Although vector control has proven highly effective in preventing disease transmission, it is not being used to its full potential, thereby depriving disadvantaged populations of the benefits of well tried and tested methods. Following the discovery of synthetic residual insecticides in the 1940s, large-scale programmes succeeded in bringing many of the important vector-borne diseases under control. By the late 1960s, most vector-borne diseases - with the exception of malaria in Africa - were no longer considered to be of primary public health importance. The result was that control programmes lapsed, resources dwindled, and specialists in vector control disappeared from public health units, within two decades, many important vector-borne diseases had re-emerged or spread to new areas. The time has come to restore vector control to its key role in the prevention of disease transmission, albeit with an increased emphasis on multiple measures, whether pesticide-based or involving environmental modification, and with a strengthened managerial and operational capacity. Integrated vector management provides a sound conceptual framework for deployment of cost-effective and sustainable methods of vector control. This approach allows for full consideration of the complex determinants of disease transmission, including local disease ecology, the role of human activity in increasing risks of disease transmission, and the socioeconomic conditions of affected communities.

There is a growing body of evidence that social mobilization and communication are critical to sustainable dengue prevention and control. This paper summarizes key features of 12 national case studies of dengue -related social mobilization and communication initiatives (presented in this Special Supplement). The case studies were originally commissioned to illustrate key points in a WHO guide on planning social mobilization and communication for dengue prevention and control (Parks and Lloyd 2004). The paper contains the original case studies modified only to keep each reasonably brief and to facilitate cross-case comparisons. As a collection, the case studies provide unique insights into a new generation of dengue programmes.

As an alternative to the use of commercially available, expanded-polystyrene beads, a study was made of the effectiveness of shredded, waste polystyrene (SWAP) for the control of Culex quinquefasciatus. The relevant physical properties of the SWAP were first investigated in the laboratory. Then, under field conditions in wet pit latrines, mosquito emergence rates were measured before and after application of the material. In the laboratory, when compared with the commercial product, the irregular shape of the SWAP particles greatly reduced their capacity to spread over the water surface and the interstitial air spaces also permitted respiration and development of mosquito larvae. Nevertheless, under field conditions, with careful application of the SWAP over the water surfaces in wet pit latrines, almost complete control of mosquito breeding was observed within a few days. This was sustained for 60 days, at which time observations were discontinued. SWAP appears to offer an effective, cheap and readily available alternative to the commercial product for the control of C. quinquefasciatus. The practicality of using it in community-based, mosquito-control programmes warrants further study.

A microfilaria survey was conducted in Trinidad in 1992, 12 years after mass treatment with spaced doses of diethylcarbamazine citrate (DEC-C) for the control of Bancroftian filariasis; 348 persons were examined using thick blood smears and a membrane filtration technique. They included 104 who had participated in the mass chemotherapy campaign in 1980. No Wuchereria bancrofti microfilariae were detected among 66% of the population examined. In 1980, 86 of 592 persons examined were found to be infected with W. bancrofti, 140 with Mansonella ozzardi and 44 with mixed infections, while in 1992, only M. ozzardi infections persisted despite treatment with DEC-C. Of the 104 persons reexamined 12 years later, 46 had M. ozzardi, of which five were new cases, but none had W. bancrofti. During both the 1980 and 1992 surveys, low microfilariae rates for M. ozzardi were observed among those 19 years of age or younger. Of the 302 persons newly examined in 1992, 29 were infected with significantly (P < 0.001) more males (79.3%) than females (20.9%) being microfilaremic. The combined results showed similar prevalence rates for M. ozzardi from 23.3% to 21.6% in 1980 and 1992. Nuclepore membrane filtration and thick blood films were very efficient in demonstrating the presence of microfilariae. The usefulness of these methods and spaced treatment using DEC-C are also discussed.

The priorities of public health planners are often at variance with the community's own environmental sanitation priorities and perspectives. Public opinion about individual, collective, and governmental responsibilities in addressing these issues and priorities is of particular importance when designing community-based programs. In a study conducted in Trinidad and Tobago on knowledge, attitudes, and practice regarding dengue, its prevention and control, a high level of awareness about dengue and its etiology was evident, but there was poor understanding of the symptoms and hence little concern about the health risks associated with it. The most important household pest problem identified by the respondents was related to mosquito nuisance, particularly from night-biting mosquitoes. Rodents were also a major concern perceived as being responsible for economic losses, ruined food, and a health hazard. Unreliable water supply, a factor associated with Aedes aegypti abundance, was an environmental sanitation issue of major importance to householders in rural areas. No correlation was found between knowledge of dengue and levels of Ae. aegypti abundance as measured by larval surveys of the respondents' premises. The study gave a clear indication of the need for broad-based environmental sanitation strategies when planning community-based vector control initiatives for the prevention and control of dengue in Trinidad and Tobago.

