Epidemiology

Laboratory study was carried out to evaluate the repellent efficiency of most commonly known four traditional insect/mosquito repellent plants Wogert [vernacular name (local native language, Amharic); Silene macroserene], Kebercho [vernacular name (local native language, Amharic); Echinops sp.], Tinjut [vernacular name (local native language, Amharic); Ostostegia integrifolia], and Woira[vernacular name (local native language, Amharic); Olea europaea] against Anopheles arabiensis under the laboratory conditions. One hundred (4-5 days old) female A. arabiensis were introduced into the both 'control' and 'test' repellent chamber through the hole on top. Traditional charcoal stoves were used for direct burning. The experiment was conducted by applying the smoke into the repellent "test" mosquito cage by direct burning of 25 gm of dried plant materials (leaves and roots) until plant materials completely burned. The number of mosquitoes driving away from the "test" and "control" cage was recorded for every 5 min. In the present investigation, the results clearly revealed that the roots of S. macroserene has potent repellent efficiency (93.61%) and was the most effective. The leaves of Echinops sp. (92.47%), leaves of O. integrifolia (90.10%) and O. europaea (79.78%) were also effective. Roots of S. macroserene exhibited the highest repellent efficiency by direct burning.

A cross-sectional descriptive study was carried out to assess the knowledge and usage custom of traditional insect/mosquitoes repellent plants among the inhabitants in Addis Zemen Town, Ethiopia.Stratified, systematic random sampling was used for selection of 393 households from the total of 5161 households. One adult from each household was interviewed. The ethnobotonical survey was carried out during the period February 2007 to March 2007. Data analysis was carried out using SPSS, version 9.0. Range and mean were analysed and appropriate tables, graphs and percentage were displayed. Level of significance also determined by using 95% of confidence intervals and p-value.Overall, 97.2% of the respondents had ample knowledge and usage custom concerning traditional insect/mosquito repellent plants. Application of smoke (91.55%) was one of the most commonly well-known methods amongst local community by burning the plant parts such as leaves, stems and roots. Leaves were used by 90.2% for the application smoke. Knowledge and usage custom of traditional insect/mosquito repellent plants had significantly associated with sex (p = 0.013) and lower income of respondents (p = 0.002). In spite of this, knowledge and usage custom had no significant association with age and educational status. Furthermore, the survey also indicated that most commonly known traditional insect/mosquito repellent plants were Woira*1 (Olea europaea) 44%, Tinjut* (Ostostegia integrifolia) 39%, Neem* (Azadirachta indica) 14.1%, Wogert* (Silene macroserene) 1.4%, and Kebercho* (Echinops sp.) 1.1%.Indigenous traditional insect/mosquito repellent plants have been used by local hamlet since ancient times for various medicinal purposes. Besides, they are not toxic like existing modern synthetic chemical repellents. Therefore, the traditional use of repellent plants should be encouraged and promoted among the local community.

Malaria is a major public health problem in Ethiopia. Over the past years, the disease has been consistently reported as the first leading cause of outpatient visits, hospitalization and death in health facilities across the country. Thus, a retrospective study was conducted to determine the prevalence of malaria from peripheral blood smear examination from the Serbo Health Center of Ethiopia. The case notes of all malaria cases treated between July 2007 and June 2008 were carefully reviewed and analyzed. Of the total 6863 smears, 3009 were found to be positive and contribute 43.8% of diagnostic yield. Plasmodium falciparum constituted the most predominant [64.6% (1946/3009 cases)], while Plasmodium vivax confirmed with 34.9% (1052/3009) cases. Among patients who underwent diagnostic testing and treatment for malaria, males [63.8% (1918/3009 cases)] were more prone to have a positive malaria smear than females [36.2% (1091/3009 cases)]. Chi-square statistical analysis shown that there was a statistically significant association found between male cases and number of positive blood smear ( 2 = 28.1; df = 7; p-value = 0.001). The present study results clearly suggest that the catchment area of Serbo Health Center is prone for epidemic malaria and the situation is quite deteriorating. At the moment, although we are not equipped with magic bullet for malaria effective low-cost strategies are available for its treatment, prevention, and control. Therefore, creating awareness by active health education campaigns and applying integrated malaria control strategy could bring the constructive outcome in the near future.

