The Retail Market for Bednets in Kenya: How Well Is It Working?

Background Achieving the goals set by Roll Back Malaria and the Government of Kenya for use of insecticide treated bednets (ITNs) will require that the private retail market for nets and insecticide treatments grow substantially. This paper applies some basic concepts of market structure and pricing to a set of recently-collected retail price data from Kenya in order to answer the question, “How well are Kenyan retail markets for ITNs working?” Methods Data on the availability and prices of ITNs at a wide range of retail outlets throughout Kenya were collected in January 2002, and vendors and manufacturers were interviewed regarding market structure. Findings Untreated nets are manufactured in Kenya by a number of companies and are widely available in large and medium-sized towns. Availability in smaller villages is limited. There is relatively little geographic price variation, and nets can be found at competitive prices in towns and cities. Marketing margins on prices appear to be within normal ranges. No finished nets are imported. Few pre-treated nets or net+treatment combinations are available, with the exception of the subsidized Supanet/Power Tab combination marketed by a donor-funded social marketing project. Conclusions Retail markets for untreated nets in Kenya are well established and appear to be competitive. Markets for treated nets and insecticide treatment kits are not well established. The role of subsidized ITN marketing projects should be monitored to ensure that these projects support, rather than hinder, the development of retail markets.

Spatial distribution of bednet coverage under routine distribution through the public health sector in a rural district in Kenya.

Insecticide-treated nets (ITNs) are one of the most important and cost-effective tools for malaria control. Maximizing individual and community benefit from ITNs requires high population-based coverage. Several mechanisms are used to distribute ITNs, including health facility-based targeted distribution to high-risk groups; community-based mass distribution; social marketing with or without private sector subsidies; and integrating ITN delivery with other public health interventions. The objective of this analysis is to describe bednet coverage in a district in western Kenya where the primary mechanism for distribution is to pregnant women and infants who attend antenatal and immunization clinics. We use data from a population-based census to examine the extent of, and factors correlated with, ownership of bednets. We use both multivariable logistic regression and spatial techniques to explore the relationship between household bednet ownership and sociodemographic and geographic variables. We show that only 21% of households own any bednets, far lower than the national average, and that ownership is not significantly higher amongst pregnant women attending antenatal clinic. We also show that coverage is spatially heterogeneous with less than 2% of the population residing in zones with adequate coverage to experience indirect effects of ITN protection.

Reduction of malaria prevalence by indoor residual spraying: a meta-regression analysis.

Indoor residual spraying (IRS) has become an increasingly popular method of insecticide use for malaria control, and many recent studies have reported on its effectiveness in reducing malaria burden in a single community or region. There is a need for systematic review and integration of the published literature on IRS and the contextual determining factors of its success in controlling malaria. This study reports the findings of a meta-regression analysis based on 13 published studies, which were chosen from more than 400 articles through a systematic search and selection process. The summary relative risk for reducing malaria prevalence was 0.38 (95% confidence interval = 0.31-0.46), which indicated a risk reduction of 62%. However, an excessive degree of heterogeneity was found between the studies. The meta-regression analysis indicates that IRS is more effective with high initial prevalence, multiple rounds of spraying, use of DDT, and in regions with a combination of Plasmodium falciparum and P. vivax malaria.

Using decision analysis to improve malaria control policy making.

Malaria and other vector-borne diseases represent a significant and growing burden in many tropical countries. Successfully addressing these threats will require policies that expand access to and use of existing control methods, such as insecticide-treated bed nets (ITNs) and artemesinin combination therapies (ACTs) for malaria, while weighing the costs and benefits of alternative approaches over time. This paper argues that decision analysis provides a valuable framework for formulating such policies and combating the emergence and re-emergence of malaria and other diseases. We outline five challenges that policy makers and practitioners face in the struggle against malaria, and demonstrate how decision analysis can help to address and overcome these challenges. A prototype decision analysis framework for malaria control in Tanzania is presented, highlighting the key components that a decision support tool should include. Developing and applying such a framework can promote stronger and more effective linkages between research and policy, ultimately helping to reduce the burden of malaria and other vector-borne diseases.