A random sample bloodsmear survey was conducted during evening hours in Georgetown, Guyana, to determine the prevalence of Wuchereria bancrofti microfilariae. In all, 182 of 2,818 persons tested (6.5%) yielded positive results--indicating that the overall prevalence of Bancroftian filariasis has not diminished and may be on the rise. Relatively high prevalences found in children and adolescents point to active transmission. It appears likely that certain socioeconomic and environmental factors have been contributing to such transmission, and that similar factors could encourage increased transmission elsewhere in the Americas as well.

The effects of a mass chemotherapy programme using spaced doses of diethylcarbamazine citrate on Wuchereria bancrofti microfilaraemias and vector infection rates were studied in an isolated rural community of 650 people in north Trinidad where a microfilaria rate of 15% had previously been recorded. A single oral dose of 6mg/kg body weight was given at monthly intervals for one year. After 6 months, 79% (52/66) of persons previously microfilaraemic had become negative. After 12 months the negative proportion had increased to 90% (63/70). The geometric mean microfilaria density of those still microfilaraemic was reduced from 19.7 to 4.6 per 100mm3 of blood. Of 147 initially negative persons, none had become positive following treatment. Filarial infection rates in Culex quinquefasciatus from randomly sampled houses fell from 6.4% to zero; in houses where occupants with microfilaraemia had been identified before treatment, the rate was reduced from 15.8% to zero. In a supplementary study, however, weekly collections from one initially positive house showed a rapid decline in the vector infection rate from 43% to 2% after three months but an additional 3 months elapsed before the index reached zero. There was negligible microfilarial uptake by the vectors from residual low-density microfilaraemias (<10 microfilariae per 100mm3 of blood) after chemotherapy.

Journal Article Similar patterns of acid phosphatase activity in Mansonella ozzardi microfilariae from Trinidad and Guyana Get access M.B. Nathan, M.B. Nathan U.K. Medical Research Council, PAHO/WHO Caribbean Epidemiology Centre, P.O. Box 164, Port of Spain, Trinidad, W.I. Search for other works by this author on: Oxford Academic PubMed Google Scholar M.S. Omar M.S. Omar Bernhard-Nocht-Institut fur Schiffs- und Tropenkrankheiten, Bernhard-Nocht-Str. 74, D-2000 Hamburg 4, West Germany Search for other works by this author on: Oxford Academic PubMed Google Scholar Transactions of The Royal Society of Tropical Medicine and Hygiene, Volume 77, Issue 1, 1983, Page 141, https://doi.org/10.1016/0035-9203(83)90048-2 Published: 01 January 1983 Article history Accepted: 21 September 1982 Published: 01 January 1983

In order to conduct experimental infection studies of Mansonella ozzardi in local haematophagous Diptera, volunteers infected with this parasite were identified during a microfilaria survey in four Amerindian villages in the Pakaraima Mountains of western Guyana, near the Brazilian border. M. ozzardi microfilariae were detected in thick blood smears from 8-21% of persons examined. They were also found in skin snips from 8/73 persons all of whom were positive by blood smear examination. No Onchocerca volvulus microfilariae were detected. Dipetalonema perstans infections were found in three of the four villages but prevalence rates were only 1-8%. Manbaited catches of haematophagous Diptera made at the onset of the dry season in one of the villages yielded only three Simulium species. After flies were engorged on infected volunteers, M. ozzardi larvae developed to the infective stage in 6-7 days in the most abundant species, a member of the Simulium amazonicum group. Man-biting rates of up to 156 per 15-minute period were recorded for this species in midday collections along river banks near one of the villages. Developing filariae, including infective larvae of M. ozzardi, were also found in wild-caught flies. It was concluded that this Simulium species is a vector of M. ozzardi in the study area.

A parasitological and clinical survey of Wuchereria bancrofti and Mansonella ozzardi was conducted in Blanchisseuse, an isolated rural community of 650 people in coastal north Trinidad. W. bancrofti microfilariae were found in 15% of the resident population and the prevalence was higher in males (19%) than in females (12%). Microfilaraemias were undetected in children under 5 years of age but 12% of children and adolescents between 5 and 19 years of age were positive. Microfilaraemias were most common in males aged 40-59 years (34%) and in females in the same age group (21%). Whereas geometric mean microfilaria densities were generally higher in females than in males under 40 years old, in the older age groups the pattern was reversed, the difference being especially pronounced in the over 60s. There were more than 2 times as many males with M. ozzardi microfilariae (35%) than there were females (15%). The prevalence was low in children and young adults but increased with age thereafter. In the older age groups microfilaria densities followed a similar trend. Genital signs compatible with lymphatic filarial disease were seen in 29% of males; these included hydrocoele (15%) and elephantiasis of the scrotum (1%). Most signs were seen in persons over 50 years of age. 6% of females had lymphoedema of the leg(s), and in 4 cases (2.3%) this had progressed to elephantiasis. A positive association was found between M. ozzardi microfilaraemia and clinical history of articular pain. The findings suggest that both filarial species are of some public health significance in at least 1 rural area of Trinidad, and they provide a basis for the development of a lymphatic filariasis control strategy in the community.