A field trial was undertaken in order to determine the efficacy of DEET (N,N-diethyl-m-toluamide) impregnated anklets, wristbands, shoulder and pocket fabric strips against mosquito vectors of disease. The present study was conducted in the urban locality of Pondicherry, India. Human test subjects were exposed to natural populations of mosquitoes for a 12 h (18.00-06.00) night time period. The fabric strips (anklets, wristbands, shoulder, and pocket strips) were impregnated with DEET at two different concentrations of 1.5 mg/cm 2 and 2.0 mg/cm 2 . The results clearly revealed that DEET-impregnated anklets, wristbands, shoulder and pocket fabric strips were found more effective against mosquitoes remarkably. The DEET-impregnated anklets, wristbands, shoulder and pocket fabric strips at a concentration of 2 mg/cm 2 provided 5 h complete protection against mosquitoes bites and the reduction of man-landing rate varied between 65.85 and 100%. However, DEETimpregnated fabric strips at a concentration of 1.5 mg/cm 2 provided 4 h complete protection against mosquito bites and the reduction of man-landing rate varied between 51.21 and 100%. The final results clearly demonstrate that repellent activity of DEET-impregnated anklets, wristbands, shoulder, and pocket strips were dose-dependent. Certainly, the DEETimpregnated fabric strips can be used as an effective potential personal protection measure in order to avoid those insects/mosquitoes that prefer to feed outdoors or those that feed in the early evening.

Clin Microbiol Infect 2011; 17: 1608–1616Clin Microbiol Infect 2011; 17: 1608–1616AbstractOver many decades, malaria elimination has been considered to be one of the most ambitious goals of the international community. Vector control is a cornerstone in malaria control, owing to the lack of reliable vaccines, the emergence of drug resistance, and unaffordable potent antimalarials. In the recent past, a few countries have achieved malaria elimination by employing existing front-line vector control interventions and active case management. However, many challenges lie ahead on the long road to meaningful accomplishment, and the following issues must therefore be adequately addressed in malaria-prone settings in order to achieve our target of 100% worldwide malaria elimination and eventual eradication: (i) consistent administration of integrated vector management; (ii) identification of innovative user and environment-friendly alternative technologies and delivery systems; (iii) exploration and development of novel and powerful contextual community-based interventions; and (iv) improvement of the efficiency and efficacy of existing interventions and their combinations, such as vector control, diagnosis, treatment, vaccines, biological control of vectors, environmental management, and surveillance. I strongly believe that we are moving in the right direction, along with partnership-wide support, towards the enviable milestone of malaria elimination by employing vector control as a potential tool.Over many decades, malaria elimination has been considered to be one of the most ambitious goals of the international community. Vector control is a cornerstone in malaria control, owing to the lack of reliable vaccines, the emergence of drug resistance, and unaffordable potent antimalarials. In the recent past, a few countries have achieved malaria elimination by employing existing front-line vector control interventions and active case management. However, many challenges lie ahead on the long road to meaningful accomplishment, and the following issues must therefore be adequately addressed in malaria-prone settings in order to achieve our target of 100% worldwide malaria elimination and eventual eradication: (i) consistent administration of integrated vector management; (ii) identification of innovative user and environment-friendly alternative technologies and delivery systems; (iii) exploration and development of novel and powerful contextual community-based interventions; and (iv) improvement of the efficiency and efficacy of existing interventions and their combinations, such as vector control, diagnosis, treatment, vaccines, biological control of vectors, environmental management, and surveillance. I strongly believe that we are moving in the right direction, along with partnership-wide support, towards the enviable milestone of malaria elimination by employing vector control as a potential tool.

