Satyanarayan Tiwari

A community-based health education programme for bio-environmental control of malaria through folk theatre (Kalajatha) in rural India

BackgroundHealth education is an important component in disease control programme. Kalajatha is a popular, traditional art form of folk theatre depicting various life processes of a local socio-cultural setting. It is an effective medium of mass communication in the Indian sub-continent especially in rural areas. Using this medium, an operational feasibility health education programme was carried out for malaria control.MethodsIn December 2001, the Kalajatha events were performed in the evening hours for two weeks in a malaria-affected district in Karnataka State, south India. Thirty local artists including ten governmental and non-governmental organizations actively participated. Impact of this programme was assessed after two months on exposed vs. non-exposed respondents.ResultsThe exposed respondents had significant increase in knowledge and change in attitude about malaria and its control strategies, especially on bio-environmental measures (p < 0.001). They could easily associate clean water with anopheline breeding and the role of larvivorous fish in malaria control. In 2002, the local community actively co-operated and participated in releasing larvivorous fish, which subsequently resulted in a noteworthy reduction of malaria cases. Immediate behavioural changes, especially maintenance of general sanitation and hygiene did not improve as much as expected.ConclusionThis study was carried out under the primary health care system involving the local community and various potential partners. Kalajatha conveyed the important messages on malaria control and prevention to the rural community. Similar methods of communication in the health education programme should be intensified with suitable modifications to reach all sectors, if malaria needs to be controlled.

Comparative efficacy of two poeciliid fish in indoor cement tanks against chikungunya vector Aedes aegypti in villages in Karnataka, India

BackgroundIn 2006, severe outbreaks of Aedes aegypti-transmitted chikungunya occurred in villages in Karnataka, South India. We evaluated the effectiveness of combined information, education and communication (IEC) campaigns using two potential poeciliid larvivorous fish guppy (Poecilia reticulata) and mosquitofish (Gambusia affinis), in indoor cement tanks for Aedes larval control.MethodsTrials were conducted in two villages (Domatmari and Srinivaspura) in Tumkur District from March to May 2006 for Poecilia and one village (Balmanda) in Kolar District from July to October 2006 for Gambusia. A survey on knowledge, attitude and practice (KAP) on chikungunya was initially conducted and IEC campaigns were performed before and after fish release in Domatmari (IEC alone, followed by IEC + Poecilia) and Balmanda (IEC + Gambusia). In Srinivaspura, IEC was not conducted. Larval surveys were conducted at the baseline followed by one-week and one-month post-intervention periods. The impact of fish on Aedes larvae and disease was assessed based on baseline and post-intervention observations.ResultsOnly 18% of respondents knew of the role of mosquitoes in fever outbreaks, while almost all (n = 50 each) gained new knowledge from the IEC campaigns. In Domatmari, IEC alone was not effective (OR 0.54; p = 0.067). Indoor cement tanks were the most preferred Ae. aegypti breeding habitat (86.9%), and had a significant impact on Aedes breeding (Breteau Index) in all villages in the one-week period (p < 0.001). In the one-month period, the impact was most sustained in Domatmari (OR 1.58, p < 0.001) then Srinivaspura (OR 0.45, p = 0.063) and Balmanda (OR 0.51, p = 0.067). After fish introductions, chikungunya cases were reduced by 99.87% in Domatmari, 65.48% in Srinivaspura and 68.51% in Balmanda.ConclusionsPoecilia exhibited greater survival rates than Gambusia (86.04 vs.16.03%) in cement tanks. Neither IEC nor Poecilia alone was effective against Aedes (p > 0.05). We conclude that Poecilia + IEC is an effective intervention strategy. The operational cost was 0.50 (US

Observations on sporozoite detection in naturally infected sibling species of the Anopheles culicifacies complex and variant of Anopheles stephensi in India

0.011, 1 US

Effectiveness of a New Granular Formulation of Biolarvicide Bacillus thuringiensis Var. israelensis Against Larvae of Malaria Vectors in India

= 47) per capita per application. Proper water storage practices, focused IEC with Poecilia introductions and vector sanitation involving the local administration and community, is suggested as the best strategy for Aedes control.

