Vectors control importance on leishmaniasis transmission

We reviewed the control of transmission of leishmaniasis regarding chemotherapy, reservoirs elimination, vaccination and insect control through the use of chemical insecticides. We also discussed complementary measures like monitoring traps, impregnated bednets and curtains, repelents, pheromones, biological control, etc. A cost comparison of insecticide interventions through the use of products belonging to the four main chemical groups was also alone, comparing together conventional formulations versus a slow-release insecticide developed by the Núcleo de Pesquisas de Produtos Naturais, Universidade Federal do Rio de Janeiro. We finally did recommendations on the situation that would justify an insecticide intervention to control sandflies.

The brazilian leishmaniasis control program

The control methods used in Brazil for both cutaneous and visceral leishmaniasis by the Ministry of Health's National Health Foundation (Fundação Nacional de Saúde) are presented. Data referring to the programme between 1980 and 1991 is presented. There was an increase in the total number of notified cases of cutaneous leishmaniasis until 1987 and from this date onwards the number has remained between 23,000 and 26,000 per year. There were significantly fewer cases of visceral leishmaniasis during the same period and until 1991 the greatest number of cases reported in one year was 2,511 in 1985. The overall picture is that it is difficult to evaluate to what extent the control methods employed have reduced the number of cases of either form of the disease. It is suggested that there is an urgent need for a closer approximation of research and health workers to review the actual control strategies and to define procedures capable of assessing accurately their impact.

Bacillus and Serratia species for Scarab control

Few microorganisms are commercially available for use against white grubs (larvae of Scarabaeidae). Entomopathogenic bacteria, particularly Bacillus popilliae, have been used the longest for white grub suppression. Other bacteria, namely B. thuringiensis and Serratia spp. offer promise for future control. This papes examines two genera of bacteria (Bacillus and Serratia) from the historical and current perspective. Bacillus popilliae, the firs microbial control agent registered in the United States, has a long history of use in suppressing populations of the Japanese beetle, Popillia japonica. However, lack of in vitro production and the slow and sporadic nature of its activity, severely limits its utilization. B. thuringiensis, the most widely used microbial pesticide, has not been used for scarab, control. However, strains with scarab activity have recently been discovered. Scarab larvae have been collected in the United States with signs and symptoms similar to those characteristic of amber disease (caused by Serratia entomophila) in the New Zealand grass grub, Costelytra zealandica. A total of 147 bacteria have been obtained from the digestive tracts of larvae of the Japanese beetle and masked chafers, Cyclocephala spp., as well as from larvae and soil collected in Japan and China. Seventy five of these have been identified as Serratia spp. Most (40) of the remaining bacteria are in the genus Enterobacter. A majority of the bacteria (73) and of the Serratia (38) came from P. japonica.

Transfer of toxin genes to alternate bacterial hosts for mosquito control

Mosquitoes are vector of serious human and animal diseases, such as malaria, dengue, yellow fever, among others. The use of biological control agents has provide an environmentally safe and highly specific alternative to the use of chemical insecticides in the control of vector borne diseases. Bacillus thuringiensis and B. sphaericus produce toxic proteins to mosquito larvae. Great progress has been made on the biochemical and molecular characterization of such proteins and the genes encoding them. Nevertheless, the low residuality of these biological insecticides is one of the major drawbacks. This article present some interesting aspects of the mosquito larvae feeding habits and review the attempts that have been made to genetically engineer microorganisms that while are used by mosquito larvae as a food source should express the Bacillus toxin genes in order to improve the residuality and stability in the mosquito breeding ponds.

Integrated control measures against Culex quinquefasciatus, the vector of filariasis in Recife

Integrated control measures against Culex quinquefasciastus have been implemented in a pilot urban area in Recife, Brazil. About 3,000 breeding sites found within the operational area were responsible for very high mosquito densities recorded during the pretrial period. Physical control measures have been applied to cess pits before starting a series of 37 treatments of the other sites with Bacillus sphaericus strain 2362, over 27 months. In spite of the difficulties due to environmental conditions, very significant reductions in preimaginal population of C. quinquefasciatus were achieved and, as a consequence, low adult mosquito densities were maintained for a relatively long period of time. Entomological and environmental data gathered in this pilot project can contribute to design an integrated mosquito control program in Recife city.

