Baseline data on Aedes aegypti populations in Santo Domingo, Dominican Republic

Baseline field studies were conducted from April 1987 to July 1988 on Aedes aegypti in Santo Domingo, an endemic area for dengue fever. Premise, container and Breteau indices were measured in one treated area and 2 nearby control areas. These indices averaged 69.6, 46.3 and 142.1, respectively. The principal larval habitats of Ae. aegypti were 208-liter (55-gal) concrete-lined drums. The estimated daily adult production was approximately 60 per house. Adult mosquito populations were monitored using oviposition traps and by sweep net collections. There was no correlation between adult abundance and the larval indices. Monitoring the natural adult densities was more efficient for evaluating the impact of ULV malathion application than the use of standard bioassay procedures.     

Comparison of ground and aerial ultra-low volume applications of malathion against Aedes aegypti in Santo Domingo, Dominican Republic

Efficacy of ground and aerial ultra-low volume (ULV) applications of 91% malathion at 438 ml/ha against Aedes aegypti in the Dominican Republic was evaluated using indoor collections, oviposition trapping and adult sentinel mortality rates. Ground compared to aerial ULV applications in this study were found to have a greater effect on Ae. aegypti when measured by the described sampling techniques. Neither application method provided the level of Ae. aegypti suppression believed necessary for control in the event of a dengue virus epidemic.     

La vida normal: living with HIV in Santo Domingo,Dominican Republic

In this study, we explore how individuals living with HIV in the Dominican Republic strive to live a ‘normal’ life and the consequences of this pursuit of normalcy. We conducted qualitative in-depth interviews with men (n = 20) and women (n = 20) living with HIV and receiving care at two urban clinics in Santo Domingo. We analysed the data using a combination of narrative analysis and thematic coding. We aimed to identify how fears and/or lived experiences with social rejection and HIV-related stigma and discrimination shaped participants’ abilities to maintain social relationships, be economically productive and manage HIV within the context of sexual relationships. Participants used the discourse of una vida normal (a normal life) to frame their response to HIV. This pursuit of normality was driven by the social and economic pressures of living with a chronic condition in a context of HIV-related stigma; trying to keep things ‘normal’ further added to these pressures. We argue that the normal life discourse fails to recognise the dynamic and complex nature of negotiating this condition and may also create additional burdens for individuals living with HIV that could impact their wellbeing and preventive behaviours.     

Early termination of breast-feeding in periurban Santo Domingo, Dominican Republic: mothers' community perceptions and personal practices.

OBJECTIVES: The objectives of this study were to determine: 1) whether mothers' perceptions of typical community practice for breast-feeding duration influence their personal practices and 2) whether the mothers' reports of community reasons for terminating breast-feeding identify barriers not elicited through self-report. METHODS: The study was conducted in 1997 in a sample of poor neighborhoods in a periurban district of Santo Domingo, the capital of the Dominican Republic. A representative sample of 220 mothers from these neighborhoods was interviewed with a structured questionnaire. RESULTS: While the duration of breast-feeding was similar for self-report and for mothers' perceptions of typical community practice, there was no statistically significant correlation between these two variables. "Mother-driven" reasons for early termination of breast-feeding, such as "fear of loss of figure or of breast shape" and "not wanting to breast-feed," were frequently perceived as community reasons but rarely given as personal reasons. Personal reasons were predominately "child-driven," including "the child not wanting the breast," or reasons beyond the mother's control such as having "insufficient" milk. CONCLUSIONS: Maternal report of community reasons for early termination may be a useful way to identify factors that would not otherwise be revealed on self-report. These additional reasons may guide health promotion efforts aimed at increasing breast-feeding duration.     

Prevention of diarrhoea in a poor District of Santo Domingo, Dominican Republic: practices, knowledge, and barriers

The study, conducted in a poor periurban community of Santo Domingo, Dominican Republic, assessed the practices, knowledge, and barriers relating to prevention of diarrhoea. A total of 582 caregivers of children, aged less than 5 years, were systematically sampled from four barrios. Results of the study showed that 55% of the caregivers did not boil drinking water for children; 38% did not always wash hands of the children prior to meals; 87% of the children did not always wear shoes outside their house; and 54% were breastfed for less than one year. Biomedical knowledge about these practices was high among the caregivers, and was not related to the reported behaviours. However, several barriers were significantly related to practices, including lapse in caregiving, limited resources, erroneous beliefs, and non-compliance by children. Health education, based on a biomedical knowledge-deficit model, may have little impact on improving the diarrhoea-prevention practices in these communities. Greater attention should, therefore, be directed toward the barriers experienced by caregivers of children.     

Nontuberculous mycobacterial infections after cosmetic surgery--Santo Domingo, Dominican Republic, 2003-2004

Rapidly growing mycobacteria have been associated with postoperative infections in patients undergoing cosmetic surgery procedures. In April 2004, CDC received reports of infections caused by rapidly growing mycobacteria in patients who had undergone cosmetic surgery procedures in Santo Domingo, Dominican Republic (DR). CDC, along with state and local health departments, is investigating additional cases identified by passive surveillance (i.e., solicitation of reports from clinicians by using electronic networks) and, in some areas, active surveillance (i.e., review of laboratory reports).     