Determinación de la actividad insecticida de Solanum sisymbriifolium, Cestrum parqui y Chenopodium album sobre adultos de Tribolium castaneum (Coleptera, Tenebrionidae)

p.373-377

Acrinatrín 15 CE nuevo acaricida - insecticida en frutales de pepita : desarrollo a campo

p.203-213

Multi-function oxidases are responsible for the synergistic interactions occurring between repellents and insecticides in mosquitoes

Background: With the spread of pyrethroid resistance in mosquitoes, the combination of an insecticide (carbamate or organophosphate) with a repellent (DEET) is considered as a promising alternative strategy for the treatment of mosquito nets and other relevant materials. The efficacy of these mixtures comes from the fact that they reproduce pyrethroid features and that positive interactions occur between insecticides and repellent. To better understand the mechanisms involved and assess the impact of detoxifying enzymes (oxidases and esterases) in these interactions, bioassays were carried out in the laboratory against the main dengue vector Aedes aegypti. Methods: Topical applications of DEET and propoxur (carbamate), used alone or as a mixture, were carried out on female mosquitoes, using inhibitors of the two main detoxification pathways in the insect. PBO, an inhibitor of multi-function oxidases, and DEF, an inhibitor of esterases, were applied one hour prior to the main treatment. Results: Results showed that synergism between DEET and propoxur disappeared in the presence of PBO but not with DEF. This suggests that oxidases, contrary to esterases, play a key role in the interactions occurring between DEET and cholinesterase inhibitors in mosquitoes. Conclusion: These findings are of great interest for the implementation of "combination nets" in the field. They support the need to combine insecticide with repellent to overcome insecticide resistance in mosquitoes of public health importance.

Multiple attractors of host-parasitoid models with integrated pest management strategies: eradication, persistence and outbreak

Host-parasitoid models including integrated pest management (IPM) interventions with impulsive effects at both fixed and unfixed times were analyzed with regard to host-eradication, host-parasitoid persistence and host-outbreak solutions. The host-eradication periodic solution with fixed moments is globally stable if the host's intrinsic growth rate is less than the summation of the mean host-killing rate and the mean parasitization rate during the impulsive period. Solutions for all three categories can coexist, with switch-like transitions among their attractors showing that varying dosages and frequencies of insecticide applications and the numbers of parasitoids released are crucial. Periodic solutions also exist for models with unfixed moments for which the maximum amplitude of the host is less than the economic threshold. The dosages and frequencies of IPM interventions for these solutions are much reduced in comparison with the pest-eradication periodic solution. Our results, which are robust to inclusion of stochastic effects and with a wide range of parameter values, confirm that IPM is more effective than any single control tactic.

Label-free based quantitative proteomics analysis of primary neonatal porcine Leydig cells exposed to the persistent contaminant 3-methylsulfonyl-DDE

