The paddy, the vector and the caregiver: lessons from an ecosystem approach to irrigation and malaria in Northern Côte d'Ivoire

Malaria is one of the most serious public health problems in the world. For the last few decades, numerous studies have focused on the potential links between environmental transformations (such as the expansion of irrigation) and malaria occurrence. Most of these studies have been based on relatively simple models outlining the interactions of the host-vector-parasite triad. In this paper, we investigate the links between the intensification of irrigated rice cultivation and malaria. In an attempt to complement biomedical and entomological approaches we propose a model that recognises the influence of human-vector contacts on transmission processes, but stresses the importance of taking into consideration socio-economic and cultural factors in the management of disease episodes, and how these can be affected by transformations of natural resource management strategies. Using a case study in Northern C?te d'Ivoire, we investigated the complex mechanisms by which agriculture-generated changes in ecosystems and socio-economic organisation influence disease risks and produce new scenarios in the management of disease. Our results show that the socio-economic transformation and gender repositioning induced, or facilitated, by the intensification of lowland irrigated rice cultivation influence the health care system for malaria in the study area. They lead to a reduction of the capacity of women to manage malaria episodes among children and influence their vulnerability to the disease. We argue that these elements contribute to higher malaria prevalence in villages involved in double cropping of rice annually.     

疟疾感染与单采血浆还输血细胞关系的研究

本文探讨了永清县人群疟疾感染与供血的关系。在２４９例疟疾中，２４４例（９８．０％）为单采血浆还输血细胞（简称单采浆）供血者，５例（２．０％）为受血者。人群疟疾发病率与单采血浆率呈显著正相关，而与人群总供血率和供全血率无相关关系；不同年龄组人群疟疾发病率与该年龄组人群单采浆率呈显著正相关；病例对照调查结果表明，单采浆是疟疾发病的危险因素；单纯单采浆供血者疟疾发病率为３３．７％，既单采血浆又供全血者为１５．７６％，无供血史者为０．００１４％，单纯供全血者无人发病。对单采浆血站调查发现，在采血、离心分浆和血细胞还输过程中存在血液交叉污染环节，血站停业后疟疾疫情平息。认为永清县人群疟疾感染与单采浆有关。     

2003年全国疟疾形势

2003年全国疟疾疫情连续第3年出现较大幅度的回升，21个省（市、区）910个县有疟疾病例报告，发病数较2002年上升15.3%。安徽、浙江、云南、福建、海南、湖北等6省疟疾发病有不同程度的上升。中部3省（安徽、湖北、江苏）和云南、贵州等5省14县39个乡镇约48万人口范围内出现疟疾局部爆发，爆发病例（5 697例）占发病总数的14%。     

上海市疟疾基本消灭后的流行特征分析

目的　分析上海市基本消灭疟疾后 ,1994～ 1999年疟疾流行的变化趋势。　方法　对全市 1994～ 1999年多项疟疾监测指标、调查结果资料进行回顾性研究。　结果　 6年共发现 74 7例疟疾病例 ,总发病率本地居民为 0 .31/10万 ,外来流动人口为 8.88/10万 ,差别有统计学意义 (χ2 =4 312 .31,P<0 .0 0 1) ;两者 1999年发病率较 1994年分别下降了6 7.4 4 %和 95 .2 5 %。输入病例占病例总数的 82 .4 6 % ;市区只有输入病例 ,5 7.94 %外省输入病例和 5 5 .73%本地感染病例相对集中在流动人口较为聚集的 4个区 (县 ) ,前者的发病高峰约较本地病例提前 1个月。本地居民未查见带虫者 ,纵向监测点青少年儿童 IFAT抗体阳性率为 0 .31%。82 .5 0 %为非活动性病灶点 ,99.4 0 %病灶点仅有 1个病例。　结论　上海市疟疾以输入病例为主 ,虽然市郊区 (县 )仍发生低水平的本地传播和感染 ,但未引起局部流行或暴发流行     

恶性疟原虫融合抗原PfCP-2.9的单克隆抗体制备及功能分析

目的 制备恶性疟原虫（FCC1/HN株）融合抗原PfCP-2.9的单克隆抗体，分析其生物学特性及功能。 方法 用PfCP-2.9免疫BALB/c小鼠，取其脾细胞及SP2/0骨髓瘤细胞在聚乙二醇（PEG1500）作用下进行融合，制备单克隆抗体，并分析其特性。 结果 获得1株能分泌抗PfCP-2.9的小鼠杂交瘤细胞株单克隆抗体F12D，经免疫球蛋白类型和亚类鉴定为IgG1。ELISA和蛋白质印迹法（Western blotting）显示单克隆抗体F12D能与PfCP-2.9发生特异性反应，F12D所识别的PfCP-2.9抗原表位不能耐受还原剂巯基乙醇，表明F12D识别的是构象表位。间接免疫荧光试验（IFA）显示F12D可识别培养的FCC1/HN。体外抑制试验结果显示，F12D终浓度为0.3 mg/ml时，对FCC1/HN的抑制率为56%。 结论 单克隆抗体F12D能与PfCP-2.9发生特异性反应，其所识别表位为构象表位，F12D可识别体外培养的FCC1/HN，并对其生长具有抑制作用。     

