The dominant Anopheles vectors of human malaria in Africa, Europe and the Middle East: occurrence data, distribution maps and bionomic précis

<p>Abstract</p> <p>Background</p> <p>This is the second in a series of three articles documenting the geographical distribution of 41 dominant vector species (DVS) of human malaria. The first paper addressed the DVS of the Americas and the third will consider those of the Asian Pacific Region. Here, the DVS of Africa, Europe and the Middle East are discussed. The continent of Africa experiences the bulk of the global malaria burden due in part to the presence of the <it>An. gambiae </it>complex. <it>Anopheles gambiae </it>is one of four DVS within the <it>An. gambiae </it>complex, the others being <it>An. arabiensis </it>and the coastal <it>An. merus </it>and <it>An. melas</it>. There are a further three, highly anthropophilic DVS in Africa, <it>An. funestus</it>, <it>An. moucheti </it>and <it>An. nili</it>. Conversely, across Europe and the Middle East, malaria transmission is low and frequently absent, despite the presence of six DVS. To help control malaria in Africa and the Middle East, or to identify the risk of its re-emergence in Europe, the contemporary distribution and bionomics of the relevant DVS are needed.</p> <p>Results</p> <p>A contemporary database of occurrence data, compiled from the formal literature and other relevant resources, resulted in the collation of information for seven DVS from 44 countries in Africa containing 4234 geo-referenced, independent sites. In Europe and the Middle East, six DVS were identified from 2784 geo-referenced sites across 49 countries. These occurrence data were combined with expert opinion ranges and a suite of environmental and climatic variables of relevance to anopheline ecology to produce predictive distribution maps using the Boosted Regression Tree (BRT) method.</p> <p>Conclusions</p> <p>The predicted geographic extent for the following DVS (or species/suspected species complex*) is provided for Africa: <it>Anopheles </it>(<it>Cellia</it>) <it>arabiensis</it>, <it>An. </it>(<it>Cel.</it>) <it>funestus*</it>, <it>An. </it>(<it>Cel.</it>) <it>gambiae</it>, <it>An. </it>(<it>Cel.</it>) <it>melas</it>, <it>An. </it>(<it>Cel.</it>) <it>merus</it>, <it>An. </it>(<it>Cel.</it>) <it>moucheti </it>and <it>An. </it>(<it>Cel.</it>) <it>nili*</it>, and in the European and Middle Eastern Region: <it>An. </it>(<it>Anopheles</it>) <it>atroparvus</it>, <it>An. </it>(<it>Ano.</it>) <it>labranchiae</it>, <it>An. </it>(<it>Ano.</it>) <it>messeae</it>, <it>An. </it>(<it>Ano.</it>) <it>sacharovi</it>, <it>An. </it>(<it>Cel.</it>) <it>sergentii </it>and <it>An. </it>(<it>Cel.</it>) <it>superpictus*</it>. These maps are presented alongside a bionomics summary for each species relevant to its control.</p

Effect of injection of Atropine-Promethazine on the duration of active phase of labor

History and Objectives: Due to importance of reducing the duration of the active phase of labor and controversies about effect of injection of Atropine-Promethazine combination on the duration of the active phase of labor, this study was performed on multiparous women referring to Shaheed Dr. Shabihkhani maternity hospital in Kashan in the second half of 1374 to evaluate the effects of injection of Atropine-Promethazine on the duration of active phase of labor. Materials and Methods: A single-blinded clinical trial was performed on 2 experimental and control groups with intramuscular injection of 0.5mg Atropine and 25mg Promethazine and 2 milliliter distilled water respectively at the beginning of the active phase of labor. Onset of the active phase was characterized by 3 centimeters dilation and 50% effacement. The previous delivery was normal in all samples and rupture of amniotic sac occurred after the onset of the active phase of labor. Women with history of abortion, hypertension, diabetes cardiac disease twin pregnancy, abnormal fetal presentation and pelvic stricture were excluded from the study. Then duration of the active phase, i.e. the time from 3 centimeters to 10 centimeters dilation, was evaluated by repeated vaginal examinations and recorded. Results: 200 multiparous women aged 18-35 years were studied. They were para 2 to para 4. Experimental and control groups each contained 100 patients that were age and para-matched. The duration of active phase of labor was 190±100 and 149±81 minutes in the experimental and control groups respectively. Injection of Atropine and Promethazine combination reduces the duration of the active phase of labor by 23.7% (P<0.001). Conclusion: Considering the effect of Atropine-Promethazine combination in reducing the duration of the active phase of labor, its administration is recommended during labor