Assessing perceptions about malaria among the elected representatives in rural India

Sporozoites were detected in naturally infected sibling species of the primary rural vector Anopheles culicifacies complex in two primary health centres (PHCs) and a variant of the urban vector Anopheles stephensi in Mangalore city, Karnataka, south India while carrying out malaria outbreak investigations from 1998–2006. Sibling species of An. culicifacies were identified based on the banding patterns on ovarian polytene chromosomes, and variants of An. stephensi were identified based on the number of ridges on the egg floats. Sporozoites were detected in the salivary glands by the dissection method. Of the total 334 salivary glands of An. culicifacies dissected, 17 (5.08%) were found to be positive for sporozoites. Of the 17 positive samples, 11 were suitable for sibling species analysis; 10 were species A (an efficient vector) and 1 was species B (a poor vector). Out of 46 An. stephensi dissected, one was sporozoite positive and belonged to the type form (an efficient vector). In malaria epidemiology this observation is useful for planning an effective vector control programme, because each sibling species/variant differs in host specificity, susceptibility to malarial parasites, breeding habitats and response to insecticides.

Prevalence of malaria, dengue and chikungunya significantly associated with mosquito breeding sites

Control of vector(s) or mosquitoes, in general, through biolarvicide as an alternate biocontrol agent is a greatest desire. We evaluated a water-dispersible granular formulation biolarvicide Bacillus thuringiensis var. israelensis (Bti, H-14 serotype; VectoBac(®) WDG) in the laboratory and also in the field against two principal malaria vectors, Anopheles culicifacies and Anopheles stephensi. Laboratory evaluations against laboratory-reared immature of the two species were carried out at a temperature of 28°C ± 2°C and 70%-80% relative humidity. Field trials were conducted in a rural area and in Bangalore city, Karnataka, South India. First trial against the rural vector An. culicifacies was carried out in stone quarry pits at dosages of 0.05, 0.2, and 1 g/m(2). The second trial against urban vector An. stephensi was carried out in ring wells at 0.05, 0.1, 0.2, 0.5, and 1 g/m(2) dosages. Laboratory tests revealed increased efficacy against An. stephensi. The fifty percent lethal concentration (LC(50)) and LC(90) values against An. culicifacies and An. stephensi were 0.348 and 1.008 mg/L (χ(2) = 8.49; p > 0.05) and 0.245 and 0.533 mg/L (χ(2) = 4.67; p < 0.05), respectively. Based on the findings of no pupal production in the field, the formulation was effective up to 14 days at 0.2 g/m(2) or more appropriately at 0.25 g/m(2) dose for both the species under field conditions. We discuss how this new formulation was evaluated against An. culicifacies and An. stephensi under laboratory and field conditions. No adverse effects were observed on the nontarget species such as frogs, their tadpoles, small local fish, Notonectid bugs, and water scatters. We conclude that VectoBac WDG is effective at 0.25 g/m(2) and be recommended for its use in the vector-borne disease control program under integrated vector management concept.

Socio-Economic-Political-Cultural Aspects in Malaria Control Programme Implementation in Southern India

