Background & objectives: The distribution of insecticide-treated bednets (ITNs), as an alternative to untreated bednets or no bednet at all, not only directly prevents the mosquito from biting an individual, but kills the mosquito as well. This reduces the mosquito infestation at the household and community levels. However, barriers may exist limiting the effectiveness of malaria prevention by these tactics. Objectives of the study were to assess current disparities in access to ITNs, what factors may be associated with disparities in access and the progress of antimalaria interventions. Methods: This study examined disparities in access to intervention resources between rural and urban locations by assessing the percentage of households in each area that has at least one ITN. Demographic Health Survey (DHS) 2005 data from 16,823 survey respondents from Cambodia were explored, examining the ratio of households with at least one ITN according to various socioeconomic determinants. Statistical analysis was done using Chi-square and logistic regression with SPSS. Results: Problematic distance from ITN distributors, rural location, and poverty were all associated with greater unlikelihood of possession of least one household ITN. Conclusion: In order to effectively combat high malaria prevalence, interventions need to be refocused on increasing accessibility to ITNs. The limitations of this study require further investigation into alternative socioeconomic determinants.

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Background: In the past 60 years, antibiotics have been critical in the fight against infectious diseases caused by bacteria and other microbes. Development of resistance to the antibiotics is emerging as a major public health issue which has resulted in the search for new antibiotics in order to maintain a pool of effective drugs at all times. Currently, there is a great interest in cationic peptides as antibiotics. These are reported to destroy the host cell membrane rather interacting with the other cell components, which may not face emergence of resistance. In mosquitoes, peptides like cecropin, defensin and gambicin reported to have inhibitory effect on bacteria, fungi and parasites. These peptides are well-characterized at both the biochemical and molecular level from Anopheles and Culex species, yet their 3D structures were not reported. Methods: Defensin, cecropin and gambicin immune peptides of Culex pipiens was characterised to have antiparasitic, antibacterial and antifungal activities. Since the crystal structure of defensin, cecropin and gambicin are not yet available their 3D structures were determined using homology modeling and Rosetta fragment insertion methods and were validated. Results: Stereo chemical evaluation indicated that defensin and gambicin showed that 100% residues of constructed model lie in the most favoured and allowed regions. Cecropin iso-forms A and B showed 100% while C showed 97.6% residues that lie in most favoured and allowed regions, which indicated quality models. Conclusion: Predicted model provide insight into their structure and aid in the development of novel antibiotic peptides.

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Background & objectives: Mosquitoes transmit diseases to >700 million people annually. Malaria kills three million persons every year, including one child every 30 sec. Worldwide there are >3000 mosquito species. In Iraq, 37 species have been identified in different surveys over several decades. We conducted an entomological survey to determine the mosquito species and their distribution in Iraq in 2009. Methods: Between January 20 and December 31, 2009, mosquitoes in houses in 12 Iraqi provinces were collected and speciated. Five to 10 villages were selected randomly in each province and in each village 10 houses were selected randomly to collect mosquitoes and the density of mosquitoes per room was calculated. Kits for entomological investigation were used and the collected mosquitoes were sent to the vector borne disease section laboratory for classification using the Naval Medical Research Unit 3 standard classification key. Results: A total of 29,156 mosquitoes were collected, representing two genera: Anopheles (n=13,268, or 46% of the total collected) and Culex (n=15,888, or 54% of the total collected). Four Anopheles (An. pulcherrimus, An. stephensi, An. superpictus, and An. sacharovi) and one Culex (Cx. pipiens) species were identified. Anopheles pulcherrimus was found in 11 provinces, An. stephensi in 7, An. superpictus in 2 and An. sacharovi in one province, while Cx. pipiens was found in all the 12 provinces. Two peaks of mosquito density were found: the first from April–June and the other from September–October. Interpretation & conclusion: There are clear differences in Anopheles mosquito species geographical distribution and density among Iraqi provinces, while Cx. pipiens mosquitoes are distributed all over Iraq. All mosquito genera show clear seasonal density variation. The study highlights that the manual mosquito classification is not enough to identify all the species of mosquitoes in Iraq.