Mechansim and outcome of hip fracture: a multi-center study

Background: We aimed to demonstrate the mechanism of fracture and functional outcome of patients with hip injury in our clinical setting. Methods: In a historical cohort, all women 50 years of age and older admitted to three university hospitals of Tehran University of Medical Sciences (Shariati, Imam Khomeini and Sina) with the diagnosis of hip fracture from 21 March 2003 to 21 March 2004 were included in this study (n=115). Follow up was conducted via telephone post and even home visit to record the functional status of the patients at the time of study (5 Jan 2005) measured with Barthel index in addition to the exact mechanism of injuries. Results: The mean and standard deviation of age were 76.3 ± 10.6 years. About 88.7% of injuries had occurred at home (65.2% on the carpet), the remaining happening in the streets. Mean length of hospitalization was 11 ± 7.9 days. Among our patients, 71% could mobilize spontaneously without aids before injuries. This had reduced to 20% at the time of follow-up. The mean Barthel index was 97.2 ± 8.2 before fracture and 75 ± 21.1 at the present. Among our patients, five cases died during hospitalization and 29 of them died afterwards (total: 34 or 29.6%). Conclusion: The most common external cause of injuries in our cases was stumbling at home especially on carpeted surfaces. This necessitates preventive measures aimed at physical standards of houses and education of elderly on healthy locomotion, indoors

Effect of Glucantime on hepatic enzymes and renal function test among patients suffering from visceral Leishmaniosis

History and Objectives: Due to the prevalence of the disease in Kashan and the fact that the treatment by glucantime as a therapeutic agent is elective, this study was conducted to evaluate the side effects of the glucantime on liver and kidney. Hepatic enzyme profile and renal function test were performed on the patients suffering from cutaneous Leishmaniosis. The present study was done on such patients in 1995. Materials and Methods: An experimental study was designed to assess the effect of glucantime therapy before and after treatment. A questionnaire pertaining to the age, sex, occupation and address of the patients was filled. Blood samples (5ml) were taken and hepatic enzymes (ALT, AST, ALP) and renal function test (BUN, Creatinine) were determined by Technicon RA-100 auto analyzer (Control group). Liver tests and renal function tests were done after 21 days of therapy by intramuscular injection of glucantime (60 mg/kg body weight/day) (Experimental group). Statistical paired t-test was conducted. Results: 70 patients, 47 females (67.1%) and 23 males (32.9%) were followed in this study (Mean age: 26.3±7.9 intervals of 5-69). Therapeutic administration of glucantime altered the concentration of ALT 1.6±7.9 P<0.05) however it did not any effects on other tests (AST, ALP, BUN, Cre). Conclusion: Therefore it is suggested that hepatic enzyme tests should be performed at intervals in order to prevent any hepatic damage

Predicted Distribution of Visceral Leishmaniasis Vectors (Diptera: Psychodidae; Phlebotominae) in Iran: A Niche Model Study

