Impact of polystyrene beads as a mosquito control measure to supplement lymphatic filariasis elimination activities in Socotra Island, Yemen.

Lymphatic filariasis (LF) is targeted for worldwide elimination. In Yemen, all mainland implementation units met the WHO criteria for stopping mass drug administration (MDA) after 5 rounds. However, in Socotra Island these criteria were not met. Our study evaluated the efficacy of applying expanded polystyrene beads (EPBs) on the Culex population and the effect on LF transmission. Human and mosquito surveys were conducted in 40 randomly selected households in Hadibo (capital of Socotra) before and after application of EPBs. The EPBs intervention resulted in a reduction in mosquito density of 80% and a 64.3% reduction in microfilaria prevalence. The majority of interviewed households (98%) thought EPBs considerably reduced the mosquito population. After the intervention all collected pools tested negative. Application of EPBs is an effective supplement to MDA for achieving the goal of LF elimination.

Impact of polystyrene beads as a mosquito control measure to supplement lymphatic filariasis elimination activities in Socotra Island, Yemen

Lymphatic filariasis [LF] is targeted for worldwide elimination. In Yemen, all mainland implementation units met the WHO criteria for stopping mass drug administration [MDA] after 5 rounds. However, in Socotra Island these criteria were not met. Our study evaluated the efficacy of applying expanded polystyrene beads [EPBs] on the Culex population and the effect on LF transmission. Human and mosquito surveys were conducted in 40 randomly selected households in Hadibo [capital of Socotra] before and after application of EPBs. The EPBs intervention resulted in a reduction in mosquito density of 80% and a 64.3% reduction in microfilaria prevalence. The majority of interviewed households [98%] thought EPBs considerably reduced the mosquito population. After the intervention all collected pools tested negative. Application of EPBs is an effective supplement to MDA for achieving the goal of LF elimination

The short-term effect of water-pipe smoking on the baroreflex control of heart rate in normotensives.

UNLABELLED: The aim of this study is to analyse the acute effect of water-pipe smoking on heart rate, blood pressure and the baroreflex control of heart rate. SUBJECTS AND METHODS: Non-invasive continuous methods were used for investigating inter-beat interval (IBI; ms), systolic blood pressure (SBP; mm Hg), diastolic blood pressure (DBP; mm Hg), pulse pressure (PP; mm Hg), mean blood pressure (MBP; mm Hg); baroreflex sensitivity in ms/mm Hg (BRS) and baroreflex sensitivity in Hz/mm Hg (BRSf), were determined by spectral analysis, in 20 normotensive volunteers age of 27+/-6 years (mean+/-S.D.) who served as their own control. The measurements were taken twice. The first measurement was taken before the water-pipe smoking session (this is after >12 h of smoking cessation with a complete stopping of alcohol, coffee or tea consumption). The second measurement was taken during a 5 min period immediately after that session. (In the smoking session the volunteer smokes 5 g Maassel (fruit flavoured tobacco) for a period of 45 min). RESULTS: The inter-beat interval decreased (846+/-100 to 709+/-109 ms, p=0.0003), SBP increased (110+/-13 to 123+/-12 mm Hg, p=0.004), DBP increased (67+/-11 to 81+/-11 mm Hg, p=0.0002), PP decreased (43+/-10 to 41+/-9 mm Hg, p=0.46 ns), MBP increased (82+/-10 to 95+/-11 mm Hg, p=0.0001), BRS decreased (9.16+/-4 to 5.67+/-3 ms/mm Hg, p=0.003) and BRSf (0.013+/-0.005 to 0.011+/-0.004 Hz/mm Hg, p=0.3 ns). CONCLUSIONS: Water-pipe smoking induced a high increase in heart rate, SBP, DBP, MBP and markedly impaired BRS. All of those markers are known as risk factors in cardiovascular diseases, hence it is concluded that water-pipe smoking is not as harmless as is thought.

Multidrug therapy--the pathway for global leprosy elimination.

Introduction of dapsone therapy paved the way for better and more humanitarian way of dealing with the leprosy victims who, prior to 1943, were simply rejected and segregated from society. Emergence of dapsone-resistant M. leprae and mycobacterial persistence provoked our quest for another solution. More drugs were discovered for treatment of leprosy. But the real breakthrough was the recommendation of regimens of multidrug therapy (MDT) for the treatment of leprosy by the WHO Study Group on Chemotherapy of Leprosy in October 1981. Subsequent world wide development of leprosy control activities was phenomenal. The impact of MDT has led to the cure of over eight million leprosy sufferers and the saving of one million patients from becoming crippled. Leprosy prevalence has decreased by 80% in ten years. By the end of May 1999 the leprosy burden remained concentrated in only 12 countries of the world. These achievements are mainly attributed to the development and worldwide adoption of the MDT programme.

Dermatologists combat leprosy in Yemen.

BACKGROUND: Leprosy has been prevalent in Yemen for many years. The ostracization and stigmatization of leprosy patients are well documented in the yemeni literature. No control activities were carried out until 1980. AIM: To document the development of leprosy control activities in the Republic of Yemen during the period from 1982 to 1996. MATERIALS AND METHODS: The dermatologists in Yemen used various methods, including the media, to fight the stigma of leprosy and thus to mobilize the community for the reintegration of leprosy patients. They sought support from international non-governmental organizations (NGOs) to start mobile teams all over the country. RESULTS: The support of the German Leprosy Relief Association (GLRA) and the World Health Organization (WHO) enabled the National Leprosy Control Program (NLCP) to reach people in remote areas. The prevalence of leprosy has declined from 1.9 per 10,000 population in 1989 to 0.5 per 10,000 population in 1996. CONCLUSIONS: The stigma associated with leprosy also extends to other skin diseases. To combat this stigma, various methods, such as health education, training of medical personnel, and mass treatment for skin diseases, have been used.

PIP: In the Republic of Yemen, leprosy patients face social stigmatization and considerable suffering. Diagnosis and treatment are delayed by the poor health infrastructure, difficult terrain, and political instability, resulting in unnecessary complications and deformities. The National Leprosy Control Program, established in 1982 with the support of the German Leprosy Relief Association and the World Health Organization, has sought to reach people in remote rural areas. 63 leprosy clinics have been established in 14 regions; 60 of these clinics are integrated into the primary health care system. In addition, dermatologists, with support from international nongovernmental organizations, have campaigned through the media and mobile teams for an end to the ostracism of leprosy patients and urged their reintegration into the community. Other interventions have included the production of posters for health education, construction of an orthopedic workshop, reconstructive surgeries performed by an international corps of volunteer physicians, training courses for medical personnel, and a rehabilitation program to teach sewing to women with leprosy. As a result of early passive detection and other leprosy control efforts, Yemen's leprosy caseload has declined from a peak of 2314 registered for treatment in 1989 to 765 in 1996. The prevalence of leprosy has declined from 1.9/10,000 population in 1989 to 0.5/10,000 in 1996. A combined leprosy-tuberculosis pilot project is under development. By the year 2000, leprosy should be eliminated as a public health problem in Yemen.