Difusión masiva de reportes situacionales sobre dengue: efectos de la intervención en Guadalajara de Buga, Colombia / Mass communication of dengue surveillance data: effect of an intervention in Guadalajara de Buga, Colombia

Introducción. La retroalimentación a las comunidades de la situación de dengue en su localidad, podría ser útil para mantener la motivación para su participación en el control del dengue y disminuir los índices entomológicos de Aedes . Objetivos. Evaluar la cobertura y el alcance de una intervención basada en la difusión masiva de reportes situacionales sobre el dengue y su efecto en la presencia de criaderos intradomiciliarios de Aedes spp. en Guadalajara de Buga, Colombia. Materiales y métodos. Se llevó a cabo un estudio observacional de corte transversal en 1.426 viviendas, para establecer la presencia de criaderos intradomiciliarios y caracterizar la exposición a la intervención. El efecto de la intervención se evaluó en un estudio de casos y controles. Los casos obedecieron al total de viviendas con criaderos positivos y, entre las viviendas sin criaderos positivos ubicadas en la misma manzana del caso, se seleccionaron aleatoriamente cuatro controles por caso. Resultados. El índice de viviendas positivas fue de 2,5 %. La cobertura fue del 59,4 % y el alcance del 22,3 %. El contacto con la intervención no se asoció con la ausencia de criaderos intradomiciliarios positivos. La presencia de matas con agua o floreros se asoció con criaderos positivos (p=0,01) y el uso de anjeos se consideró como factor protector (p=0,02). Conclusiones. Aunque la cobertura de la intervención fue adecuada, no se observó que tuviera efecto sobre la ausencia de criaderos intradomiciliarios positivos. Por lo tanto, se requiere la evaluación de la intervención en términos de su fidelidad, diseño y proceso de implementación.

Introduction: Maintaining communities abreast of their local dengue situation could help to keep them motivated to participate in dengue control and to decrease Aedes entomological indexes. Objectives: To evaluate the coverage and reach of an intervention based on mass-media communication of dengue surveillance reports and its effect on the presence of intra-domiciliary breeding sites for Aedes in Guadalajara de Buga, Colombia. Materials and methods: An observational cross-sectional study was conducted in 1,426 households to identify the intra-domiciliary breeding sites and to characterize the intervention exposure. To evaluate the effect of the intervention, a case-control study was performed. All households with positive breeding sites were considered as cases. Four controls per case were randomly selected among the non-positive breeding site households located on the same block of the case. Results: The positive house index was 2.5%; coverage was 59.4% and reach was 22.3%. There was no association between the intervention and the presence of intra-domiciliary breeding sites. The presence of water plants and flower pots were associated to positive breeding sites (p=0.01) and the use of screens was associated to the absence of breeding sites (p=0.02). Conclusions: Although intervention coverage was adequate, the lack of association between the intervention and the absence of positive breeding sites requires assessing its fidelity, factors related to the design, and the implementation process.

Plan de mejoramiento del control de la malaria hacia su eliminación en Mesoamérica / Plan to improve malaria control towards its elimination in Mesoamerica

Desarrollar un plan de fortalecimiento del control de la mala-ria hacia su eliminación. En 2009, bajo la coordinación del Instituto Nacional de Salud Pública, se integró un equipo técnico transdisciplinario para hacer un diagnóstico situacional de la malaria y de los programa de control y para la selección de prácticas efectivas de intervención que serían incorporadas al plan, en el marco de un ejercicio de teoría de cambio. Se establecieron criterios de estratificación de las localidades con base en sus condiciones de transmisión. Se identificaron limitaciones estructurales y operativas de los programas de control. Se elaboró un plan de intervenciones para mejorar la cobertura de vigilancia epidemiológica, intervenciones antimaláricas y diagnóstico y tratamiento oportunos de casos. El plan delinea con fases progresivas de implementación: reorganización, intensificación de intervenciones y evaluación de la factibilidad de eliminación. La adopción de un plan estratégico único brindará lineamientos y elementos administrativos para conformar un sistema que coordine las actividades de los programas nacionales de control y facilite la eliminación de la malaria en la región.

