Health
Treating Mosquito Nets With New Insecticides Nearly Halves Malaria Infections – Contagionlive.com
Malaria, the parasitic infection spread by mosquito bites, is especially deadly for young children. Long-lasting insecticidal nets (LLINs) have significantly reduced malaria infections in sub-Saharan Africa. However, a large proportion of mosquitoes have since developed resistance to the insecticides.
One study, published in The Lancet, tested LLINs with new active ingredients to evaluate their success against malaria vectors. The study found that LLINs treated with the insecticides chlorfenapyr and pyrethroid reduced malaria infections by nearly half.
“Malaria remains a huge problem across sub-Saharan Africa and is one of the leading causes of death in Tanzania,” said Jacklin F. Mosha, PhD, the first author of the study. “We urgently need new interventions to get control efforts back on track and protect young people from this deadly disease. These exciting results highlight that we have another effective tool to help control malaria.”
The investigators conducted a cluster-randomized trial in Misungwi, Tanzania, an area in sub-Saharan African with high malaria incidence among children. The clusters were villages of at least 119 households with children 6 months-14 years of age living in the central area.
Clusters received 1 of 4 types of LLIN treated with α-cypermethrin only (pyrethroid-only control group); pyriproxyfen and α-cypermethrin (pyriproxyfen group); chlorfenapyr and α-cypermethrin (chlorfenapyr group); or the synergist piperonyl butoxide and permethrin (piperonyl butoxide group). At least 1 LLIN was given to every 2 people.
The investigators collected malaria prevalence data by administering cross-sectional surveys to randomly chosen households within each cluster. Children 6 months-14 years were screened for Plasmodium falciparum malaria infection via rapid diagnostic testing.
Each of the duel-active-ingredient LLINs were compared to the standard pyrethroid-only LLINs. The primary study outcome was malaria prevalence at 24 months after LLIN distribution. Secondary outcomes included cost-effectiveness of dual-active-ingredient LLINs.
From May 11-July 2, 2018, the investigators recruited 39307 households, broken into 84 clusters. A total of 147230 LLINs were distributed amongst the households from January 26-January 28, 2019. LLIN use was reported in 72.1% of surveyed participants at 3 months after distribution, which decreased to a 40.9% response rate at 24 months after distribution.
Malaria infection at 24 months after LLIN dispersal was 45.8% in the pytheroid-only group, 37.5% in the pyriproxyfen group, 40.7% in the piperonyl butoxide group, and 25.6% in the chlorfenapyr group. The most cost-effective LLINs were chlorfenapyr, and the most commonly reported adverse events were skin irritation or paresthesia. The study authors noted that poor textile quality and active ingredient durability of the piperonyl butoxide and pyriproxyfen LLINs may have lowered their efficacy.
Overall, the LLINs treated with chlorfenapyr and pytheroid reduced malaria infections by 43% in the first year and 37% in the second year. Chlorfenapyr works differently from the standard pytheroid-only LLINs, causing wing muscles cramps that stop the mosquitos from flying, and thus from biting hosts.
“What really threw us for a long time was that in daytime tests the chlorfenapyr was not very toxic to the mosquito,” said Mark Rowland, PhD, an author of the study. “But at night when the malaria mosquitoes naturally fly up against the treated bednet it gets a severe case of muscle cramps so it buckles and falls to where it is likely to be carried off by scavenging ants. No other mosquito insecticide works like this, and because of the unique mode of action it kills all kind of mosquito that have evolved resistance to other insecticides. It should have a long future.”
The investigators concluded that after 2 years, the chlorfenapyr LLINs provided better malaria protection than the pyrethroid-only LLINs, in an area with pyrethroid-resistant mosquitoes.
However, they noted that switching over to the chlorfenapyr nets should be done with caution, to avoid the mosquitoes once again developing resistance. “The massive scale-up of standard pyrethroid LLINs 10-20 years ago led to the rapid spread of pyrethroid resistance. The challenge now is to preserve chlorfenapyr’s effectiveness by developing rational resistance management strategies,” said Natacha Protopopoff, PhD, a principal investigator.
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Alberta Health Services (AHS) has confirmed a case of measles in Edmonton, and is advising the public that the individual was out in public while infectious.
Measles is an extremely contagious disease that is spread easily through the air, and can only be prevented through immunization.
AHS says individuals who were in the following locations during the specified dates and times, may have been exposed to measles.
- April 16
- Edmonton International Airport, international arrivals and baggage claim area — between 3:20 p.m. and 6 p.m.
- April 20
- Stollery Children’s Hospital Emergency Department — between 5 a.m. to 3 p.m.
- April 22
- 66th Medical Clinic (13635 66 St NW Edmonton) — between 12:15 p.m. to 3:30 p.m.
- Pharmacy 66 (13637 66 St NW Edmonton) — between 12:15 p.m. to 3:30 p.m.
- April 23
- Stollery Children’s Hospital Emergency Department — between 4:40 a.m. to 9:33 a.m.
AHS says anyone who attended those locations during those times is at risk of developing measles if they’ve not had two documented doses of measles-containing vaccine.
Those who have not had two doses, who are pregnant, under one year of age, or have a weakened immune system are at greatest risk of getting measles and should contact Health Link at 1-877-720-0707.
Symptoms
Symptoms of measles include a fever of 38.3° C or higher, cough, runny nose, and/or red eyes, a red blotchy rash that appears three to seven days after fever starts, beginning behind the ears and on the face and spreading down the body and then to the arms and legs.
If you have any of these symptoms stay home and call Health Link.
In Alberta, measles vaccine is offered, free of charge, through Alberta’s publicly funded immunization program. Children in Alberta typically receive their first dose of measles vaccine at 12 months of age, and their second dose at 18 months of age.
Health
U.S. tightens rules for dairy cows a day after bird flu virus fragments found in pasteurized milk samples – Toronto Star
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Infected cows were already prohibited from being transported out of state, but that was based on the physical characteristics of the milk, which looks curdled when a cow is infected, or a cow has decreased lactation or low appetite, both symptoms of infection.
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Germans Debate Longer Hours and Later Retirement as Economic Growth Falters – Bloomberg
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