User friendliness, efficiency & spray quality of stirrup pumps versus hand compression pumps for indoor residual spraying.

Background & objectives: Indoor residual spraying (IRS) is a proven tool to reduce visceral leishmaniasis vectors in endemic villages. In India IRS is being done with stirrup pumps, whereas Nepal, Bangladesh, and other countries use compression pumps. The present study was conducted with the objectives to compare the efficiency, cost and user friendliness of stirrup and compression pumps. Methods: The study was carried out in Gorigawan village of the Vaishali district in north Bihar and included a total population of 3259 inhabitants in 605 households. Spraying with 50 per cent DDT was done by two teams with 6 persons per team under the supervision of investigators over 5 days with each type of pump (10 days in total using 2 stirrup pumps and 3 compression pumps) by the same sprayers in an alternate way. The spraying technique was observed using an observation check list, the number of houses and room surfaces sprayed was recorded and an interview with sprayers on their satisfaction with the two types of pumps was conducted. Results: On average, 65 houses were covered per day with the compression pump and 56 houses were covered with the stirrup pump. The surface area sprayed per squad per day was higher for the compression pump (4636 m2) than for the stirrup pump (4102 m2). Observation showed that it was easy to maintain the spray swath with the compression pump but very difficult with the stirrup pump. The wastage of insecticide suspension was negligible for the compression pump but high for the stirrup pump. Interpretation & conclusions: The compression pump was found to be more user friendly due to its lower weight, easier to operate, lower operation cost, higher safety and better efficiency in terms of discharge rate and higher area coverage than the stirrup pump.

Postcoital intra-uterine aspirate--a unique criterion for selecting patients for natural or assisted conception.

The success of any infertility management programme is reflected in its efficacy to achieve a pregnancy either spontaneously or through assistance. For this purpose some routine investigations are carried out to pinpoint the nature of problem(s) which an infertile couple is troubled with. As the basic requisite for conception to occur is the accumulation of motile spermatozoa around the egg at the site of fertilisation, proper assessment of sperm transit from the vagina to the tubal ampulla becomes a very important criterion to predict the possibility of spontaneous pregnancy. Till date postcoital test was the sole investigative tool available to serve this purpose but unfortunately it fails to furnish any information about the concentration and nature of quality of spermatozoa beyond the cervix. This results in the disparity between postcoital test results and pregnancy outcome. In the present study intra-uterine fluid was examined along with cervical mucus 4-6 hours postcoitus in the pre-ovulatory period. The objective was to gather information about the fate of spermatozoa subjected to the uterine environment after being vaginally deposited during coitus. The result of this combined test has been found to be very much informative and helpful for the fertility physician to set the criteria for timed intercourse and / or intra-uterine insemination. This simple test thus appears to play a leading role in infertility management in near feature.

The epidemiology of visceral leishmaniasis in Bangladesh: prospects for improved control.

The parasitic disease kala-azar (visceral leishmaniasis, VL) was first described in 1824 in Jessore district, Bengal (now Bangladesh). Epidemic peaks were recorded in Bengal in the 1820s, 1860s, 1920s, and 1940s. After achieving good control of the disease during the intensive vector control efforts for malaria in the 1950s-1960s, Bangladesh experienced a VL resurgence that has lasted to the present. Surveillance data show an increasing trend in incidence since 1995. Research in recent years has demonstrated the utility of non-invasive diagnostic modalities such as the direct agglutination test and rapid tests based on the immune response to the rK39 antigen. In common with its neighbours India and Nepal, VL in Bangladesh is anthroponotic. Living in proximity to a kala-azar case is the strongest risk factor for disease, while consistent use of bed nets in the summer months and the presence of cattle are protective. Shortages of first-line antileishmanial drugs and insecticide for indoor spraying programmes have hindered VL treatment and vector control efforts. Effective control of VL will require activities to improve availability and access to diagnostic testing and antileishmanial drugs, enhanced surveillance for kala-azar, post-kala-azar dermal leishmaniasis and VL treatment failures, and increased coverage and efficacy of vector control programmes.