The efficacy of a membrane (Nuclepore) filtration technique using capillary blood (100 mm2) for the detection of blood-circulating microfilariae was investigated during a prevalence survey for Wuchereria bancrofti and Mansonetta ozzardi in north Trinidad by comparing results thus obtained with results from conventional thick smear preparations (25 mm3) and from membrane (Nuclepore) filtration of venous blood (1 ml).Prevalence rates of W. bancrofti were 14% by thick smear, 17% by filtration of capillary blood and 16% by filtration of venous blood. For M. ozzardi the corresponding rates were 27%, 29% and 31%.A total of 389 persons was examined by all three methods. Microfilaria detection rates for both of the filtration techniques were significantly higher than by thick smear preparation, with the exception of results for M. ozzardi obtained by filtration of capillary blood.There was no significant difference between the number of positive persons detected by filtration of capillary blood and filtration of venous blood.Significantly higher microfilaria densities per unit volume of blood were recorded by thick smear preparation and filtration of capillary blood than by filtration of venous blood, whereas results for the two capillary blood techniques were similar.In the detection of low density microfilaraemias, membrane filtration of capillary blood provides a practical and sensitive alternative to venous blood filtration and has the additional advantage of capillary blood collection rather than venepuncture.

Between June 1976 and November 1977, man-baited and truck-trap collections of haematophagous Diptera were made on the foreshore of Las Cuevas Bay, north Trinidad, close to a fishing village where Mansonella ozzardi infections are prevalent in man. Culicoides phlebotomus (Will.) predominated in all collections, forming 96·1% of the total catch. Analysis of blood-meals from engorged C. phlebotomus collected by truck trapping at sunset indicated frequent feeding on mammals, with feeds on man comprising 47% of those identified. Filarial larvae were found in 0·8% of 6767 females of C. phlebotomus captured on man, and five (0·08%) had infective larvae of M. ozzardi. Similarly, 1·3% of 7028 females obtained by truck trapping were infected, including nine (0·13%) with infective larvae. Growth rates of M. ozzardi in C. phlebotomus were determined by experimental infection and were used to estimate daily survival rates of wild-caught females of C. phlebotomus based on filarial growth stages found in them. The daily survival rate varied from 85 to 95% in flies 1–3 days after infection to 69% in flies six days after infection. It was estimated that a person spending one hour on the beach every morning would receive 38 infective bites from C. phlebotomus per annum.

The diurnal flight and biting activity patterns of Culicoides phlebotomus (Will.) were investigated during ten all-day (06·00–19·00 h) trapping sessions at Las Cuevas Bay, north Trinidad. A comparison was made of the results obtained by biting catches, paddle trapping (in which a piece of greased wire screen was swung in front of the collector's legs) and truck trapping. Biting activity persisted throughout the day, with peaks of activity one to two hours after sunrise and again at sunset. Truck trapping recorded little variation in flight activity of empty females during daylight hours, but that of engorged, half-gravid and gravid females was greater during the afternoon than in the morning. Male flight activity was high in the early morning and mid-afternoon but declined rapidly towards sunset. Paddle trapping alone recorded a substantial increase in the blood-seeking activity of parous females after sunset. The paddle-trapping technique was found to be a useful alternative to biting collections for the study of anthropophilic Culicoides.

The intensity of transmission of Wuchereria bancrofti was measured in a coastal community in north Trinidad where 15% of the residents were microfilaraemic. The only significant vector, Culex quinquefasciatus, was studied in detail to determine seasonal abundance, longevity, infection and infectivity rates. Only 2·1% of the indoor biting population and 7·0% of the indoor resting population were infected. The daily mortality rate of the vector increased with age from 27% at four days to 44 to 47% at 12 days and is considered to be an important factor contributing to the low infectivity rate (0·1%). The mean number of C. quinquefasciatus bites received by a resident of the village during the year of observation was estimated to be 17,948 of which 14 were from mosquitoes harbouring infective larvae of W. Bancrofti. The results from similar studies elsewhere are outlined, but the need for standardization of procedures is emphasized before more reliable comparisons can be made.