A laboratory study was carried out to evaluate the relative efficacy of N-N-diethyl-m-toluamide (DEET)- and N,N-diethyl phenylacetamide (DEPA)-treated wristbands against three major vector mosquitoes viz., Anopheles stephensi Liston, Culex quinquefasciatus Say and Aedes aegypti (L.), at two different concentrations viz., 1.5 and 2.0 mg/cm2. Overall, both DEET and DEPA have shown various degrees of repellency impact against all three vector mosquitoes. DEET offered the highest 317.0 min mean complete protection against An. stephensi and DEPA provided 275.6 min complete protection to Cx. quinquefasciatus at 2.0 mg/cm2. However, DEPA-treated wristbands did not show any significant differences in terms of reduction of human landing rate and mean complete protection time against An. stephensi and Ae. aegypti between 1.5 and 2.0 mg/cm2. DEET demonstrated relatively higher repellency impact to vector mosquitoes than DEPA. However, χ2 analysis revealed that there was no statistically significant difference found in repellent efficiency between DEET and DEPA (P = 0.924). The present study result suggests that repellent-treated wristbands could serve as a means of potential personal protection expedient to avoid insect's annoyance and reduce vector-borne disease transmission. They are extremely valuable whenever and wherever other kinds of personal protection measures are unfeasible.

Methanol leaf extracts of two Ethiopian traditional medicinal plants viz., Lomisar [vernacular name (local native language, Amharic); Cymbopogon citratus (DC) Stapf. (Poaceae)] and Bisana [vernacular name (local native language, Amharic); Croton macrostachyus Del. (Euphorbiaceae)] were screened for larvicidal activity against late third instar larvae of Anopheles arabiensis Patton, a potent malaria vector in Ethiopia. The larval mortality was observed 24 h of post treatment. Both plant extracts demonstrated varying degrees of larvicidal activity against Anopheles arabiensis. Cymbopogon citratus extract has exhibited potent larvicidal activity than Croton macrostachyus at lower concentrations. The LC50 and LC90 values of Cymbopogon citratus were 74.02 and 158.20 ppm, respectively. From this data, a chi-square value 2.760 is significant at the P<0.05 level. While, the LC50 and LC90 values of Croton macrostachyus were 89.25 and 224.98 ppm, respectively and the chi-square value 1.035 is significant at the P<0.05 level. The present investigation establishes that these plant extracts could serve as potent mosquito larvicidal agents against Anopheles arabiensis. However, their mode of actions and larvicidal efficiency under the field conditions should be scrutinized and determined in the near future.

A cross-sectional descriptive study was conducted to determine HIV/AIDS patient's level of satisfaction and their expectations with pharmacy service at specialist antiretroviral therapy (ART) unit's in the government hospitals of Addis Ababa, Ethiopia. The present investigation clearly revealed that 82.5% of HIV/AIDS patients indicated long waiting time was a major reason for their dissatisfaction with pharmacy service. Majority of patients indicated few more other issues are also responsible for their dissatisfaction with pharmacy service such as lack of description about antiretroviral therapy drugs (45.20%), staffs impoliteness (22.40%), and shortage of drugs (4.20%). 93.33% of the respondents prefer to get their pharmacy service within a shorter span, 18.02% wanted comfort waiting hall, 14.32% expecting staffs politeness, 5.18% insisted sufficient number of ART units, 8.88% adequate supply of ART drugs and 21.48% cleanliness. In addition, 20.98% of the patients call for personal interaction with their pharmacist and 4.44% ask for information on ARTs side effects. Chi-square test results showed that patient's level of satisfaction and length of waiting time to get pharmacy service was inter related and statistically significant (p<0.002). Therefore, the concern ART units must provide better pharmacy service within shorter span to enhance the patient's satisfaction. At the end of the day, improving health care services to persons living with HIV/AIDS in our community is all of our duty and responsibility too. Ultimately, increasing HIV/AIDS patient's level of satisfaction and fulfilling their expectations is extremely essential and inevitable to diminish the unbearable burden of HIV/AIDS pandemic in the near future.

