Usavadee Thavara

Climatic and social risk factors for Aedes infestation in rural Thailand

An intense epidemic of dengue haemorrhagic fever in 1998 prompted the Thai government to investigate the feasibility of focalized vector (Aedes aegypti) control programmes. We tested for correlations of three indices of Aedes larval abundance (housing index, container index and Breteau index) against 38 socio‐economic and four climatic variables. Availability of public water wells, existence of transport services and proportion of tin houses were positively associated with larval indices. Private water wells, health education, health insurance coverage, thatched houses and use of firewood for cooking were negatively associated. These probably represent both direct effects on breeding sites (private vs. public wells decrease necessity to store water, and health education may encourage breeding site removal), and more general effects of health‐related attitudes, housing quality and remoteness from urban areas. Indices were positively associated with daily minimum temperature, an increase in precipitation from the previous month (reflecting the onset of the rainy season) and daily maximum temperatures of approximately 33–34 °C. The associations were used to derive statistical models to predict the rank order of larval indices within the study area (Spearmans correlation coefficients = 0.525–0.554). The study provides a rational basis for identifying possible social interventions, and for prioritizing previously unsurveyed villages for further monitoring and focalized vector control.

Insecticide Resistance in Bedbugs in Thailand and Laboratory Evaluation of Insecticides for the Control of Cimex hemipterus and Cimex lectularius (Hemiptera: Cimicidae)

ABSTRACT Bedbugs are found in many countries around the world, and in some regions they are resistant to numerous insecticides. This study surveyed bedbugs in Thailand and determined their resistance to insecticides. The surveys were carried out in six provinces that attract large numbers of foreign tourists: Bangkok, Chonburi, Chiang Mai, Ubon Ratchathani, Phuket, and Krabi. Bedbugs were collected from hotels and colonized in the laboratory to evaluate their resistance to insecticides. Cimex hemipterus (F.) was found in some hotels in Bangkok, Chonburi, Phuket, and Krabi, whereas Cimex lectularius L. was found only in hotels in Chiang Mai. No bedbugs were found in Ubon Ratchathani. The colonized bedbugs showed resistance to groups of insecticides, including organochlorines (dichlorodiphenyl trichloroethane, dieldrin), carbamates (bendiocarb, propoxur), organophosphates (malathion, fenitrothion), and pyrethroids (cyfluthrin, deltamethrin, permethrin, &lgr;-cyhalothrin, etofenprox) in tests using World Health Organization insecticide-impregnated papers. The new insecticides imidacloprid (neonicotinoid group), chlorfenapyr (pyrrole group), and fipronil (phenylpyrazole group) were effective against the bedbugs; however, organophosphate (diazinon), carbamates (fenobucarb, propoxur), and pyrethroids (bifenthrin, cypermethrin, esfenvalerate, etofenprox) were ineffective. Aerosols containing various pyrethroid insecticides with two to four different active ingredients were effective against the bedbugs. The results obtained from this study suggested that both species of bedbugs in Thailand have developed marked resistance to various groups of insecticides, especially those in the pyrethroid group, which are the most common insecticides used for pest control. Therefore, an integrated pest management should be implemented for managing bedbugs in Thailand.

FIELD EVALUATION OF DEET, REPEL CARE®, AND THREE PLANT-BASED ESSENTIAL OIL REPELLENTS AGAINST MOSQUITOES, BLACK FLIES (DIPTERA: SIMULIIDAE), AND LAND LEECHES (ARHYNCHOBDELLIDA: HAEMADIPSIDAE) IN THAILAND

ABSTRACT Diethyl methyl benzamide or deet, a commercial plant-based repellent (Repel Care®), and essential oils from 3 species of plants (finger root rhizomes, guava leaves, and turmeric rhizomes), steam distillated and formulated as insect repellents, were evaluated in the field on human volunteers against hematophagous mosquitoes, black flies, and land leeches in Thailand. Field trials were conducted against wild mosquitoes in Bang Bua Thong District, Nonthaburi Province, and in the Thap Lan National Park Headquarters, Nadee District, Prachinburi Province; anthropophilic black flies (Diptera: Simuliidae) at the Forestry Fire Control Station in Doi Inthanon National Park, Chomthong District, Chiang Mai Province; and land leeches (Arhynchobdellida: Haemadipsidae) in the Khao Yai National Park, Pak Chong District, Nakhon Ratchasima Province. The 3 experimental plant-based essential oil formulations as well as Repel Care and deet provided complete protection from mosquito landing and biting for up to 9 h (duration of the experiment). Similar results were obtained with the 5 products against black flies, providing 100% protection for 9 h but 96–82% protection after 10 and 11 h posttreatment. The 5 repellent products also provided 100% protection against land leeches for at least 8 h. This is the 1st report of repellency of plant-based repellents against black flies and land leeches in Thailand. The identification and availability of inexpensive sources of plant-based oils, i.e., finger root rhizomes, guava leaves, and turmeric rhizomes providing long-lasting repellency against blood-sucking organisms are promising leads into commercial production of relatively safe and effective repellents.