Objective: The short-term objective of our endeavour was to understand the perception of Grama panchayat presidents and secretaries on the issues related to malaria and its control, being the key leaders of the Panchayat Raj Institutions (PRIs) at a Grama panchayat level. This was necessary to achieve the long-term objective of the role of PRIs in malaria control and their enhanced participation/partnership with the public health sector. Materials and Methods: Grama panchayat presidents and secretaries representing all the 28 Grama panchayats of Chikkanayakanahalli taluk Tumkur district in Karnataka were invited for a 1-day workshop. Deliberations with the participants (n = 32) shed light on their perceptions with respect to knowledge, attitude and practice vis-a-vis malaria and its control strategies. Results: Their knowledge of malaria as a disease was fairly good as they were well aware of it being a communicable disease and its transmission by mosquitoes. However, knowledge about the breeding sources of malaria mosquitoes (Anophelines) was very poor. Many practices in vogue to control mosquitoes at the community level were unscientific. There was a general negative attitude toward the government′s handling of the malaria problem and the credibility of the health care system. Conclusion: Existence of health committees in every Grama panchayat coupled with their jurisdiction and responsibilities toward sanitation, water supply and health care resources makes PRIs a natural partner to the health sector. While health education and public health intervention strategies should be based on generic principles of science, the implementation and operational specifics should definitely be based on a sociological perspective of the stakeholders.

Village-scale (Phase III) evaluation of the efficacy and residual activity of SumiShield® 50 WG (Clothianidin 50%, w/w) for indoor spraying for the control of pyrethroid-resistant Anopheles culicifacies Giles in Karnataka state, India

Objectives: To observe the prevalence of malaria, dengue, and chikungunya and their association with mosquito breeding sites. Methods: The study was observational and analytical. A total of 162 houses and 670 subjects were observed during the study period. One hundred forty-two febrile patients were eligible for the study. After obtaining informed consent from all febrile patients, 140 blood samples were collected to diagnose malaria, dengue, and chikungunya. Larval samples were collected by the standard protocol that follows. Correlation of data was performed by Pearson correlation test. Results: Forty-seven blood samples were found positive: 33 for chikungunya, 3 for dengue, and 11 for malaria. Fifty-one out of 224 larval samples were found positive. Out of the 51 positive samples, 37 were positive for Aedes, 12 were positive for Anopheles, and two were positive for Culex larvae. Interpretation and Conclusion: Mosquito-borne fevers, especially malaria, dengue, and chikungunya, have shown a significant relationship with mosquito breeding sites.

Influence of midgut microbiota in Anopheles stephensi on Plasmodium berghei infections

Objective. A Socio-economic-political-cultural (SEPC) study was undertaken under the Roll Back Malaria (RBM) initiative to understand the process of programme implementation and how far in the changing malaria context, the broader environment has been understood and programme components have undergone changes. Material and Methods. Two studies were carried out; first in four villages under the primary health unit (PHU) Banavaralu in Tiptur Taluka in September 2002 and the second one in April 2003 in four villages in Chitradurga district, namely, Kappagere, Kellodu in Hosadurga Taluka, and Vani Vilas Puram and Kathrikenhally in Hiriyur Taluka. Focus group discussion and key interviews were adopted to collect the qualitative data. Results. Gender discrimination and lack of empowerment of women came out strongly in social analysis. In the rural elected bodies called Panchayats, the concept of health committees was not known. Health committees as one of the important statutory committees under every Panchayat were nonexistent in reality in these villages. Financial difficulties at Grama Panchayat level and also meager budget allocation for health have led to indifferent attitude of Panchayat members towards health. It was observed that there were generally no specific cultural practices in relation to malaria cure. Cultural and traditional practices in malaria-related issues were not predominant in the community except for some sporadic instances. Conclusion and Recommendation. SEPC study is an important indicator in malaria control programme. It is ultimately the community that takes the major decision directly or indirectly and the health authority must guide them in right direction.

Small-scale (Phase II) evaluation of the efficacy and residual activity of SumiShield® 50 WG (clothianidin 50%, w/w) for indoor residual spraying in comparison to deltamethrin, bendiocarb and pirimiphos-methyl for malaria vector control in Karnataka state, India

There is an urgent need to test and incorporate new molecules with promising efficacy and novel mode of action to control insecticide‐resistant mosquito vectors for disease control. We tested a new compound, clothianidin (SumiShield 50 WG), for its efficacy as an indoor residual spray (IRS) for the control of pyrethroid‐resistant Anopheles culicifacies (Diptera: Culicidae) in comparison with pirimiphos methyl (Actellic CS) as a positive control.