Eliminating Malaria Vectors.

Malaria vectors which predominantly feed indoors upon humans have been locally eliminated from several settings with insecticide treated nets (ITNs), indoor residual spraying or larval source management. Recent dramatic declines of An. gambiae in east Africa with imperfect ITN coverage suggest mosquito populations can rapidly collapse when forced below realistically achievable, non-zero thresholds of density and supporting resource availability. Here we explain why insecticide-based mosquito elimination strategies are feasible, desirable and can be extended to a wider variety of species by expanding the vector control arsenal to cover a broader spectrum of the resources they need to survive. The greatest advantage of eliminating mosquitoes, rather than merely controlling them, is that this precludes local selection for behavioural or physiological resistance traits. The greatest challenges are therefore to achieve high biological coverage of targeted resources rapidly enough to prevent local emergence of resistance and to then continually exclude, monitor for and respond to re-invasion from external populations

The improbable transmission of Trypanosoma cruzi to human: the missing link in the dynamics and control of Chagas disease

Chagas disease has a major impact on human health in Latin America and is becoming of global concern due to international migrations. Trypanosoma cruzi, the etiological agent of the disease, is one of the rare human parasites transmitted by the feces of its vector, as it is unable to reach the salivary gland of the insect. This stercorarian transmission is notoriously poorly understood, despite its crucial role in the ecology and evolution of the pathogen and the disease. The objective of this study was to quantify the probability of T. cruzi vectorial transmission to humans, and to use such an estimate to predict human prevalence from entomological data. We developed several models of T. cruzi transmission to estimate the probability of transmission from vector to host. Using datasets from the literature, we estimated the probability of transmission per contact with an infected triatomine to be 5.8x10(-4) (95%CI: [2.6; 11.0] x 10(-4)). This estimate was consistent across triatomine species, robust to variations in other parameters, and corresponded to 900-4,000 contacts per case. Our models subsequently allowed predicting human prevalence from vector abundance and infection rate in 7/10 independent datasets covering various triatomine species and epidemiological situations. This low probability of T. cruzi transmission reflected well the complex and unlikely mechanism of transmission via insect feces, and allowed predicting human prevalence from basic entomological data. Although a proof of principle study would now be valuable to validate our models' predictive ability in an even broader range of entomological and ecological settings, our quantitative estimate could allow switching the evaluation of disease risk and vector control program from purely entomological indexes to parasitological measures, as commonly done for other major vector borne diseases. This might lead to different quantitative perspectives as these indexes are well known not to be proportional one to another

Eco-bio-social determinants for house infestation by non-domiciliated Triatoma dimidiata in the Yucatan peninsula, Mexico

Background Chagas disease is a vector-borne disease of major importance in the Americas. Disease prevention is mostly limited to vector control. Integrated interventions targeting ecological, biological and social determinants of vector-borne diseases are increasingly used for improved control. Methodology/principal findings We investigated key factors associated with transient house infestation by T. dimidiata in rural villages in Yucatan, Mexico, using a mixed modeling approach based on initial null-hypothesis testing followed by multimodel inference and averaging on data from 308 houses from three villages. We found that the presence of dogs, chickens and potential refuges, such as rock piles, in the peridomicile as well as the proximity of houses to vegetation at the periphery of the village and to public light sources are major risk factors for infestation. These factors explain most of the intra-village variations in infestation. Conclusions/significance These results underline a process of infestation distinct from that of domiciliated triatomines and may be used for risk stratification of houses for both vector surveillance and control. Combined integrated vector interventions, informed by an Ecohealth perspective, should aim at targeting several of these factors to effectively reduce infestation and provide sustainable vector control

Subcutaneous Rituximab-MiniCHOP compared with subcutaneous Rituximab-MiniCHOP plus Lenalidomide in diffuse large B-Cell lymphoma for patients age 80 years or older.