Molecular survey of the head louse Pediculus humanus capitis in Thailand and its potential role for transmitting Acinetobacter spp.

BackgroundHead louse infestation, which is caused by Pediculus humanus capitis, occurs throughout the world. With the advent of molecular techniques, head lice have been classified into three clades. Recent reports have demonstrated that pathogenic organisms could be found in head lice. Head lice and their pathogenic bacteria in Thailand have never been investigated. In this study, we determined the genetic diversity of head lice collected from various areas of Thailand and demonstrated the presence of Acinetobacter spp. in head lice.MethodsTotal DNA was extracted from 275 head louse samples that were collected from several geographic regions of Thailand. PCR was used to amplify the head louse COI gene and for detection of Bartonella spp. and Acinetobacter spp. The amplified PCR amplicons were cloned and sequenced. The DNA sequences were analyzed via the neighbor-joining method using Kimura’s 2-parameter model.ResultsThe phylogenetic tree based on the COI gene revealed that head lice in Thailand are clearly classified into two clades (A and C). Bartonella spp. was not detected in all the samples, whereas Acinetobacter spp. was detected in 10 samples (3.62%), which consisted of A. baumannii (1.45%), A. radioresistens (1.45%), and A. schindleri (0.72%). The relationship of Acinetobacter spp. and the head lice clades showed that Acinetobacter spp. was found in clade A and C.ConclusionsHead lice in Thailand are classified into clade A and B based on the COI gene sequences. Pathogenic Acinetobacter spp. was detected in both clades. The data obtained from the study might assist in the development of effective strategies for head lice control in the future. Detection of pathogenic bacteria in head lice could raise awareness of head lice as a source of nosocomial bacterial infections.

Mitochondrial DNA-based identification of some forensically important blowflies in Thailand.

Accurate identification of insects collected from death scenes provides not only specific developmental data assisting forensic entomologists to determine the postmortem interval more precisely but also other kinds of forensic evidence. However, morphological identification can be complicated due to the similarity among species, especially in the early larval stages. To simplify and make the species identification more practical and reliable, DNA-based identification is preferentially considered. In this study, we demonstrate the application of partial mitochondrial cytochrome oxidase I (COI) and cytochrome oxidase II (COII) sequences for differentiation of forensically important blowflies in Thailand; Chrysomya megacephala, Chrysomya rufifacies and Lucilia cuprina by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The PCR yields a single 1324bp-sized amplicon in all blowfly specimens, followed by direct DNA sequencing. Taq(α)I and VspI predicted from the sequencing data provide different RFLP profiles among these three species. Sequence analysis reveals no significant intraspecific divergence in blowfly specimens captured from different geographical regions in Thailand. Accordingly, neighbor-joining tree using Kimuras 2-parameter model illustrates reciprocal monophyly between species. Thus, these approaches serve as promising tools for molecular identification of these three common forensically important blowfly species in Thailand.

Morbidity Rate Prediction of Dengue Hemorrhagic Fever (DHF) Using the Support Vector Machine and the Aedes aegypti Infection Rate in Similar Climates and Geographical Areas.