To develop a plan to strengthen the control of malaria towards its elimination. In 2009, under the coordination of the National Public HealthInstitute ofMexico, atransdisciplinary equipment of technical and operative experts was conformed to carry out a situational analysis of malaria and control programs and for the selection of effective practices of intervention that would be incorporated to the plan, within the framework of an exercise in Theory of Change. Criteria for thestratificationof thelocalities, based ontheirtransmission characteristics were established. The structural and operative limitations of the control programs were identified. A plan of interventions was elaborated to improve the coverage of epidemiological surveillance, anti-malaria interventions and opportune diagnosis and treatment of cases. The plan delineates progressive phases of implementation: reorganization, intensification of interventions and evaluation of elimination feasibility. The adoption of a regional strategic plan will provide guidance and administrative elements to conform a system that coordinates the activities of the national control programs and facilitate the elimination of malaria in the region.

La estrategia para la prevención y el control integrado del dengue en Mesoamérica / Integrated prevention and control strategy for dengue in Mesoamerica

El dengue en las Américas es un problema de salud pública en ascenso. Las estrategias de control han sido poco efectivas al sustentarse en el uso intensivo de insecticidas y la poca participación de la comunidad. La Iniciativa Mesoamericana para la Prevención y el Control Integrado del Dengue integra los trabajos generados por la Estrategia de Gestión Integrada de la Organización Panamericana para la Salud (OPS) y la estrategia de estratificación de riesgos diseñada para los países de la región mesoamericana. El objetivo es reducir progresivamente la incidencia de dengue hasta un 50% de los casos en cinco años. En este documento se describen los elementos para la estratificación de riesgo, las actividades de prevención y control escalonadas en intensidad y frecuencia y los indicadores de seguimiento para el logro de los objetivos. Frente a la dispersión del problema se propone concentración de esfuerzos de control en las áreas de mayor riesgo; ante la rapidez de la transmisión se propone la oportunidad en la detección de casos; contra la expansión de los criaderos se propone la focalización de las acciones sobre los criaderos más productivos; y ante la severidad de la infección se propone un manejo clínico adecuado. Dicha estrategia se diseñó con los representantes nacionales de los programas de control para crear planes maestros que proporcionaran las bases para la prevención y el control integrado del dengue en la región mesoamericana.

Dengue in the Americas is a public health problem in ascent. The control strategies have not been effective when sustained in the intensive use of insecticides and poor community participation. The Mesoamerican Initiative for the Prevention and the Integrated Control of Dengue synthesizes the works generated by the Integrated Strategy of the Pan-American Health Organization (PAHO) and the risks stratification strategy designed by the countries of the Mesoamerican region. The objective is to progressively reduce the incidence of dengue cases until a 50% reduction is reached over a five years period. This document describes the elements for the risk stratification, the activities for prevention and control organized by levels of intensity and frequency and the indicators used to pursuit the objectives. To face the dispersion of the problem a concentration of efforts for control in the areas of greater risk is presented; the opportunity in the detection of cases is highlighted to tackle the fast dissemination of the infection; focus on the most productive breeding sites is proposed to battle against the vast dissemination of the breeding sites; and the severity of the infection must be addressed by capable clinical human resources. This strategy was designed along with the national representatives of the control programs to create master plans that provided the basis for the integrated prevention and control of dengue in the Mesoamerican region.

Costo-efectividad de prácticas en salud pública: revisión bibliográfica de las intervenciones de la Iniciativa Mesoamericana de Salud / Cost-effectiveness of public health practices: A literature review of public health interventions from the Mesoamerican Health Initiative

OBJETIVO: Presentar y analizar información de costo-efectividad de intervenciones propuestas por la Iniciativa Mesoamericana de Salud (IMS) en las áreas de nutrición infantil, inmunizaciones, paludismo, dengue y salud materno-infantil y reproductiva. MATERIAL Y MÉTODOS: Se llevó a cabo una revisión sistemática de la literatura de evaluaciones económicas publicadas entre el año 2000 y agosto 2009 sobre intervenciones en las áreas de la salud mencionadas, en los idiomas inglés y español. RESULTADOS: Las intervenciones en nutrición y de salud materno-infantil mostraron ser altamente costo-efectivas (con rangos menores a US$200 por año de vida ajustado por discapacidad [AVAD] evitado para nutrición y US$100 para materno-infantil). En dengue sólo se encontró información sobre la aplicación de larvicidas, cuya razón de costo efectividad estimada fue de US$40.79 a US$345.06 por AVAD evitado. Respecto al paludismo, las intervenciones estudiadas resultaron costo-efectivas (