Evidence that persistent environmental pollutants may target the male reproductive system is increasing. The male reproductive system is regulated by secretion of testosterone by testicular Leydig cells, and perturbation of Leydig cell function may have ultimate consequences. 3-Methylsulfonyl-DDE (3-MeSO₂-DDE) is a potent adrenal toxicants formed from the persistent insecticide DDT. Although studies have revealed the endocrine disruptive effect of 3-MeSO₂-DDE, the underlying mechanisms at cellular level in steroidogenic Leydig cells remains to be established. The current study addresses the effect of 3-MeSO₂-DDE on viability, hormone production and proteome response of primary neonatal porcine Leydig cells. The AlamarBlue™ assay was used to evaluate cell viability. Solid phase radioimmunoassay was used to measure concentration of hormones produced by both unstimulated and Luteinizing hormone (LH)-stimulated Leydig cells following 48h exposure. Protein samples from Leydig cells exposed to a non-cytotoxic concentration of 3-MeSO₂-DDE (10μM) were subjected to nano-LC-MS/MS and analyzed on a Q Exactive mass spectrometer and quantified using label-free quantitative algorithm. Gene Ontology (GO) and Ingenuity Pathway Analysis (IPA) were carried out for functional annotation and identification of protein interaction networks. 3-MeSO₂-DDE regulated Leydig cell steroidogenesis differentially depending on cell culture condition. Whereas its effect on testosterone secretion at basal condition was stimulatory, the effect on LH-stimulated cells was inhibitory. From triplicate experiments, a total of 6804 proteins were identified in which the abundance of 86 proteins in unstimulated Leydig cells and 145 proteins in LH-stimulated Leydig cells was found to be significantly regulated in response to 3-MeSO₂-DDE exposure. These proteins not only are the first reported in relation to 3-MeSO₂-DDE exposure, but also display small number of proteins shared between culture conditions, suggesting the action of 3-MeSO₂-DDE on several targeted pathways, including mitochondrial dysfunction, oxidative phosphorylation, EIF2-signaling, and glutathione-mediated detoxification. Further identification and characterization of these proteins and pathways may build our understanding to the molecular basis of 3-MeSO₂-DDE induced endocrine disruption in Leydig cells.

Ecotoxicological tests using Chironomus riparius

Os sistemas aquáticos naturais podem estar sujeitos frequentemente a entrada de tóxicos, quer seja através da lixiviação dos campos agrícolas ou da descarga por parte de unidades industriais. Avaliar o impacto potencial destes contaminantes nos sistemas aquáticos é muito importante, porque pode promover consequências sérias no balanço ecológico dos ecossistemas. Os efeitos de níveis sub-letais destes tóxicos nas populações aquáticas são detectados, em muitos casos, somente após diversas gerações, dependendo da espécie e do contaminante. O comportamento animal é considerado como sendo a primeira linha de defesa perante estímulos ambientais, e pode ser uma representação de alterações fisiológicas no organismo, sendo portanto um indicador excelente de alterações ambientais. O desenvolvimento dos sistemas de aviso prévio que integram parâmetros comportamentais pode ajudar a prever mais rapidamente possíveis alterações ao nível das populações naturais, do que a utilização de testes ecotoxicológicos padrão com a mesma finalidade. O conhecimento acerca de possíveis implicações devido a alterações comportamentais, em organismos bentónicos e em populações do campo sujeitas a tóxicos, é ainda escasso. Sabendo isto, neste estudo pretendeu-se investigar como o comportamento de Chironomus riparius – usando um biomonitor em tempo real – e outros parâmetros tais como crescimento, emergência de adultos, bioacumulação e biomarcadores, são afectados pela exposição a imidacloprid e ao mercúrio, que foram seleccionados como contaminantes. Os resultados demonstraram que a exposição às concentrações sub-letais de imidacloprid afecta o crescimento e o comportamento dos quironomídeos e que estes organismos podem recuperar de uma exposição curta ao insecticida. O comportamento que corresponde à ventilação de C. riparius revelou-se como um parâmetro mais sensível do que a locomoção e do que as respostas bioquímicas, quando as larvas foram sujeitas ao imidacloprid. Larvas de C. riparius expostas a concentrações sub-letais de mercúrio apresentaram uma tendência de diminuição de actividade comportamental, em testes com concentrações crescentes do tóxico; o crescimento das larvas foi também prejudicado, e as taxas de emergência de adultos e o tempo de desenvolvimento apresentaram retardamento. Estes organismos podem bioacumular rapidamente o mercúrio em condições de não alimentação e apresentam uma lenta depuração deste metal. Estes efeitos podem, em último caso, conduzir a prováveis repercussões ao nível da população e das comunidades. As reduções em actividades comportamentais, mesmo em concentrações baixas, podem diminuir a quantidade de tempo gasta na procura de alimento, produzindo efeitos aos níveis morfo-fisiológicos, e assim afectar severamente o desempenho dos quironomídeos no ambiente. O uso destes factores comportamentais como um parâmetro ecotoxicológico sub-letal relevante ao nível da toxicologia aumentará a versatilidade dos testes, permitindo uma resposta comportamental mensurável e quantitativa ao nível do organismo, utilizando uma avaliação não destrutiva, e assim certificando que esta aproximação pode ser usada em testes ecotoxicológicos futuros.

