Donor-substituted phosphanes – surprisingly weak Lewis donors for phosphenium cation stabilisation

Paradoxically, N- and O- donor substituted tri-arylphosphanes are shown to be weaker donors than PPh$_3$ when binding the soft Lewis acid moiety [PPh$_2$]$^+$. This arises from internal solvation and rehybridisation at phosphorus, precluding chelation and increasing steric demand, in direct contrast to coordination modes observed for metal complexes

Cost-Effectiveness of Chagas Disease Vector Control Strategies in Northwestern Argentina

Despite decreasing rates of prevalence and incidence, Chagas disease remains a serious problem in Latin America, especially for the rural poor. Without vaccines, control and prevention rely mostly on residual spraying of insecticides. Under the aegis of the Southern Cone Initiative, and in agreement with global trends in decentralization of the health systems, in 1992 the Argentinean vector control launched a new vector control program based on community participation. The present study represents the first thorough evaluation of the overall performance of such vector control program and the first comparative assessment of the cost-effectiveness of different vector control strategies in a highly endemic rural area of northwestern Argentina. Supported by results of independent studies, the present work shows that in rural, poor and dispersed areas of the Gran Chaco region, the implementation of a mixed (i.e., vertical attack phase followed by horizontal surveillance) strategy constantly supervised and supported by national or local vector control programs would be the most cost-effective option to interrupt vector-borne transmission of Chagas disease

The costs of preventing and treating chagas disease in Colombia

Background: The objective of this study is to report the costs of Chagas disease in Colombia, in terms of vector disease control programmes and the costs of providing care to chronic Chagas disease patients with cardiomyopathy. Methods: Data were collected from Colombia in 2004. A retrospective review of costs for vector control programmes carried out in rural areas included 3,084 houses surveyed for infestation with triatomine bugs and 3,305 houses sprayed with insecticide. A total of 63 patient records from 3 different hospitals were selected for a retrospective review of resource use. Consensus methodology with local experts was used to estimate care seeking behaviour and to complement observed data on utilisation. Findings: The mean cost per house per entomological survey was $4.4 (in US$ of 2004), whereas the mean cost of spraying a house with insecticide was $27. The main cost driver of spraying was the price of the insecticide, which varied greatly. Treatment of a chronic Chagas disease patient costs between$46.4 and $7,981 per year in Colombia, depending on severity and the level of care used. Combining cost and utilisation estimates the expected cost of treatment per patient-year is$1,028, whereas lifetime costs averaged $11,619 per patient. Chronic Chagas disease patients have limited access to healthcare, with an estimated 22% of patients never seeking care. Conclusion: Chagas disease is a preventable condition that affects mostly poor populations living in rural areas. The mean costs of surveying houses for infestation and spraying infested houses were low in comparison to other studies and in line with treatment costs. Care seeking behaviour and the type of insurance affiliation seem to play a role in the facilities and type of care that patients use, thus raising concerns about equitable access to care. Preventing Chagas disease in Colombia would be cost-effective and could contribute to prevent inequalities in health and healthcare.Wellcome Trus

Synthetic, structural, and spectroscopic studies of sterically crowded tin-chalcogen acenaphthenes

The work in this project was supported by the Engineering and Physical Sciences Research Council (EPSRC) and EaStCHEM.A series of sterically encumbered peri-substituted acenaphthenes have been prepared containing chalcogen and tin moieties at the close 5,6-positions (Acenap[SnPh3][ER], Acenap = acenaphthene-5,6-diyl, ER = SPh (1), SePh (2), TePh (3), SEt (4); Acenap[SnPh2Cl][EPh], E = S (5), Se (6); Acenap[SnBu2Cl][ER], ER = SPh(7), SePh (8), SEt (9)). Two geminally bis(peri-substituted) derivatives ({Acenap[SPh2]}2SnX2, X = Cl (10), Ph (11)) have also been prepared, along with the bromo–sulfur derivative Acenap(Br)(SEt) (15). All 11 chalcogen–tin compounds align a Sn–CPh/Sn–Cl bond along the mean acenaphthene plane and position a chalcogen lone pair in close proximity to the electropositive tin center, promoting the formation of a weakly attractive intramolecular donor–acceptor E···Sn–CPh/E···Sn–Cl 3c-4e type interaction. The extent of E→Sn bonding was investigated by X-ray crystallography and solution-state NMR and was found to be more prevalent in triorganotin chlorides 5–9 in comparison with triphenyltin derivatives 1–4. The increased Lewis acidity of the tin center resulting from coordination of a highly electronegative chlorine atom was found to greatly enhance the lp(E)−σ*(Sn–Y) donor–acceptor 3c-4e type interaction, with substantially shorter E–Sn peri distances observed in the solid state for triorganotin chlorides 5–9 (∼75% ∑rvdW) and significant 1J(119Sn,77Se) spin–spin coupling constants (SSCCs) observed for 6 (163 Hz) and 8 (143 Hz) in comparison to that for the triphenyltin derivative 2 (68 Hz). Similar observations were observed for geminally bis(peri-substituted) derivatives 10 and 11.PostprintPeer reviewe