Biological control program against simuliids in the State of São Paulo, Brazil

In Brazil, the use of biological vector-control methods has been largely confined to experimental research, with little or no application of such techniques by public institutions responsible for implementing control programs. The notable exceptions have been the black fly control program carried out by the Health Secretariat in the State of São Paulo. Since the 1980s, São Paulo's "Superintendência de Controle de Endemias" has been conducting studies on the viability of using Bacillus thuringiensis (H-14) for simuliid control, and the results have been so encouraging that the agency has now incorporated this method into its Simuliid Control Program.

Determination and control of schistosomiasis

The subject of this conference reflects the scientific community's interest in seeking to understand the complex causal web whose various social, economic, and biological components interact in the production and reproduction of schistosomiasis and its control in relation to community participation. From the onset, the author stresses the impossibility of dealing separately with community participation, as if social components were just one more "weapon" in the arsenal for schistosomiasis control. This study begins with a brief historical review of the 71 years of control activities with this endemic disease, stressing the enormous efforts and huge expenditures in this field vis-à-vis the limited results, despite the extraordinary technological development of specific, classical control inputs such as new treatment drugs and molluscicides. The article then discusses the various strategies used in control programs, emphasizing ideological consistencies and contradictions. Interactions at the macro and micro levels are discussed, as are the determinants and risk factors involved in producing the disease's endemicity. Unequal occupation of space leaves the segregated portion of the population exposed to extremely favorable conditions for transmission of the disease. This raises the issue of how to control an endemic disease which is so closely linked to the way of life imposed on the population. The study challenges the classical control model and suggests an alternative model now undergoing medium-term investigation in the States of Espirito Santo, and Pernambuco, Brazil. The author concludes that we do not need new strategies, but a new control model, contrary to the prevailing classical model in both concept and practice. From the conceptual point of view, the new model mentioned above is different from others in that schistosomiasis control is seen from a social perspective stressing the population's accumulated knowledge in addition to the building of shared knowledge. The model's praxis has the following characteristics: (1) it is integrated with and financed by research agencies and health services; (2) it operates at the local health services level; (3) use of molluscicides has been eliminated; (4) emphasis is given to individual medical treatment and improvement of sanitary conditions.

Molluscicide control of snail vectors of schistosomiasis

A review of the methodology recommended by the World Health Organization for the use of molluscicides for the control of snail vectors of schistosomiasis is presented. Discussion of the principle molluscicides used, their advantages and disadvantages, the techniques and equipment required for their application and evaluation of effect as well as the biological control of snails is included.

Schistosoma mansoni: control of female fertility by the male

We have established an in vitro culture system for adult schistosomes that allows monitoring gene expression for up to more than ten days. Comparing female worms that are paired with those that have been separated, we find distinct differences, clearly documenting an influence of the male in female gene expression. In perfect coincidence with classical observations that were based on histological techniques, we find that the male particularly regulates gene expression in those tissues that are characterized by cell proliferation, e.g. the vitellaria. From these results, we hypothesize that the key target for the inductive signal that is transferred from the male to the female during pairing is the activation of a growth factor that stimulates mitotic proliferation.

The snail hosts of schistosomiasis: some evolutionary and ecological perspectives in relation to control

Despite opportunities for radiation provided by spatio-temporal isolation, the basic morphological plan of pulmonate snails has remained conservative. In consequence of the resulting dearth of morphological characters and their plasticity, there is a case for using biochemical characters such as exogenous chemicals released by the snails (e.g. amino acids) and their chemoreception niche as taxonomic aids to classify snails of medical importance. As these same chemicals are used by snails to distinguish conspecifics they could also be used as "environmental antibodies" in controlled release formulations (CRF's) designed to remove target snails in a specific, cost-effective and ecologically acceptable manner. The snails, surface-living bacteria, algae and macrophytic plants are considered as co-evolved, interactive modular systems with strong mutualistic elements. Recently, anthropogenic perturbations such as deforestation, and damming of flowing waters, have benefited these modules whereas others such as river canalization, acid deposition, accumulation of pesticide residues and eutrophication have harmed them. Research is needed to elucidate the factors which limit the growth of snails in primitive habitats, uninfluenced by man, as well as in those subject to harmful anthropogenic factors. The understanding thus gained could be applied to develop cost-effective primary health care strategies to reduce or prevent transmission of schistosomiasis and other water related diseases.