Family size and malnutrition in Santo Domingo.

A case-control study of 82 urban Dominican women with a malnourished child and 82 women with a well-nourished child of the same age, sex, and neighborhood of residence revealed that the women of the control group had significantly lower parity and also had fewer living children. More women in the case group had used contraception at one time. Nevertheless, the prevalence of current contraceptive use was identical in the two groups. More women in the control group had undergone one or more spontaneous or induced abortions. Although the women in both groups were selected from the same neighborhoods, there is evidence to suggest that the the women in the control group may have had higher family incomes. The higher incomes could well account, at least in part, for the difference in parity between the two groups as well as for the difference in nutritional status in the preschool children of the mothers of these groups.     

Larval susceptibility to chemical insecticides of two Aedes aegypti populations

OBJECTIVE: Insect susceptibility has been one of the most important aspects to be monitored in public health programs for vector control. The purpose of the study is to assess the susceptibility to chemical insecticides of Aedes aegypti larvae in both areas under vector control and no vector control. METHODS: World Health Organization standard bioassays for diagnostic concentration and multiple concentrations were performed in mosquito larvae collected in an area under no vector control (Campinas, SP) and an area under vector chemical control (Campo Grande, MS), in Brazil. RESULTS: Potential resistance to a diagnostic concentration of temephos (DC=0.04 ppm) was registered for an Ae. aegypti larval population collected in Campinas. Multiple concentration tests confirmed the larvae resistance, with 24.5% of them surviving at the 0.0125 ppm concentration. Bioassays with the organophosphate fenitrothion (DC=0.08 ppm) and pyrethroid cypermethrin (DC=0.01 ppm) in the same population revealed their susceptibility to these agents. Bioassays carried out in an Ae. aegypti larval population collected in Campo Grande showed their susceptibility to temephos (DC=0.04 ppm) and cypermethrin (DC=0.01 ppm). LC50 and LC95 for cypermethrin (CE25), cyfluthrin (CE5), betacyfluthrin (SC1.25) and propoxur (CE20) were determined for Ae. aegypti. Using the Rockefeller standard strain values, ratios of resistance were estimated: 2.9, 2.2, 2.4 and 1.3 for LC50 and 3.5, 2.6, 3.9 and 1.3 for LC95, respectively. CONCLUSION: The findings reinforce the need for routinely monitoring pesticide efficacy as a very important step in vector control management programs.     

Studies of the susceptibility of Anopheles albimanus and Anopheles vestitipennis from Dajabon, Dominican Republic, to insecticides

Insecticide susceptibility of Anopheles albimanus and An. vestitipennis in Dajabon Province, Dominican Republic, was investigated. Only 74.3% of An. albimanus exposed to 4% DDT for 1 h died. The mortality in this species following exposure for 1 h to 0.25% permethrin was also 74.3%. However, this species was susceptible to malathion, fenitrothion and propoxur. The mortality obtained following exposure of An. vestitipennis to 4% DDT and 0.1% propoxur, both for 1 h, was 71% and 100%, respectively. However, the number of specimens exposed to propoxur was small.     

Replacement of Aedes aegypti by Aedes albopictus in Mobile, Alabama.

Aedes albopictus was first detected in Mobile, AL, in 1987 during a CDC sponsored ovitrap survey in the Historic District. A comparison of ovitrap and larval surveys, done in 1957, 1984, 1987 and 1990, indicates that Ae. albopictus had replaced Aedes aegypti in urban Mobile. Possible explanations of this replacement, including displacement, are discussed.     

Infant feeding practices in a poor district of Santo Domingo

We conducted a survey of infant feeding practices by interviewing 103 randomly selected primary care givers of children three years of age and under in poor areas of Los Alcarrizos, Santo Domingo, Dominican Republic. We did the survey to identify community specific deficits in infant feeding practices in order to determine target issues for local health education interventions which are presently based on generalized guidelines. This study identified deficits in milk use, weaning, hygiene, and frequency of food consumption. At least some of these deficits are theoretically amenable to change through nutrition education.     