From genes to population: effects of toxicants on Enchytraeus albidus

Nowadays, a systems biology approach is both a challenge as well as believed to be the ideal form of understanding the organisms’ mechanisms of response. Responses at different levels of biological organization should be integrated to better understand the mechanisms, and hence predict the effects of stress agents, usable in broader contexts. The main aim of this thesis was to evaluate the underlying mechanisms of Enchytraeus albidus responses to chemical stressors. Therefore, there was a large investment on the gene library enrichment for this species, as explained ahead. Overall, effects of chemicals from two different groups (metals and pesticides) were assessed at different levels of biological organization: from genes and biochemical biomarkers to population endpoints. Selected chemicals were: 1) the metals cadmium and zinc; 2) the insecticide dimethoate, the herbicide atrazine and the fungicide carbendazim. At the gene and sub-cellular level, the effects of time and dosage were also adressed. Traditional ecotoxicological tests - survival, reproduction and avoidance behavior - indicated that pesticides were more toxic than metals. Avoidance behaviour is extremely important from an ecological point of view, but not recommended to use for risk assessment purposes. The oxidative stress related experiment showed that metals induced significant effects on several antioxidant enzyme activities and substrate levels, as well as oxidative damage on the membrane cells. To increase the potential of our molecular tool to assess transcriptional responses, the existing cDNA library was enriched with metal and pesticide responding genes, using Suppression Subtractive Hybridization (SSH). With the sequencing information obtained, an improved Agilent custom oligonucleotide microarray was developed and an EST database, including all existing molecular data on E. albidus, was made publicly available as an interactive tool to access information. With this microarray tool, most interesting and novel information on the mechanisms of chemical toxicity was obtained, with the identification of common and specific key pathways affected by each compound. The obtained results allowed the identification of mechanisms of action for the tested compounds in E. albidus, some of which are in line with the ones known for mammals, suggesting across species conserved modes of action and underlining the usefulness of this soil invertebrate as a model species. In general, biochemical and molecular responses were influenced by time of exposure and chemical dosage and these allowed to see the evolution of events. Cellular energy allocation results confirmed the gene expression evidences of an increased energetic expenditure, which can partially explain the decrease on the reproductive output, verified at a later stage. Correlations found throughout this thesis between effects at the different levels of biological organization have further improved our knowledge on the toxicity of metals and pesticides in this species.

Toxicidade de químicos em mistura: o caso da albufeira do Alqueva

In the environment humans and biota are generally exposed to chemical mixtures rather than individual chemicals. Therefore, when assessing the environmental risk of chemicals, it is important to consider chemical mixtures and their possible interactions. The main objective of this work focused on the environmental risk assessment of pesticides found in the water of the Alqueva reservoir and their binary combinations. In this aquatic ecosystem several pesticides were above of the environmental quality standards. But in addition, there were several sampling points of the reservoir where ecotoxicity was observed despite the presence of these contaminants at low concentrations. Here, a component-based approach was used to assess the effects of the pesticide mixtures. The effects of the binary combinations of four herbicides, atrazine (ATR), terbuthylazine (TER), simazine (SIM) and metolachlor (MET), on the growth rate of the microalgae Pseudokirchneriella subcapitata and the effects of the binary combinations of the s-triazine herbicides ATR and TER and the insecticide chlorpyrifos (CPF) on the swimming behaviour and acetylcholinesterase (AChE) activity of the zebrafish Danio rerio were assessed using the two reference models of concentration addition (CA) and independent action (IA). Moreover, the combined effects of the herbicides (ATR, TER and MET) and the insecticide CPF were also tested on the swimming behaviour and AChE activity of the aquatic midge Chironomus riparius after the cholinesterases characterization. In this risk characterization, the calculated risk quotients for the herbicides ATR, TER, SIM and MET were higher than 1, meaning that these herbicides present a high risk for the Alqueva ecosystem. As expected, the microalgae P. subcapitata was the most sensitive species to the herbicides. However, despite these herbicides pose no or low risk to other aquatic organisms tested in this study, with EC50 values much higher than the concentrations found in this aquatic ecosystem, they are able to increase the toxic effects of CPF when they are tested in binary mixtures. Moreover, the risk quotients of mixtures of these herbicides present simultaneously in three different locations of the reservoir were also higher than 1, so this confirms the fact that these herbicides when present in mixtures, present a greater risk for this ecosystem than the expected considering each single chemical by its own.