Methods: The repellent efficacy of dimethyl phthalate (DMP) treated wristband was determined against mosquitoes, viz Anopheles stephensi Liston, Aedes aegypti Linnaeus, Culex quinquefasciatus Say at two concentrations viz., 1.5 and 2.0 mg/cm 2 under the laboratory conditions. DMP treated wristband had shown variable degrees of repellency impact against different mosquito species.

Aim This study was conducted to determine the knowledge and practice of pregnant women attending specialist antenatal clinics (ANCs) concerning malaria, ITN (insecticide-treated net) utilization and antimalarial treatment. Subjects and methods The study recruited 225 women who voluntarily presented at ANCs in Jimma town, Ethiopia. A pre-tested questionnaire was administered. Results A great majority (98.2%; 221/225) of the respondents were aware of malaria. Among them, 77.4% (174/225) indicated mosquito bites as a mode of malaria transmission. Overall, 94.3% (212/225) and 98.3% (221/225) of pregnant women had knowledge about ITNs and antimalarials, respectively. Overall, 76.8% (173/225) and 57.4% (129/225) of the study participants erroneously indicated mosquito bites and stagnant water as causes of malaria, respectively. In general, the majority of pregnant women were unable to distinguish between malaria transmission and cause. Chi-square analysis revealed a strong association between the educational status of the pregnant women and their daily usage of ITNs (P = 0.001; χ2 = 22.9; df = 8). Conclusion The results clearly suggest that although the majority of the pregnant women had ample awareness of malaria, ITN usage and antimalarial treatment, a sizable faction still had misconceptions and misunderstandings. Therefore, appropriate communication strategies should be designed and implemented among the marginalized and most vulnerable section of society, especially through health education campaigns, in order to have a constructive outcome in the near future.

This paper reveals the trend of knowledge and practice of traditional antimalarial plants (TAPs) to prevent/treat malaria.Stratified, systematic random sampling was adopted. The ethnomedicinal survey was conducted between January and March 2011 by involving the selected 371 household members on knowledge and practice of TAPs by administering a pre-tested questionnaire.Overall, 54.4% respondents had adequate awareness and usage custom of TAPs and 16 types of plant have been most commonly known and employed by the respondents to prevent/treat malaria. Leaves (57.2%) were most commonly used plant part to prepare traditional antimalarial phytotherapy remedies. Decoction was one of the most commonly used methods to administer TAPs. The chi-square test result revealed that a significant association is found between the usage custom of traditional antimalarial plants and gender (P-value = 0.0282), age (P-value = 0.0024), educational status (P-value = 0.0295), and monthly income (P-value = 0.0001), although not with the ethnicity (P-value = 0.7933) of the respondents.TAPs usage is an integral part of the tradition and custom of the Ethiopians. However, nearly half of the respondents have had lack of awareness about TAPs and majority of them are reluctant in exercising either due to its ineffectiveness or its bitter taste. Therefore, further laboratory-based research is extremely imperative to identify their antiplasmodial activity and bioactive molecules which could pave the way to formulate the novel affordable as well as accessible potent antimalarials in the near future.Ethiopian antimalarial plant Croton macrostachyus.

Arthropod-borne diseases are major causes of morbidity and mortality in many tropical and subtropical countries and principally the devastating nature of malaria is indubitably intolerable . Malaria has been one of the most potent scourges of mankind from time immemorial and it is one of the three major communicable diseases . The recent WHO Malaria Report 2011 [3] estimates that 3.3 billion people were at the risk of malaria in 2010, although of all geographical regions, populations living in sub-Saharan Africa (SSA) have the highest risk of acquiring malaria; among 216 million episodes of malaria in 2010, which approximately 81%, or 174 million cases, were reported from the African Region. There were an estimated 655,000 of malaria deaths in 2010, of which 91% were from Africa.