OBJECTIVE: Present and analyze cost-effectiveness information of public health interventions proposed by the Mesoamerican Health Initiative in child nutrition, vaccination, malaria, dengue, and maternal, neonatal, and reproductive health. MATERIAL AND METHODS: A systematic literature review was conducted on cost-effectiveness studies published between January 2000 and August 2009 on interventions related to the health areas previously mentioned. Studies were included if they measured effectiveness in terms of Disability-Adjusted Life Year (DALY) or death averted. RESULTS: Child nutrition and maternal and neonatal health interventions were found to be highly cost-effective (most of them below US$200 per DALY averted for nutritional interventions and US$100 for maternal and neonatal health). For dengue, information on cost-effectiveness was found just for application of larvicides, which resulted in a cost per DALY averted ranking from US$40.79 to US$345.06. Malarial interventions were found to be cost-effective (below US$150 per DALY averted or US$4,000 per death averted within Africa). In the case of pneumococcus and rotavirus vaccination, cost-effectiveness estimates were always above one GDP per capita per DALY averted. CONCLUSIONS: In Mesoamerica there are still important challenges in child nutrition, vaccination, malaria, dengue and maternal, neonatal, and reproductive health, challenges that could be addressed by scaling-up technically feasible and cost-effective interventions.

Diseño mixto de evaluación de la iniciativa Salud Mesoamérica 2015 / Mixed design for the evaluation of the Mesoamerica Health 2015 initiative

El propósito de la iniciativa Salud Mesoamérica 2015 (SM-2015) es mejorar el estado de salud y nutrición de la población con mayor grado de vulnerabilidad en Mesoamérica. El objetivo de la evaluación es generar evidencia sobre la efectividad conjunta de un paquete de intervenciones diseñadas para mejorar las condiciones de salud en la región. Se propone una evaluación de impacto con métodos mixtos, para conocer la magnitud de los cambios atribuibles a la SM-2015, e identificar los significados de estos cambios para la población objetivo, en el contexto de cada país. El eje conductor es un panel de localidades con el que se colectará información de individuos, hogares y unidades de salud de primero y segundo nivel de atención. El diseño que se describe en este documento fue desarrollado entre junio y diciembre de 2009, y su articulación se llevó a cabo en talleres realizados en Cuernavaca (México), Managua (Nicaragua), y San José (Costa Rica). El diseño propuesto permitirá generar evidencia sobre la efectividad conjunta del paquete de intervenciones propuesto en los planes maestros mesoamericanos. El éxito de este diseño radica en la voluntad y en el compromiso político de los países y los donantes.

Since the Salud Mesoamerica 2015 initiative (SM-2015) aim is to improve health and nutrition conditions of those most vulnerable in Mesoamerica, the goal of the evaluation is to generate evidence of the joint effectiveness of a package of interventions designed to improve the health conditions. We propose a mix design for the evaluation, which will allow to know the magnitude of changes attributable to the interventions, as well as the meanings of these changes for the target population, taking into account the specificities of each country. The main axis of this design is a locality panel where information about individuals, households, and health facilities (first and second level) will also be collected. The evaluation design described in this paper was developed between June and December, 2009, and it was integrated during workshops in Cuernavaca (Mexico), Managua (Nicaragua), and San Jose (Costa Rica). The proposed design will allow to generate evidence about the joint effectiveness of the package of interventions proposed for the SM-2015. The success of this design rests on the political commitment of countries and donors.

Evaluación preliminar de la Estrategia de Información, Comunicación y Educación para el control del Aedes aegypti, en La Dorada, Colombia / Evaluating an Information, Education and Communication (IEC) strategy which was adopted for Aedes aegypti control in La Dorada, Colombia

Objetivo Estimar el impacto de la estrategia de Información, Educación y Comunicación sobre la infestación de Aedes aegypti en viviendas de La Dorada. Métodos Estudio transversal adelantado entre junio y julio de 2008 en La Dorada, Colombia. Se seleccionaron 228 viviendas donde se midió presencia del vector a través del método rapid sweeping para formas inmaduras en tanques y de captura activa para adultos. Simultáneamente, una encuesta midió la exposición a la estrategia. La base de datos se analizó en EPI info 2000. Se calcularon Razones de Prevalencia e intervalos de confianza al 95 por ciento. Resultados Las viviendas que no tenían larvas se caracterizaban por tener mujeres cabeza de familia o moradores con conocimiento acerca de las larvas y la forma de transmisión del dengue. Aquellas viviendas donde se lavaba el tanque de agua al menos una vez por semana, carecían de formas inmaduras. La presencia de mosquitos adultos era más frecuente en las casas que tenían más de un tanque. Cerca del 80 por ciento de los encuestados adquirieron el conocimiento de transmisión del dengue a través de la estrategia. Conclusiones Si bien la estrategia no ha sido aplicada en todos sus componentes, se encontraron factores que podrían tener un efecto protectivo al estar relacionados con ausencia del vector. El estudio revela solo un éxito parcial de la estrategia en La Dorada.

