Infectious Disease

Knudsen AB, Slooff R. Vector-borne disease problems in rapid urbanization: new approaches to vector control. Bull World Health Organ [Internet]. 1992;70 :1-6. Publisher's VersionAbstract

Owing to population growth, poor levels of hygiene, and increasing urban poverty, the urban environment in many developing countries is rapidly deteriorating. Densely packed housing in shanty towns or slums and inadequate drinking-water supplies, garbage collection services, and surface-water drainage systems combine to create favourable habitats for the proliferation of vectors and reservoirs of communicable diseases. As a consequence, vector-borne diseases such as malaria, lymphatic filariasis and dengue are becoming major public health problems associated with rapid urbanization in many tropical countries. The problems in controlling these diseases and eliminating vectors and pests can be resolved by decision-makers and urban planners by moving away from the concept of "blanket" applications of pesticides towards integrated approaches. Sound environmental management practices and community education and participation form the mainstay of some of the most outstanding successes in this area. On the basis of these examples, it is argued that the municipal authorities need to apply a flexible methodology, which must be based on the possibilities of mobilizing community resources, with minimal reliance on routine pesticidal spraying. In this way, vector control becomes a by-product of human development in the city environment. This is now a true challenge.

Patz JA, Graczyk TK, Geller N, Vittor AY. Effects of environmental change on emerging parasitic diseases. International Journal for Parasitology [Internet]. 2000;30 :1395-1405. Publisher's VersionAbstract

Ecological disturbances exert an influence on the emergence and proliferation of malaria and zoonotic parasitic diseases, including, Leishmaniasis, cryptosporidiosis, giardiasis, trypanosomiasis, schistosomiasis, filariasis, onchocerciasis, and loiasis. Each environmental change, whether occurring as a natural phenomenon or through human intervention, changes the ecological balance and context within which disease hosts or vectors and parasites breed, develop, and transmit disease. Each species occupies a particular ecological niche and vector species sub-populations are distinct behaviourally and genetically as they adapt to man-made environments. Most zoonotic parasites display three distinct life cycles: sylvatic, zoonotic, and anthroponotic. In adapting to changed environmental conditions, including reduced non-human population and increased human population, some vectors display conversion from a primarily zoophyllic to primarily anthrophyllic orientation. Deforestation and ensuing changes in landuse, human settlement, commercial development, road construction, water control systems (dams, canals, irrigation systems, reservoirs), and climate, singly, and in combination have been accompanied by global increases in morbidity and mortality from emergent parasitic disease. The replacement of forests with crop farming, ranching, and raising small animals can create supportive habitats for parasites and their host vectors. When the land use of deforested areas changes, the pattern of human settlement is altered and habitat fragmentation may provide opportunities for exchange and transmission of parasites to the heretofore uninfected humans. Construction of water control projects can lead to shifts in such vector populations as snails and mosquitoes and their parasites. Construction of roads in previously inaccessible forested areas can lead to erosion, and stagnant ponds by blocking the flow of streams when the water rises during the rainy season. The combined effects of environmentally detrimental changes in local land use and alterations in global climate disrupt the natural ecosystem and can increase the risk of transmission of parasitic diseases to the human population.

Shaman J, Day JF, Stieglitz M. St. Louis encephalitis virus in wild birds during the 1990 south Florida epidemic: the importance of drought, wetting conditions, and the emergence of Culex nigripalpus (Diptera: Culicidae) to arboviral amplification and transmission. J Med Entomol [Internet]. 2003;40 :547-54. Publisher's VersionAbstract

We analyzed the prevalence of hemagglutination inhibition (HI) antibodies to St. Louis encephalitis (SLE) virus in wild birds during the 1990 SLE epidemic in Indian River County. The initial presence of SLE HI antibody was associated significantly with modeled drought 15 wk prior, wetting conditions 1 wk prior, and the emergence of the Florida SLE virus vector, Culex nigripalpus, 5 wk prior. Our findings indicated that three factors conspired to create the 1990 epidemic: (1) a large population of susceptible wild birds; (2) severe springtime drought, which facilitated amplification of the SLE virus among the Cx. nigripalpus and a portion of the wild bird population; and (3) continued rainfall and wetting of the land surface in the summer and early fall, which sustained a large, host-seeking Cx. nigripalpus population. The continued biting and reproductive activity of Cx. nigripalpus maintained epizootic transmission throughout the summer and early fall in Indian River County. The high level of SLE virus amplification resulted in spillover transmission to humans. We hypothesize that without the continued reproductive activity of the vector mosquito, brought about by excessive summer and fall wetness, the unprecedented SLE virus amplification and consequent transmission to humans would not have been realized in 1990.

