments for both <it>An. gambiae </it>s.s. and <it>Cx. quinquefasciatus</it>. Developmental time was found to be significantly different with single species treatments developing better than co-habitation treatments. Sex ratio was found to be significantly different from the proportion of 0.5 among single and co-habitation treatments species at different densities. Single species treatments had more males than females emerging while in co-habitation treatments more females emerged than males. In this study, there was no significant competitive survival advantage in co-habitation.</p> <p>Conclusion</p> <p>These results suggest that co-habitation of <it>An. gambiae </it>s.s. and <it>Cx. quinquefasciatus </it>in semi-natural conditions affect mostly <it>An. gambiae </it>s.s. body size. Hence, more has to be understood on the effects of co-habitation of <it>An. gambiae </it>s.s. and <it>Cx. quinquefasciatus </it>in a natural ecology and its possible consequences in malaria and filariasis epidemiology.</p

Patient satisfaction with antiretroviral services at primary health-care facilities in the Free State, South Africa – a two-year study using four waves of cross-sectional data

<p>Abstract</p> <p>Background</p> <p>The study's first objective was to determine the levels of patient satisfaction with services at antiretroviral treatment (ART) assessment sites. Differences in patient satisfaction with several aspects of service over time and among health districts were measured. The second objective was to examine the association between human resource shortages and levels of patient satisfaction with services.</p> <p>Methods</p> <p>Four cross-sectional waves of data were collected from a random sample of 975 patients enrolled in the Free State's public-sector ART programme. One-way analysis of variance (ANOVA) with the Bonferroni adjustment for multiple comparisons was used to assess the differences in patient satisfaction among the Province's five districts and among the four waves of data. Correlation coefficient analysis using Pearson's <it>r </it>was used to assess the association between ART nurse vacancy rates and patient satisfaction with the services provided by nurses over time.</p> <p>Results</p> <p>With respect to both general services and the services provided by nurses, our results indicate high overall satisfaction among Free State patients receiving public-sector ART. However, our data present a less positive picture of patient satisfaction with waiting times. Patients in Fezile Dabi District were generally slightly dissatisfied with the waiting times at their assessment sites. In fact, waiting times at assessment sites were the most important predictor of discontent among ART patients. Significant geographical (<it>P </it>< 0.001) and temporal differences (<it>P </it>< 0.005) were observed in these three aspects of patient satisfaction. Patients were most satisfied in Thabo Mofutsanyana District and least satisfied in Motheo District. Patients in Fezile Dabi District were generally slightly dissatisfied with the waiting times at their assessment sites. Finally, our analysis revealed a strong negative association (<it>r </it>= -0.438, <it>P </it>< 0.001) between nurse vacancy rates and mean satisfaction levels with services performed by nurses at baseline. Patients attending facilities with high professional nurse vacancy rates reported significantly less satisfaction with nurses' services than did those attending facilities with fewer vacant nursing posts.</p> <p>Conclusion</p> <p>Collectively, our findings show high levels of patient satisfaction with ART-related services, but also confirm claims by other studies, which have identified human resource shortages as the most important obstacle to a successful South African AIDS strategy.</p