Background In the past few decades, several researchers have proposed highly accurate prediction models that have typically relied on climate parameters. However, climate factors can be unreliable and can lower the effectiveness of prediction when they are applied in locations where climate factors do not differ significantly. The purpose of this study was to improve a dengue surveillance system in areas with similar climate by exploiting the infection rate in the Aedes aegypti mosquito and using the support vector machine (SVM) technique for forecasting the dengue morbidity rate. Methods and Findings Areas with high incidence of dengue outbreaks in central Thailand were studied. The proposed framework consisted of the following three major parts: 1) data integration, 2) model construction, and 3) model evaluation. We discovered that the Ae. aegypti female and larvae mosquito infection rates were significantly positively associated with the morbidity rate. Thus, the increasing infection rate of female mosquitoes and larvae led to a higher number of dengue cases, and the prediction performance increased when those predictors were integrated into a predictive model. In this research, we applied the SVM with the radial basis function (RBF) kernel to forecast the high morbidity rate and take precautions to prevent the development of pervasive dengue epidemics. The experimental results showed that the introduced parameters significantly increased the prediction accuracy to 88.37% when used on the test set data, and these parameters led to the highest performance compared to state-of-the-art forecasting models. Conclusions The infection rates of the Ae. aegypti female mosquitoes and larvae improved the morbidity rate forecasting efficiency better than the climate parameters used in classical frameworks. We demonstrated that the SVM-R-based model has high generalization performance and obtained the highest prediction performance compared to classical models as measured by the accuracy, sensitivity, specificity, and mean absolute error (MAE).

Multiple Cutaneous Nodules in an HIV-Infected Patient

1 Medical Science Program, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand, 2 Division of Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand, 3 Department of Parasitology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand, 4 Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand, 5 Medical Sciences, National Institutes of Health Ministry of Public Health, Nonthaburi, Thailand, 6 Excellence Center for Emerging Infectious Diseases, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand

Dengue Haemorrhagic Fever in Thailand: Current Incidence and Vector Management

Dengue, dengue haemorrhagic fever and dengue shock syndrome are endemic throughout South East Asia where they present a serious public health concern. The current status of these diseases in Thailand is described along with the challenges that confront those who seek to control the spread of these diseases.

Detection of an Unknown Trypanosoma DNA in a Phlebotomus stantoni (Diptera: Psychodidae) Collected From Southern Thailand and Records of New Sand Flies With Reinstatement of Sergentomyia hivernus Raynal & Gaschen, 1935 (Diptera: Psychodidae).

Abstract Although female sand flies are best known as the vectors of Leishmania parasites and viruses, several previous reports have demonstrated that these insects can also act as vectors for the trypanosomes of bats, lizards, and snakes. In this report, we created an inventory of Phlebotomine sand flies from southern Thailand. A novel trypanosome was found in a specimen of Phlebotomus stantoni, and two sand fly species newly recorded in the country, Sergentomyia khawi and Sergentomyia hivernus, were described. PCR primer pairs specific for the internal transcribed spacer 1 (ITS1) and the small subunit ribosomal DNA (SSU rDNA) gene of trypanosomatids were used to demonstrate the presence of the parasite in the sand fly. In addition, the Cytochrome b (CytB) gene was used to identify the sand fly species. Among the 45 samples of the sand fly that were collected, seven samples were Ph. stantoni sand flies and a single sample was positive for Trypanosoma sp. through PCR analysis. This study represents the first detection of Trypanosoma sp. in a sand fly from Thailand. The ITS1 and SSU rDNA sequences indicated that this specimen is suspected to be a novel Trypanosoma species. Further studies of this suspected new Trypanosoma species, including its vertebrate hosts and pathogenic potential, are therefore necessary.

Efficacy and safety of topical Trikatu preparation in, relieving mosquito bite reactions: a randomized controlled trial.

INTRODUCTION Trikatu is composed of dried fruits of Piper nigrum L and Piper retrofractum Vahl, and dried rhizomes of Zingiber officinale R. Although this preparation has been used to relieve pruritis, pain, and inflammation for a long time, there is no clinical evidence to confirm its efficacy and safety. Therefore, we performed a double-blind, within person-randomized controlled study of 30 healthy volunteers to determine efficacy and safety of topical Trikatu on mosquito bite reactions. METHODS All subjects were bitten by Aedes aegypti laboratory mosquitoes on their forearms and they were randomly assigned arms to apply either Trikatu or reference product on the mosquito bite papule. The main outcome was the difference of papule size reduction at 30 min, measured by a caliper, between the Trikatu and reference arms. Pruritis, redness, pain, and patient satisfaction were assessed at 15, 30, 60, 180, and 360 min as secondary outcomes. RESULTS There were no significant differences between treatment and reference arms on any outcome at any time of measurement. CONCLUSION Trikatu did not show additional effects for relieving mosquito bite reaction as compared with the reference product containing camphor, menthol, and eucalyptus. For further study, it is very important to consider a proper selection of subjects, comparator product, and concentration of extract when Trikatu preparation is investigated.