Objective Estimating the impact of the Information, Education and Communication strategy on Aedes aegypti infestation in homes in La Dorada, Colombia. Methods A cross-sectional study was carried out during June and July 2008 in La Dorada; 228 houses were chosen and vector presence was measured in two ways: immature forms were captured by the rapid sweeping method in water tanks and adults were captured by active collection. A survey simultaneously measured exposure to the strategy. EPI Info 2000 was used for analysing the database so created. Prevalence ratios and 95 percent confidence intervals were calculated. Results A relationship was found between being a housewife and not having larvae present in the home. No immature forms were found in houses where somebody washed the water tank at least once a week. There were also no larvae in homes where people had knowledge about larvae and dengue transmission. The presence of adult forms was found in houses having more than one water tank. Almost 80 percent of the interviewees acquired knowledge about dengue transmission through the strategy. Conclusions Although all strategy components had not been implemented, several factors were found which might have a protective effect (i.e. being related to vector absence). The study showed that the strategy achieved only partial success in La Dorada.

Avaliação da vigilância entomo-epidemiológica no programa de controle da dengue no município de Cuiabá – MT / Evaluation of surveillance and epidemiological entomo in dengue control program in the city of Cuiabá – MT

A dengue pela sua capacidade de produção de epidemias de vulto nas grandes cidades e regiões metropolitanas é de vital interesse para os setores da saúde pública. Desde 2002, existe uma variação anual nos casos notificados no estado, especialmente no município de Cuiabá, com sucessivas epidemias. Em 2009, observou-se um crescimento exacerbado dos casos notificados, principalmente dos casos graves e na faixa etária dos menores de 15 anos. O objetivo desse estudo é avaliar o grau implantação do programa de controle da dengue a partir do componente técnico vigilância entomo-epidemiológica (VEE), considerando a estrutura, processo e influência dos contextos externo, político e organizacional, no município de Cuiabá. O trabalho se inicia com a contextualização da dengue e da implantação do programa. O estudo discorre também sobre os aspectos sócio-econômicos e ambientais urbanos relacionados ao ciclo de transmissão da dengue e os vários conceitos e abordagens da VE da dengue e da avaliação existentes, utilizadas no presente trabalho. A descrição da intervenção foi realizada a partir da construção de um modelo lógico (ML), que permitiu apresentar a racionalidade existente entre os componentes da intervenção: insumos, atividades, produtos, resultados e impacto. A partir do ML da intervenção, foi desenvolvido o modelo teórico da avaliação e as matrizes de informação, de análise e julgamento, com as dimensões e sub-dimensões, além dos indicadores, critérios e as pontuações, que objetivaram o estabelecimento dos parâmetros para avaliação...

The dengue fever for its capacity for producing important epidemics in the large cities and metropolitan areas is of a vital concern for the sectors of public health. Since 2002, there has been an annual variation in the cases reported in the state, mainly in the municipality of Cuiabá, with recurrent epidemics. In 2009, a marked increase of the reported cases was observed, especially of the severe cases and in the age group of children with less than fifteen years. The aim of the study is to evaluate the level of implantation of the dengue control program from the entomo-epidemiological surveillance technical component (EES), taking into account the structure, process and influence of the external, political and organizational contexts in the municipality of Cuiabá. The work begins with the contextualization of dengue fever and the implantation of the program. The study is also about the urban socio-economic and environmental aspects related to the cycle of dengue fever transmission and the several concepts and approaches of the VE of dengue fever and the existent evaluation used in this study. The description of the intervention was carried out from the construction of a logical model (ML), that allowed to present the rationality existent among the components of the intervention: inputs, activities, products, results and impact. From the LM model of intervention, the theoretical evaluation model and the matrices of information of analysis and judgment with the dimensions and sub-dimensions were developed, besides the indicators, criteria and the scores that were responsible for the setting of the parameters for evaluation. The methodological approach that is adopted is that of the evaluative research, of a normative and formative kind, using qualitative and quantitative methods...