Effects of environmental factors on the toxicity of pesticides to zebrafish embryos

During the last century mean global temperatures have been increasing. According to the predictions, the temperature change is expected to exceed 1.5ºC in this century and the warming is likely to continue. Freshwater ecosystems are among the most sensitive mainly due to changes in the hydrologic cycle and consequently changes in several physico-chemical parameters (e.g. pH, dissolved oxygen). Alterations in environmental parameters of freshwater systems are likely to affect distribution, morphology, physiology and richness of a wide range of species leading to important changes in ecosystem biodiversity and function. Moreover, they can also work as co-stressors in environments where organisms have already to cope with chemical contamination (such as pesticides), increasing the environmental risk due to potential interactions. Therefore, the objective of this work was to evaluate the effects of climate change related environmental parameters on the toxicity of pesticides to zebrafish embryos. The following environmental factors were studied: pH (3.0-12.0), dissolved oxygen level (0-8 mg/L) and UV radiation (0-500 mW/m2). The pesticides studied were the carbamate insecticide carbaryl and the benzimidazole fungicide carbendazim. Stressors were firstly tested separately in order to derive concentration- or intensity-response curves to further study the effects of binary combinations (environmental factors x pesticides) by applying mixture models. Characterization of zebrafish embryos response to environmental stress revealed that pH effects were fully established after 24 h of exposure and survival was only affected at pH values below 5 and above 10. Low oxygen levels also affected embryos development at concentrations below 4 mg/L (delay, heart rate decrease and edema), and at concentrations below 0.5 mg/L the survival was drastically reduced. Continuous exposure to UV radiation showed a strong time-dependent impact on embryos survival leading to 100% of mortality after 72 hours of exposure. The toxicity of pesticides carbaryl and carbendazim was characterized at several levels of biological organization including developmental, biochemical and behavioural allowing a mechanistic understanding of the effects and highlighting the usefulness of behavioural responses (locomotion) as a sensitive endpoint in ecotoxicology. Once the individual concentration response relationship of each stressor was established, a combined toxicity study was conducted to evaluate the effects of pH on the toxicity of carbaryl. We have shown that pH can modify the toxicity of the pesticide carbaryl. The conceptual model concentration addition allowed a precise prediction of the toxicity of the jointeffects of acid pH and carbaryl. Nevertheless, for alkaline condition both concepts failed in predicting the effects. Deviations to the model were however easy to explain as high pH values favour the hydrolysis of carbaryl with the consequent formation of the more toxic degradation product 1- naphtol. Although in the present study such explanatory process was easy to establish, for many other combinations the “interactive” nature is not so evident. In the context of the climate change few scenarios predict such increase in the pH of aquatic systems, however this was a first approach focused in the lethal effects only. In a second tier assessment effects at sublethal level would be sought and it is expectable that more subtle pH changes (more realistic in terms of climate changes scenarios) may have an effect at physiological and biochemical levels with possible long term consequences for the population fitness.

Microextração adsortiva em barra (BAuE) : fundamentos avanços e aplicações na análise vestigial de compostos emergentes em matrizes reais

Tese de doutoramento, Química (Química Analítica), Universidade de Lisboa, Faculdade de Ciências, 2014

Medicinal chemistry approaches to malaria drug discovery

Tese de doutoramento, Farmácia (Química Farmacêutica e Terapêutica), Universidade de Lisboa, Faculdade de Farmácia, 2016