疟疾疫苗现场试验研究进展

安全有效的疟疾疫苗可能是预防、控制疟疾的有效途径。然而,迄今为止,仍无一个安全有效的疟疾疫苗应用于现场。疟疾疫苗主要分为红前期疫苗、红内期疫苗及传播阻断疫苗,本文对这3类疫苗临床试验的进展进行综述。     

云南省2001-2005年疟疾疫情分析

目的 分析2001-2005年云南省疟疾流行态势, 为制定和实施“十一五”抗疟规划提供参考依据。方法 用Microsoft office excel 2003 及ArcView GIS 3.3等软件, 对2001-2005年疟疾疫情数据进行统计分析。 结果 2001-2005年云南省16州(市)129县(市)各县各月均有疟疾病例报告, 计63 562例, 发病高峰在5～8月和10～11月。5年平均发病率为3.049/万, 比前5年上升4.67％, 差异具有统计学意义( χ2＝63.15, P＜0.05), 各年发病率呈上升趋势。发病数和发病率处于前5位州(市)和排名前10位的县(市)除梁河县(二线边境县)外均为边境州(市)和一线边境县(市)。发病率为5/万以上的23县人口仅占全省总人口的12.74%, 发病占全省的80.31%。45岁以下年龄组发病占87.30％, 死亡占79.36％; 发病数和死亡数男女之比分别为3.44 ∶ 1和6 ∶ 1; 农民、 民工和学生的发病率在各职业中居前3位; 流动人口发病和死亡数分别占全省发病和死亡数的17.06％和23.42％,是感染疟疾的高风险人群。 结论 云南省疟疾流行态势依然严峻。“十一五”期间, 应全面抓好疟疾的病例管理、 态势监测并及时开展各种防控工作。     

2004年全国疟疾形势

本文根据2004年全国有疟疾发病的23省（区、市）专业单位上报的年度疟疾防治工作总结和有关疫情报表（年报系统）汇总整理。除注明“网络直报”外，所有疫情数据均来自年报系统。     

云南省疟疾流行现状与防制对策

近年云南省报告疟疾病例的县（市）达１１０个，年病例数在１．２～１．６万，而漏报率高达８倍左右。Ｎ２２°～２４°及高黎贡山西侧是主要流行区，海拔１５００米以下发经高，恶性疟比重大，每年均有以自然村为单位的点状暴发流行，６～１０月是疟疾流行高峰期，１９９０～１９９４年，年均发病率为４３．６９／１０万，平均死亡率为０．０８／１０万，病死率为１３．６４％，发热病人血检阳性率为３．１７％，居民带虫率为１．２     

Malaria vector control strategies. What is appropriate towards sustainable global eradication?

Malaria a mosquito-borne disease caused by Plasmodium remains to be a main global burden despite concerted efforts to eliminate it. While diverse control strategies have been put in place for mosquito-borne diseases, vector control continues to be a critical component in infection prevention. Vector control majorly focuses on the eradication of mosquitoes using a variety of chemical insecticides that includes organochlorides, carbamates, organophosphates, and pyrethroids. The use of conventional insecticide-based as mosquito control strategies poses several challenges such as the widespread development of insecticide resistance, environmental damage concerns, and effects on non-target organisms. These challenges create a demand for the development and use of alternative pest control strategies that are sustainable, safer, and environmentally friendly to mosquito vector management. This review provides insight into alternative sustainable interventions for mosquito vector control in the form of biorational pesticides. Biorational pesticides are pesticides that have little or no effect on humans and environments and include entomopathogenic microorganisms, insect growth regulators, and endosymbiotic bacteria. It also puts into perspective their environmental impacts, benefits, and challenges. Further, countries like Sri Lanka, that are certified as malaria free by World Health Organization (WHO) incorporated the use of entomopathogenic bacteria, insect growth regulators and larvivorous fish in their national vector control programs leading to the successful elimination of malaria in 2016. We therefore highlight success stories of the countries that have implemented these interventions bringing out the lessons for countries that are battling malaria epidemics.