Dengue in Southeast Asia: epidemiological characteristics and strategic challenges in disease prevention / Dengue no Sudeste Asiático: características epidemiológicas e desafios estratégicos na prevenção da doença

Dengue emerged as a public health burden in Southeast Asia during and following the Second World War and has become increasingly important, with progressively longer and more frequent cyclical epidemics of dengue fever/dengue hemorrhagic fever. Despite this trend, surveillance for this vector-borne viral disease remains largely passive in most Southeast Asian countries, without adequate laboratory support. We review here the factors that may have contributed to the changing epidemiology of dengue in Southeast Asia as well as challenges of disease prevention. We also discuss a regional approach to active dengue virus surveillance, focusing on urban areas where the viruses are maintained, which may be a solution to limited financial resources since most of the countries in the region have developing economies. A regional approach would also result in a greater likelihood of success in disease prevention since the large volume of human travel is a major factor contributing to the geographical spread of dengue viruses.

A dengue emergiu como problema de saúde pública no Sudeste Asiático durante e após a Segunda Guerra Mundial, e vem se agravando cada vez mais, com epidemias cíclicas progressivamente mais longas e freqüentes de dengue e de febre hemorrágica da dengue. Apesar dessa tendência, a vigilância dessa virose transmitida por vetores permanece basicamente passiva na maioria dos países do Sudeste Asiático, sem apoio laboratorial adequado. O artigo apresenta uma revisão dos fatores que podem ter contribuído para a mudança no perfil epidemiológico da dengue na região, além de discutir os desafios para a prevenção da doença. Analisa-se também uma abordagem regional para a vigilância ativa dos vírus da dengue, focando as áreas urbanas onde eles se mantêm, o que pode representar uma solução à limitação de recursos financeiros, uma vez que a maioria dos países da região tem economias em desenvolvimento. Uma abordagem regional também resultaria em maior probabilidade de sucesso na prevenção da doença, já que a grande circulação de viajantes na região é um fator importante na disseminação dos vírus da dengue.

Estrategia intersectorial y participativa con enfoque de ecosalud para la prevención de la transmisión de dengue en el nivel local / An inter-sector participatory strategy in Cuba using an ecosystem approach to prevent dengue transmission at the local level

Cuba is located among a group of countries with high dengue incidence. Following several epidemics in the last 10 years, the country designed, implemented, and evaluated a participatory strategy based on the Ecohealth approach. The aim was to promote inter-sector ecosystem management to decrease Aedes aegypti infestation and prevent dengue transmission in the municipality of Cotorro, in Havana city. The study adopted a participatory research methodology. The strategy ensured active participation by the community, diverse sectors, and government in the production of healthy ecosystems. Timely and integrated measures for prevention and control were developed, thereby decreasing the risk of vector proliferation and local dengue transmission. The approach allowed holistic problem analysis, priority setting, and administration of solutions. The strategy has been sustained two years after concluding the process.

Cuba está ubicada en una zona de países con alta incidencia de dengue. En los últimos 10 años ha sido afectada por varias epidemias, es por ello que se diseñó, implementó y evaluó una estrategia participativa, basada en el enfoque de ecosalud, la cual estuvo dirigida a propiciar acciones intersectoriales en la gestión del ecosistema para disminuir las poblaciones del mosquito Aedes aegypti y prevenir la transmisión de dengue en el municipio Cotorro de Ciudad de La Habana, Cuba. Para el desarrollo de este trabajo se utilizó la metodología de investigación acción participativa. Como resultado del proceso se pudo describir una estrategia que garantiza la participación activa de la comunidad, los sectores y el gobierno en la producción de ecosistemas saludables, se desarrollaron acciones de prevención y control oportunas e integrados que disminuyeron los riesgos para la proliferación del vector y la transmisión local de la enfermedad. Este enfoque permitió el análisis holístico de los problemas, su priorización y la gestión de sus soluciones; la estrategia se sostiene dos años después de concluido el proceso.

O programa de controle do mosquito culex sp (culicidae) como ferramenta na prevenção de doenças e agravos em São Paulo / SP / The driver of the culex sp mosquitoes (culicidae) as a tool in the prevention of diseases and disorders in Sao Paulo / SP

Verificamos que quando as ações de monitoramento e controle, são realizadas com a periodicidade e técnicas preconizadas pelo Programa de Controle de Culex sp, os resultados são o positivos e os objetivos propostos são alcançados. A melhoria no controle destes mosquitos e a ampliação do programa para toda a cidade.