Victor TJ, Reuben R. Effects of organic and inorganic fertilisers on mosquito populations in rice fields of southern India. Medical and Veterinary Entomology [Internet]. 2000;14 :361-368. Publisher's VersionAbstract

The effects of nitrogenous (inorganic) fertilisers, organic manures and blue-green algae (BGA) biofertiliser on mosquito populations (Diptera: Culicidae) were studied in rice fields of Madurai, Tamil Nadu, south India, with particular attention to Culex vishnui Theobald, Cx. pseudovishnui Colless and Cx. tritaeniorhynchus Giles, the vectors of Japanese encephalitis (JE). The application of urea, a nitrogenous fertilizer, in rice fields significantly increased the grain yield and the population densities of mosquito larvae and pupae (anophelines as well as culicines) in a dose-related manner. Fields treated with inorganic fertilisers (N, P, K) had significantly higher population densities of mosquito immatures than fields treated with organic manures (farmyard manure and green manure). Without nitrogenous fertiliser, BGA increased paddy yield without enhancing mosquito production. Therefore, the use of BGA with less nitrogenous fertiliser is recommended, which is beneficial economically and agronomically to the farming community and also significantly reduces mosquito production in rice fields. Increased use of nitrogenous fertiliser over the past two decades may have contributed to the increased severity of Japanese encephalitis epidemics, vectors of which breed in rice fields.

Bavia ME, Malone JB, Hale L, Dantas A, Marroni L, Reis R. Use of thermal and vegetation index data from earth observing satellites to evaluate the risk of schistosomiasis in Bahia, Brazil. Acta Tropica [Internet]. 2001;79 :79-85. Publisher's VersionAbstract

A geographic information system (GIS) was constructed using maps of regional agroclimatic features, vegetation indices and earth surface temperature data from environmental satellites, together with Schistosoma mansoni prevalence records from 270 municipalities including snail host distributions in Bahia, Brazil to study the spatial and temporal dynamics of infection and to identify environmental factors that influence the distribution of schistosomiasis. In an initial analysis, population density and duration (months) of the annual dry period were shown to be important determinants of disease. In cooperation with the National Institute of Spatial Research in Brazil (INPE), day and night imagery data covering the state of Bahia were selected at approximately bimonthly intervals in 1994 (six day-night pairs) from the data archives of the advanced very high resolution radiometer (AVHRR) sensor of the National Oceanic and Atmospheric Administration (NOAA)-11 satellite. A composite mosaic of these images was created to produce maps of: (1) average values between 0 and +1 of the normalized difference vegetation index (NDVI); and (2) average diurnal temperature differences (dT) on a scale of values between 0 and 15 degrees C. For each municipality, NDVI and dT were calculated for a 3x3 pixel (9 km(2) area) grid and analyzed for relationships to prevalence of schistosomiasis. Results showed a statistically significant relationship of prevalence to dT (rho=-0.218) and NDVI (rho=0.384) at the 95% level of confidence by the Spearman rank correlation coefficient. Results support use of NDVI, dT, dry period climatic stress factors and human population density for development of a GIS environmental risk assessment model for schistosomiasis in Brazil.

Engle-Stone R, Haskell MJ, Ndjebayi AO, Nankap M, Erhardt JG, Gimou M-M, Brown KH. Plasma Retinol-Binding Protein Predicts Plasma Retinol Concentration in Both Infected and Uninfected Cameroonian Women and Children. The Journal of Nutrition [Internet]. Submitted;141 :2233-2241. Publisher's VersionAbstract

Variation in the relationship between plasma retinol-binding protein (RBP) and retinol (ROH) has implications for vitamin A (VA) status assessment using RBP. Our objectives were to identify factors affecting the RBP:ROH relationship and to derive and evaluate population-specific RBP cutoffs for VA deficiency (VAD) in Cameroon. Plasma RBP, C-reactive protein (CRP), α1-acid-glycoprotein (AGP), and ROH concentrations were compared in a subsample of women 15–49 y (n = 121) and children 12–59 mo (n = 123) included in a national survey conducted in 2009. Plasma RBP and ROH were highly correlated (r = 0.94 for women; r = 0.96 for children; P < 0.001). Pregnancy and lactation altered the RBP:ROH relationship in women, but obesity, elevated CRP and AGP, age, and VA status did not. Among children, age altered the RBP:ROH relationship, but sex, stunting, VA status, and elevated CRP and AGP did not. Cutoffs for VAD derived using regression analysis were <1.17 μmol RBP/L for women (corresponding to <1.05 μmol ROH/L) and <0.83 μmol RBP/L for children (corresponding to <0.70 μmol ROH/L). The sensitivity and specificity of derived cutoffs were 81.8 and 93.0% for women and 94.7 and 88.9% for children, respectively. The infection-adjusted prevalence of low VA status (<1.17 μmol RBP/L) was 21.9% (95% CI = 18.7–25.0%) among women. Among children, the infection-adjusted prevalence of VAD (<0.83 μmol RBP/L) was 35.0% (95% CI = 31.1–39.0%). In conclusion, VAD remains a public health problem in Cameroon. The RBP:ROH relationship should be considered in surveys using RBP to assess VA status, and use of population-specific cutoffs may be advisable.

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