Health education, public information, and communication in schistosomiasis control in Brazil: a brief retrospective and perspectives

In recent years, the strategy for the control of schistosomiasis has placed increased emphasis on the role of health education, public information, and communication. This should, not only bring about specific changes in behavior aiming at disease prevention, but also stimulate participation of the community in health programs. Beyond this, it is desirable that both community members and researchers should seek better life conditions through a transformative social action. The present paper addresses these concerns; first, by critically reviewing some health education programs that were developed in Brazil, and, secondly, by analyzing and suggesting ways to improve this area.

Current concepts of snail control

Schistosomiasis control was impossible without effective tools. Synthetic molluscicides developed in the 1950s spearheaded community level control. Snail eradication proved impossible but repeated mollusciciding to manage natural snail populations could eliminate transmission. Escalating costs, logistical complexity, its labour-intensive nature and possible environmental effects caused some concern. The arrival of safe, effective, single-dose drugs in the 1970s offered an apparently better alternative but experience revealed the need for repeated treatments to minimise reinfection in programmes relying on drugs alone. Combining treatment with mollusciciding was more successful, but broke down if mollusciciding was withdrawn to save money. The provision of sanitation and safe water to prevent transmission is too expensive in poor rural areas where schistosomiasis is endemic; rendering ineffective public health education linked to primary health care. In the tropics, moreover, children (the key group in maintaining transmission) will always play in water. Large scale destruction of natural snail habitats remains impossibly expensive (although proper design could render many new man-made habitats unsuitable for snails). Neither biological control agents nor plant molluscicides have proved satisfactory alternatives to synthetic molluscicides. Biologists can develop effective strategies for using synthetic molluscicides in different epidemiological situations if only, like drugs, their price can be reduced.

Control of schistosomiasis in Brazil: perspectives and proposals

Attempts to control schistosomiasis have hitherto involved the use of one or more of the following methods, either in isolation or in combination: (1) control of the intermediate host using molluscicides or biological methods; (2) basic sanitation and clean water supply; (3) health education; (4) individual or mass treatment; (5) protection of individuals in such a way as to prevent cercariae from penetrating the skin; (6) vaccine-based strategies against schistosomiasis. None of these methods is capable, on its own, of bringing about effective control of schistosomiasis, except in populations of a very limited size or under very special conditions. Molluscicides, besides expensive and toxic, have only a temporary effect. As for biological control, there is no effective method yet. Basic sanitation and clean water supply combined with health education potentially constitute the most effective approach, but only in the mid-to-long term. Mass treatment reduces morbidity, but does not control transmission. Protection of individuals has proved to be impracticable on a large scale. Vaccine-based strategies against schistosomiasis are still in the experimental stage. Experiments carried out in Brazil in the last 20 years have shown that mass treatment with single doses of oxamniquine or praziquantel can rapidly reduce levels of Shistosoma mansoni infection and morbidity in endemic areas. They have also shown that subsequent transmission and reinfection frequently occur in defined foci or "clusters", due to human contact with water, and in inverse proportion to the number and frequency of treatments carried out. On the basis of these experiments, the author suggests a multidisciplinary strategy for schistosomiasis control.

Control of schistosomiasis transmission

Despite the success of control programmes, schistosomiasis is still a serious public health problem in the world. More than 70 countries where 200 million individuals are evaluated to be infected of a total 600 million at risk. Though there have been important local success in the control of transmission, globally the infection has increased. Economic constrains in developing countries, environmental changes associated with migration and water resources development have been blocking the progress. The main objective of schistosomiasis control is to achieve reduction of disease due to schistosomiasis. We discussed the control measures like: health education, diagnosis and chemotherapy, safe water supplies, sanitation and snail control. We emphasized the need to give priority to school-age children and the importance of integrating the measures of control into locally available systems of health care. The control of schistosomiasis is directly related to the capacity of the preventive health services of an endemic country. The strategy of control requires long-term commitment from the international to the local level.