O programa de controle do mosquito culex sp (culicidae) como ferramenta na prevenção de doenças e agravos em São Paulo / SP

Verificamos que quando as ações de monitoramento e controle, são realizadas com a periodicidade e técnicas preconizadas pelo Programa de Controle de Culex sp, os resultados são o positivos e os objetivos propostos são alcançados. A melhoria no controle destes mosquitos e a ampliação do programa para toda a cidade

Controle de criadouros dos vetores de dengue e da febre amarela urbana na cidade de Goiânia, com participaçäo popular / Control of habitats of the vectors of Dengue and urban Eellow fever in the city of Goiania, Brasil, with community participation

Diante da necessidade de monitoramento do nível de infestaçäo do Aedes aegypti e/ou do Aedes albopictus na cidade de Goiânia, foi realizado pela Fundaçäo Nacional de Saúde, regional de Goiás, um Levantamento de ndice Amostral (LIA), em locais vulneráveis à infestaçäo pelos vetores. Selecionaram-se 30 bairros da cidade de Goiânia e pesquisaram-se 11 por cento dos imóveis. Após a conclusäo do LIA, foi desenvolvido um mutiräo de limpeza e realizada conscientizaçäo da populaçäo com o objetivo de eliminar os criadouros nos domicílios. Dentre os bairros pesquisados, houve predominância dos seguintes criadouros: garrafas, latas e plásticos (30,4 por cento), pneus (21,5 por cento), vasos com plantas (16,1 por cento), peças de carro (9,6 por cento) e material de construçäo (9,1 por cento). Verificou-se a presença de larvas de A. aegypti em todos os bairros pesquisados, enquanto que o A. albopictus foi encontrado em em único bairro (Balneário Meia Ponte), sendo este o primeiro relato de ocorrência desta espécie de Aedes na cidade de Goiânia-GO...

Projeto Piloto para erradicaçäo do Aedes Aegypti- Salvador-Bahia / Pylot project for erradication of Aedes Aegypti -Salvador-Bahia

Contempla a visäo global e abrangente da intervençäo proposta pelo Plano Diretor de Aedes aegypti, elaborado pelo Conselho Nacional de Saúde e aprovado pelo Governo Federal, que abarca o vetor, o ambiente e o modo de vida. Adota um modelo de gestäo a partir da concepçäo moderna de planejamento centrada em modulos operacionais. Consolida uma experiencia de açäo intersetorial, com articulaçäo da academia, serviços e comunidade. Associa a intervençäo mecanismos independentes de acompanhamento, avaliaçäo e pesquisa.

Malaria control program in Indonesia.

The malaria situation in Indonesia is reviewed in the major island group of Java-Bali and the remainder of the archipelago called the Outer Islands. Based on their varying epidemiological patterns the areas for control have been stratified and efforts are directed towards the rational use of antimalarial drugs and the institution of integrated vector control ie chemical control in conjunction with biological control and environmental management. The targets of malaria control vary as well between island groups. Administrative, technical and operational constraints are identified. Drug-resistant malaria, forest-related malaria, lack of personnel, supervision and coordination, inadequate resources, and community participation are among the main issues confronting the national malaria control program. Research and training needs are emphasized in the recommendations.

The cell biology of mosquito vitellogenesis

Insect vitellogenesis involves coordinated activities of the fat body and oocytes. We have studied these activities at the cellular level in the mosquito. During each vitellogenic cycle, the fat body undergoes three successive stages: 1) proliferation of biosynthetic organelles, 2) vitellogenin synthesis, 3) termination of vitellogenin synthesis and degradation of biosynthetic organelles by lysosomes. Analysis with monoclonal antibodies and radiolabelling demonstrated that the mosquito yolk protein consists of two subunits (200-kDa and 65-kDa). Both subunits are glycosylated, their carbohydrate moieties are composed of high-mannose oligosaccharides. The yolk protein subunits are derived from a single 220 kDa precursor detected by an in vitro translation. Oocytes become competent to internalize proteins as a result of juvenile hormone-mediated biogenesis of endocytotic organelles. The yolk protein is then accumulated by receptor-mediated endocytosis. A pathway of the yold protein and factors determining its routing in the oocyte have been studied.