Kaliyaperumal Karunamoorthi

Vector control: a cornerstone in the malaria elimination campaign

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.

Ethnobotanical survey of knowledge and usage custom of traditional insect/mosquito repellent plants among the Ethiopian Oromo ethnic group

AIM OF THE STUDY Repellent plants usage is an integral part of Ethiopian tradition and has been practiced over many centuries. Hence, the aim of this study was to assess the knowledge and usage custom of traditional insect/mosquito repellent plants among the Oromo ethnic group in Ethiopia. MATERIALS AND METHODS The ethnobotanical survey was conducted between January and March 2009. All 276 household members were interviewed on knowledge and usage custom of traditional repellent plants, using a pre-tested questionnaire in Kofe kebele, Jimma zone, Ethiopia. RESULTS AND CONCLUSION 83.6% respondents had adequate knowledge and usage custom regarding insect/mosquito repellent plants. Application of smoke by burning the repellent plant materials was the most common practice. The chi-square test result revealed that there was no statistically significant association found between the knowledge about insect repellent plants and sex (p-value=0.8912), educational status (p-value=0.7504), and age (p-value=0.1631) of the respondents. However, usage custom of repellent plants was significantly associated with sex (p-value=0.0002) and average monthly income (p-value=0.0001) although not with educational status (p-value=0.5206) of the respondents. Repellent efficacy of these plants is undetermined and therefore the scientific validity should be evaluated by conducting further laboratory and field research. Majority of the repellent plants have been used as medicine to treat various ailments by the local community. Furthermore, they are easily available, accessible and affordable therefore usage of traditional repellent plants should be promoted among the local residents in order to reduce vector-borne disease prevalence.

Traditional Medicinal Plants: A Source of Phytotherapeutic Modality in Resource-Constrained Health Care Settings

Despite recent scientific advancement and globalization, the system of traditional medicine and complementary/alternative medicine is considered as a primary health care modality in the resource-constrained health care settings. Herbal medicinal system has been postulated and established through empirical observation and trial and error experiments since time immemorial to maintain good health and alleviate ailments and diseases. Earlier, the importance of traditional medicinal plants and phytotherapy have often been disregarded and undervalued. Presently revitalization and renewed interest on traditional medicinal plants has been observed among the public and scientific community. However, several daunting challenges need to be flagged effectively and immediately for the promotion of traditional medicinal plants. The collaborative efforts of ethnobotanists, anthropologists, pharmacists, and physicians could be a workable strategy to evaluate and validate the usage of traditional medicinal plants with the modern scientific methods and innovative techniques. Furthermore, conducting clinical trials to assess their efficacy and human safety is imperative and inevitable.

Assessment of knowledge and usage custom of traditional insect/mosquito repellent plants in Addis Zemen Town, South Gonder, North Western Ethiopia.

AIM OF THE STUDY 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. MATERIALS AND METHODS 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. RESULTS 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%. CONCLUSIONS 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.

The counterfeit anti-malarial is a crime against humanity: a systematic review of the scientific evidence

BackgroundThe counterfeiting of anti-malarials represents a form of attack on global public health in which fake and substandard anti-malarials serve as de facto weapons of mass destruction, particularly in resource-constrained endemic settings, where malaria causes nearly 660,000 preventable deaths and threatens millions of lives annually. It has been estimated that fake anti-malarials contribute to nearly 450,000 preventable deaths every year. This crime against humanity is often underestimated or ignored. This study attempts to describe and characterize the direct and indirect effects of counterfeit anti-malarials on public health, clinical care and socio-economic conditions.MethodsA search was performed using key databases, WHO documents, and English language search engines. Of 262 potential articles that were identified using a fixed set of criteria, a convenience sample of 105 appropriate articles was selected for this review.ResultsArtemisinin-based combination therapy (ACT) is an important tool in the fight against malaria, but a sizable number of patients are unable to afford to this first-line treatment. Consequently, patients tend to procure cheaper anti-malarials, which may be fake or substandard. Forensic palynology reveals that counterfeits originate in Asia. Fragile drug regulations, ineffective law-enforcement agencies and corruption further burden ailing healthcare facilities. Substandard/fake anti-malarials can cause (a) economic sabotage; (b) therapeutic failure; (c) increased risk of the emergence and spread of resistant strains of Plasmodium falciparum and Plasmodium vivax; (d) an undermining of trust/confidence in healthcare stakeholders/systems; and, (e) serious side effects or death.ConclusionCombating counterfeit anti-malarials is a complex task due to limited resources and poor techniques for the detection and identification of fake anti-malarials. This situation calls for sustainable, global, scientific research and policy change. Further, responsible stakeholders in combination with the synthesis and supply of next generation malaria control tools, such as low-cost anti-malarials, must promote the development of a counterfeit-free and malaria-free future.

Prevalence of malaria from peripheral blood smears examination: A 1-year retrospective study from the Serbo Health Center, Kersa Woreda, Ethiopia

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 (chi(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.

Knowledge and Practices of Farmers With Reference to Pesticide Management: Implications on Human Health

ABSTRACT A study was conducted to assess the knowledge and practices of Ethiopian farmers about pesticide management: implications for human health. A pretested standardized questionnaire was administered. The results revealed that the great majority 174 (99.4%) farmers had ample awareness about pesticide impact on human health. However, various hazardous practices have also been documented. One hundred thirty-five (77.2%) farmers make use of the empty pesticide containers for various household purposes. The most frequent self-reported toxicity symptoms associated with pesticide use were headache (58.8%), salivation and vomiting (38.2%), nausea (36.5%), and sneezing (12.5%). Chi-square analysis revealed a strong association between the farmers educational status and reported toxicity symptoms (p = .0001; χ2 = 498.2; df = 30). Creating awareness about safe usage of pesticide is extremely vital by special orientation programs. Besides, promoting alternative pest control strategies such as use of biopesticides and integrated pest management (IPM) could be productive.

Knowledge and practice concerning malaria, insecticide-treated net (ITN) utilization and antimalarial treatment among pregnant women attending specialist antenatal clinics

AimThis 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 methodsThe study recruited 225 women who voluntarily presented at ANCs in Jimma town, Ethiopia. A pre-tested questionnaire was administered.ResultsA 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).ConclusionThe 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.

Ethnomedicinal knowledge, belief and self-reported practice of local inhabitants on traditional antimalarial plants and phytotherapy

ETHNOPHARMACOLOGICAL RELEVANCE This paper reveals the trend of knowledge and practice of traditional antimalarial plants (TAPs) to prevent/treat malaria. MATERIALS AND METHODS 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. RESULTS 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. CONCLUSION 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.

Peasant association member's knowledge, attitudes, and practices towards safe use of pesticide management

BACKGROUND Farmers in the developing world are at risk of pesticide exposure, particularly in low-income countries with a sizable agricultural sector like Ethiopia. The present investigation provides baseline data to develop strategies for the control of pesticide exposure and the prevention of pesticide poisoning. METHODS A questionnaire survey of a stratified random sample of peasant farmers belonging to peasant associations was conducted. RESULTS Most surveyed farmers sprayed pesticides without any personal protective equipment. The majority of participants reported using empty pesticide containers for drinking and food storage. Twenty percent of farmers applied pesticides by sweeping with plant leaves in a hazardous manner. CONCLUSIONS Ethiopian peasant farmers appeared to have limited knowledge of the hazards of pesticides and generally did not handle pesticides in a safe manner. Active health education campaigns and appropriate training programs should be instigated to promote safe use of pesticides.