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Background & objectives: The saliva of the Phlebotominae is highly immunogenic to the vertebrate host and is a determining factor in the Leishmania infection. The aim of this work was to study the saliva of Lutzomyia ovallesi as a possible risk marker for the transmission of Leishmania. Methods: Two populations of L. ovallesi from different geographical areas and subjected to different environmental conditions were compared by geometric morphometry of the wings, by protein profile analysis of salivary glands and by assessing the presence of anti-saliva protein in human sera confronted with laboratory L. ovallesi saliva. Results: The results showed differences in the isometric size and structure of the wings but no allometric effects. Protein profiles of salivary glands of both the L. ovallesi populations studied were found to be similar, based on 11 protein bands with molecular weights ranging from 16 to 99 kDa. Anti-saliva antibodies were present in human sera, but human sera infected and uninfected with leishmaniasis could not be differentiated. Interpretation & conclusion: We conclude that the saliva of laboratory-reared L. ovallesi is representative of that of the wild population. It is suggested to study the presence of anti-saliva antibodies in other species of sandflies and mosquitoes.

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Background & objectives: Malaria healthcare policy change in Kenya aimed at improving the control of malaria but faced a number of challenges in implementation related to marketing of the drugs. This research investigated the effect of the change of the national malaria policy on drug sales and strategic marketing responses of antimalarial pharmaceutical companies in Kenya. Study design: A descriptive cross-sectional design was employed to describe the existing state of antimalarials market in Kenya after the change of the malaria healthcare policy. Results & conclusion: Policy change did result in an increase in the sales of Coartem^®. Novartis Pharma recorded a 97% growth in sales of Coartem^® between 2003 and 2004. However, this increase was not experienced by all the companies. Further, SPs (which had been replaced as first-line therapy for malaria) registered good sales. In most cases, these sales were higher than the sales of Coartem^®. Generally, the sales contribution of SPs and generic antimalarial medicines exceeded that of Coartem^® for most distributors. The most common change made to marketing strategies by distributors (62.5%) was to increase imports of antimalarials. A total of 40% of the manufacturers preferred to increase their budgetary allocation for marketing activities. In view of the fact that continued sale of SP drugs and limited availability of AL poses the risk of increasing the incidence of malaria in Kenya, it is therefore, recommended that pharmacy surveillance systems be strengthened to ensure drugs that have been rendered non-viable or that prescription-only medicines are not sold contrary to the national guidelines.

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Background & objectives: Rapid and accurate diagnosis and identification of Leishmania sp causing cutaneous leishmaniasis is crucial in control and therapeutic programs. The problem of diagnosis with traditional methods is that they have a low sensitivity or time consuming but molecular techniques would be an alternative method for rapid and accurate diagnosis. In this work, tryparedoxine peroxidase gene-based real-time PCR was used for accurate identification of Leishmania spp causing Old-World cutaneous leishmaniasis. Methods: In this study, biopsies of specimens were taken from the ulcerative sites in 100 patients and used for direct microscopy, culture in NNN or fixed in alcohol for identification of Leishmania spp using tryparedoxin peroxidase gene-based realtime PCR (qPCR). Results: Using direct microscopy and culture method, Leishmania parasites were isolated from 68 out of 100 patient samples. However, 13 patients with negative finding on traditional tests, had positive results on RT-PCR test. After melting curve analysis of PCR product, Leishmania major in 75 and L. tropica in 4 cases were identified. The sensitivity and specificity of RT-PCR for diagnosis of cutaneous leishmaniasis was 98.7 and 59.8%, respectively. Conclusion: Results of this study showed that RT-PCR was the most sensitive diagnostic test for cutaneous leishmaniasis and represents a tool for rapid species identification.

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Background & objectives: The treatment of wounds with live green bottle fly larvae is receiving considerable attention in many countries. Laboratory rearing of Lucilia sericata is crucially important for the treatment of wounds. Study design: The study was carried out for mass rearing of green bottle flies from April to November 2010. Hand catch and net trap baited with beef and cattle liver were used to collect adult flies from the field. The collected samples were placed in appropriately labeled tubes and sent to the laboratory. Adult stage flies reared in the insectary were used for species identification using specific keys. Results: A total of 89 flies (55 females and 34 males) were collected from Hashtgerd area. In the first generation, 299 flies were produced in the laboratory including 105 (35.12%) males, and 194 (64.88%) females. The female/male sex ratio was 1.61 for parents, whereas it was 1.84, 1.30 for F1 and F2 generations respectively. In total, 432 flies were reared in F3 generation including 173 (40.04%) males, and 259 (59.96%) females, and the sex ratio was 1.49. Conclusion: Setting up the mass rearing of sheep blowfly at the School of Public Health, Tehran University of Medical Sciences is an important step in producing candidate flies for the treatment of myiasis by maggot therapy in future.

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