Visceral leishmaniasis (VL) is an important vector-borne disease in Iran. Till now, Leishmania infantum has been detected from five species of sand flies in the country including Phlebotomus kandelakii, Phlebotomus major s.l., Phlebotomus perfiliewi, Phlebotomus alexandri and Phlebotomus tobbi. Also, Phlebotomus keshishiani was found to be infected with Leishmania parasites. This study aimed at predicting the probable niches and distribution of vectors of visceral leishmaniasis in Iran. Data on spatial distribution studies of sand flies were obtained from Iranian database on sand flies. Sample points were included in data from faunistic studies on sand flies conducted during 1995-2013. MaxEnt software was used to predict the appropriate ecological niches for given species, using climatic and topographical data. Distribution maps were prepared and classified in ArcGIS to find main ecological niches of the vectors and hot spots for VL transmission in Iran. Phlebotomus kandelakii, Ph. major s.l. and Ph. alexandri seem to have played a more important role in VL transmission in Iran, so this study focuses on them. Representations of MaxEnt model for probability of distribution of the studied sand flies showed high contribution of climatological and topographical variables to predict the potential distribution of three vector species. Isothermality was found to be an environmental variable with the highest gain when used in isolation for Ph. kandelakii and Ph. major s.l., while for Ph. alexandri, the most effective variable was precipitation of the coldest quarter. The results of this study present the first prediction on distribution of sand fly vectors of VL in Iran. The predicted distributions were matched with the disease-endemic areas in the country, while it was found that there were some unaffected areas with the potential transmission. More comprehensive studies are recommended on the ecology and vector competence of VL vectors in the country

Modeling the Distribution of Cutaneous Leishmaniasis Vectors (Psychodidae: Phlebotominae) in Iran: A Potential Transmission in Disease Prone Areas

Cutaneous leishmaniasis (CL) is now the main vector-borne disease in Iran. Two forms of the disease exist in the country, transmitted by Phlebotomus papatasi and Phlebotomus sergenti s.l. Modeling distribution of the vector species is beneficial for preparedness and planning to interrupt the transmission cycle. Data on sand fly distribution during 1990-2013 were used to predict the niche suitability. MaxEnt algorithm model was used for prediction using bioclimatic and environmental variables (precipitation, temperature, altitude, slope, and aspect). Regularized training, area under the curve, and unregularized training gains were 0.916, 0.915, and 1.503, respectively, for Ph. papatasi. These values were calculated as 0.987, 0.923, and 1.588 for Ph. sergenti s.l. The jackknife test showed that the environmental variable with the highest gain when used in isolation has the mean temperature of the wettest quarter for both species, while slope decreases the gain the most when it is omitted from the model. Classification of probability of presence for two studied species was performed on five classes using equal intervals in ArcGIS. More than 60% probability of presence was considered as areas with high potential of CL transmission. These areas include arid and semiarid climates, mainly located in central part of the country. Mean of altitude, annual precipitation, and temperature in these areas were calculated 990 and 1,235 m, 273 and 226 mm, and 17.5 and 16.4°C for Ph. papatasi and Ph. sergenti s.l., respectively. These findings can be used in the prediction of CL transmission potential, as well as for planning the disease control interventions

Morphological and molecular characteristics of malaria vector anopheles superpictus populations in Iran

Background: Anopheles superpictus is one of the main malaria vectors in Iran. The mosquitoes of this species are found throughout the Iranian plateau up to 2000 meters above sea level in the Alborz Mountains, south of the Zagros Mountains, and in the plains near the Caspian Sea and Persian Gulf. It has been reported that different geographical populations of An. superpictus play different roles in malaria transmission. Based on the presence or absence of a black spot/band on the apical segment of the female maxillary palpi, two morphological forms have been reported in this species. This work has been conducted to study other morphological features as well as the genetic structure of these two forms of An. superpictus in Iran. Methods: The different morphological characteristics of 35 different populations were observed and recorded. An 887 bp portion of the mitochondrial DNA (mtDNA) cytochrome oxidase subunit I (COI) was amplified and assayed by restriction fragment length polymorphism (RFLP) using 18 enzymes and PCR-direct sequencing techniques.Results: Among the morphological characteristics studied, there are significant differences between the two forms with regard to the length of the palp light band (p&amp;lt;0.01), wing length (p&amp;lt;0.5), and the distance from the branching point of the II/IV veins to the tip of the wing (p&amp;lt;0.05). Results also revealed that these two forms are sympatric in most localities of Iran. RFLP analysis and sequences of about 710 bp of the gene showed that there was great variation between and/or within the populations, but these variations were not associated with the morphological forms.Conclusion: This is the first comprehensive study on the morphological and molecular characteristics of An. superpictus in the literature. To determine the role of these morphological forms or genetic haplotypes in malaria transmission, further molecular, cytological, morphological, and epidemiological studies are necessary