Infant feeding practices in a poor district of Santo Domingo

During August-December 1989, in the Dominican Republic, local health promoters interviewed 103 primary caretakers and took anthropometric measurements from 103 children aged 3 years and under during home visits in three poor neighborhoods of Los Alcarrizos (Alto de Chavon, Barrio Landia, and Pueblo Nuevo) to examine infant feeding practices. 95% of the mothers had started breast feeding. The median duration of breast feeding was 7.5 months. Almost 33% had quit breast feeding by 3 months. Perception of insufficient milk was the leading reason for early discontinuation of exclusive breast feeding. The local pharmacies in all three communities offered powdered milk. About 25% of mothers began using breast milk substitutes within the first week. A non-infant formula milk powder was the most commonly used breast milk substitute. 30% of mothers stored prepared milk for later feeds, as long as half a day. Only 13% of households had a refrigerator. The most frequently used first weaning foods were orange juice, lime juice, and beans. 76% of mothers had used or were currently using baby bottles. 95% of them reported washing the bottle in boiling water. The median age of introducing the baby bottle was 3 days. Only 44% of mother covered prepared food during storage. The most commonly eaten foods among children aged at least 1 year were milk, beans, rice, and citrus fruits. Yet the children did not eat all these foods daily. 18% of 1-2 year olds and 13% of 2-3 year olds did not eat meats and alternatives regularly. 7% of 1-2 year olds and 10% of 2-3 year olds did not eat fruits and vegetables regularly. 4% of 1-2 year olds and 3% of 2-3 year olds did not eat breads and cereals regularly. About 14% of all children were not consuming any milk at the time of the survey. These findings will be used to refine nutrition education programs in the district to make them more effective.     

Infestation of S. Paulo State, Brazil, by Aedes aegypti and Aedes albopictus

OBJECTIVE: To study the influence of the distance between infested and non-infested areas in the geographical spread of Aedes aegypti and Aedes albopictuspopulations in the state of S. Paulo. Regional patterns were also studied, considering the determinants related to soil occupation. METHODS: Information related to the counties in the state of S. Paulo where were concentrations of Ae. aegypti and Ae. albopictus and counties infested up to the end of each year (1985 to 1995), both in the state of S. Paulo and in the neighboring states, were used. Four indicators were defined to analyze the infestation process. RESULTS/CONCLUSIONS: The analysis indicated the contribution of the states of Mato Grosso do Sul and Paraná for the initial Ae. aegypti infestation in the state of S. Paulo and Ae. albopictus infestation in the states of Rio de Janeiro and Minas Gerais. In the counties where there was a concentration of these species, their establishment was more frequent among those closer to the infested area. Seventy-five percent of the counties where there were established populations of Ae. aegypti and Ae. albopictus were situated up to 34 km and 60 km, respectively, from the nearest infested county. The analysis of the geographical spread rate of the Ae. aegypti revealed three different large areas with unexpected patterns: the area with greater demographic population density (east of the state) had the lower rate of geographical mosquito spread, indicating the existence of other factors with preponderant influence on the macro-regional patterns. For Ae. albopictus, there was no evidence of a relationship between their geographical spread patterns and the demographic population density.     

Larval susceptibility of Aedes aegypti and Culex quinquefasciatus populations to chemical insecticides

OBJECTIVE: To evaluate the susceptibility to chemical insecticides of Culex quinquefasciatus and Aedes aegypt larvae from areas subjected to control treatments or not. METHODS: Bioassays for diagnostic concentration and multiple concentration were performed for organophosphate and pyrethroid insecticides according to World Health Organization parameters. The susceptibility was assessed for mosquito larvae collected from an area not subjected to chemical control (Campinas, State of S o Paulo, SP) and from other areas (Campo Grande, Mato Grosso do Sul, MS, and Cuiabá, Mato Grosso, MT), in Brazil, subjected to such treatments. RESULTS: Tests for Culex quinquefasciatus larvae from Campinas, SP, allowed suspicion of resistance to cypermethrin and gave evidence of resistance to cyfluthrin. Larvae of this species collected in Campo Grande, MS, and Campinas, SP, presented resistance to temephos. For the colony from the latter locality, the following resistance rates were established: RR50=6.36 and RR95=4.94, in relation to a standard susceptible strain. Moreover, tests for Aedes aegypti showed similar susceptibility to temephos for a field population from Cuiabá, MT, and a laboratory population. CONCLUSIONS: The results indicate resistance of Culex quinquefasciatus to organophosphate and pyrethroid insecticides and make evident the need for evaluation and monitoring of the efficiency of insecticides to be used in mosquito control programs.     

A Comparative Analysis of Oral Health on the Santo Domingo Pueblo Reservation

The study was done to compare oral health data from a tribe in a relatively accessible location between Santa Fe and Albuquerque, New Mexico to national American Indian data and broader US data sets. Participants (N = 399) were recruited via random sampling of housing units. Dental health measures included DMFT/dmft and dental sealants. Comparisons were made using data from large-scale oral health surveillance studies. There was no difference in oral health for 3–5 year olds compared to a recent study of AI/AN preschool children. Compared to the general US population, Santo Domingo Pueblo children and adults showed higher prevalence of untreated decay. Children ages 5–19 had higher rates of sealant retention on permanent teeth, and adults showed lower prevalence of complete tooth retention. The children ages 5–19 and 12–19 with at least one sealant have significantly lower DMFT and less untreated decay than those without sealants. However, the percentage of children with and without sealants who had untreated decay was still more than two times higher than the general US population. Oral health of American Indian children and adults in Santo Domingo Pueblo was worse compared to the general US population but similar to previous results reported for the same Indian Health Service Area even though their location is less isolated than many other tribes.