20 research outputs found

    Comparative efficacy of two poeciliid fish in indoor cement tanks against chikungunya vector Aedes aegypti in villages in Karnataka, India

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    <p>Abstract</p> <p>Background</p> <p>In 2006, severe outbreaks of <it>Aedes aegypti</it>-transmitted chikungunya occurred in villages in Karnataka, South India. We evaluated the effectiveness of combined information, education and communication (IEC) campaigns using two potential poeciliid larvivorous fish guppy (<it>Poecilia reticulata</it>) and mosquitofish (<it>Gambusia affinis</it>), in indoor cement tanks for <it>Aedes </it>larval control.</p> <p>Methods</p> <p>Trials were conducted in two villages (Domatmari and Srinivaspura) in Tumkur District from March to May 2006 for <it>Poecilia </it>and one village (Balmanda) in Kolar District from July to October 2006 for <it>Gambusia</it>. A survey on knowledge, attitude and practice (KAP) on chikungunya was initially conducted and IEC campaigns were performed before and after fish release in Domatmari (IEC alone, followed by IEC + <it>Poecilia</it>) and Balmanda (IEC + <it>Gambusia</it>). In Srinivaspura, IEC was not conducted. Larval surveys were conducted at the baseline followed by one-week and one-month post-intervention periods. The impact of fish on <it>Aedes </it>larvae and disease was assessed based on baseline and post-intervention observations.</p> <p>Results</p> <p>Only 18% of respondents knew of the role of mosquitoes in fever outbreaks, while almost all (<it>n </it>= 50 each) gained new knowledge from the IEC campaigns. In Domatmari, IEC alone was not effective (OR 0.54; <it>p </it>= 0.067). Indoor cement tanks were the most preferred <it>Ae. aegypti </it>breeding habitat (86.9%), and had a significant impact on <it>Aedes </it>breeding (Breteau Index) in all villages in the one-week period (<it>p </it>< 0.001). In the one-month period, the impact was most sustained in Domatmari (OR 1.58, <it>p </it>< 0.001) then Srinivaspura (OR 0.45, <it>p </it>= 0.063) and Balmanda (OR 0.51, <it>p </it>= 0.067). After fish introductions, chikungunya cases were reduced by 99.87% in Domatmari, 65.48% in Srinivaspura and 68.51% in Balmanda.</p> <p>Conclusions</p> <p><it>Poecilia </it>exhibited greater survival rates than <it>Gambusia </it>(86.04 <it>vs</it>.16.03%) in cement tanks. Neither IEC nor <it>Poecilia </it>alone was effective against <it>Aedes </it>(<it>p </it>> 0.05). We conclude that <it>Poecilia </it>+ IEC is an effective intervention strategy. The operational cost was 0.50 (US0.011,1US 0.011, 1 US= 47) per capita per application. Proper water storage practices, focused IEC with <it>Poecilia </it>introductions and vector sanitation involving the local administration and community, is suggested as the best strategy for <it>Aedes </it>control.</p

    Additional efficacy analysis of avatrombopag phase III data for the treatment of adults with immune thrombocytopenia

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    Avatrombopag is an oral thrombopoietin receptor agonist (TPO-RA) that was approved in the US in 2019 for treatment of chronic immune thrombocytopenia (ITP). This post hoc analysis of the pivotal phase III study (NCT01438840) of avatrombopag in adult patients with ITP evaluated platelet count response to avatrombopag during the core study in different subgroups, and durability of response data in patients who responded to avatrombopag treatment both during the core phase (total population) and during the core and extension phase (total population and by subgroup). Loss of response (LOR [platelet count <30 × 109/L]) was defined as LOR over two consecutive scheduled visits. The response was generally similar between subgroups though a few differences were observed. The durability of response analysis showed that avatrombopag-treated patients maintained their response for 84.5% of time on treatment during the core phase and 83.3% during the core and extension phase; 55.2% of patients in the core phase and 52.3% in the core and extension phase never experienced LOR. We conclude that the initial response to avatrombopag is both stable and durable
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