peer reviewedPURPOSE The prognosis of elderly patients with diffuse large B-cell lymphoma (DLBCL) is worse than that of young patients. An attenuated dose of chemotherapy—cyclophosphamide, doxorubicin, vincristine, and prednisone plus rituximab (R-miniCHOP)—is a good compromise between efficacy and safety in very elderly patients. In combination with R-CHOP (R2-CHOP), lenalidomide has an acceptable level of toxicity and may mitigate the negative prognosis of the non–germinal center B-cell–like phenotype. The Lymphoma Study association conducted a multicentric, phase III, open-label, randomized trial to compare R-miniCHOP and R2- miniCHOP. PATIENTS AND METHODS Patients of age 80 years or older with untreated DLBCL were randomly assigned into the R-miniCHOP21 group or the R2-miniCHOP21 group for six cycles and stratified according to CD10 expression and age. The first cycle of rituximab was delivered by IV on D1 after a prephase and then delivered subcutaneously on D1 of cycles 2-6. Lenalidomide was delivered at a dose of 10 mg once daily on D1-D14 of each cycle. The primary end point was overall survival (OS). RESULTS A total of 249 patients with new DLBCL were randomly assigned (127 R-miniCHOP and 122 R2- miniCHOP). The median age was 83 years (range, 80-96), and 55% of the patients were classified as non-GCB. The delivered dose for each R-miniCHOP compound was similar in both arms. Over a median follow-up of 25.1 months, the intention-to-treat analysis revealed that R2-miniCHOP did not improve OS (2-year OS 66% in R-miniCHOP and 65.7% in R2-miniCHOP arm, P5 .98) in the overall population or in the non-GCB population. Grade 3-4 adverse events occurred in 53% of patients with R-miniCHOP and in 81% of patients with R2- miniCHOP. CONCLUSION The addition of lenalidomide to R-miniCHOP does not improve OS. Rituximab delivered subcutaneously was safe in this population

Three species of Calydiscoides (Monogenea: Diplectanidae) from five Lethrinus spp. (Lethrinidae: Perciformes) off New Caledonia, with a description of Calydiscoides terpsichore sp. n.

Numerous specimens of Calydiscoides spp. from Lethrinus nebulosus and L. harak, and fewer specimens from L. lentjan, L. ravus and L. obsoletus, collected off New Caledonia, South Pacific, were examined. Three species of Calydiscoides were recognized. Calydiscoides difficilis (Yamaguti, 1953) Young, 1969 was generally the most abundant species on the five hosts. Specimens of C. difficilis were measured and compared to the type specimens (from Indonesia) and museum vouchers (from Australia and the Arabian Gulf). The morphology of the massive male copulatory organ and of haptoral sclerotized parts was similar, but specimens from the same host and from different hosts showed wide morphometric variations; it is concluded that C. difficilis has a high degree of variability, although the possibility of a species complex remains. Calydiscoides duplicostatus (Yamaguti, 1953) Young, 1969 was found on L. nebulosus, L. harak and L. lentjan; specimens were homogeneous in the three hosts and similar to the type specimens. Calydiscoides terpsichore sp. n. is described from L. nebulosus (type host) and L. harak and was uncommon in both fish. The new species, a member of the 'australis group', is characterized by its Y-shaped male copulatory organ, with the left branch bearing a trifurcated secondary branch. Lethrinus nebulosus and L. harak shared the 3 species of Calydiscoides studied here, a fact probably related with their close phylogenetic relationships. Among the 15 species of Lethrinus present in New Caledonia, I I were examined and 9 species harboured 1-3 species of Calydiscoides each. Only 7 species of Calydiscoides were found, due to their stenoxenous specificity. Each species of Calydiscoides has I to 5 hosts

Etablissements ruraux antiques encadrés par deux voies (IIe-Ier s. av. n. è. au II e s. de n. è. et la seconde moitié du IIIe au VIe s. de n.è.): de l'inhumation dispersée au cimetière paroissial de l'église Sainte-Marie-Madeleine de Céderas (du VIIIe-début Xe s. à la fin XIIIe-début XVe s.) à Clermont-l'Hérault (34)

Dir. Agnès Bergeret et Richard DonatColl. P. Alessandri, S. Barbey, C. Jung (ASM), C. Labarussiat, A. RecolinRapport

Etablissements ruraux antiques encadrés par deux voies (IIe-Ier s. av. n. è. au II e s. de n. è. et la seconde moitié du IIIe au VIe s. de n.è.): de l'inhumation dispersée au cimetière paroissial de l'église Sainte-Marie-Madeleine de Céderas (du VIIIe-début Xe s. à la fin XIIIe-début XVe s.) à Clermont-l'Hérault (34)

Dir. Agnès Bergeret et Richard DonatColl. P. Alessandri, S. Barbey, C. Jung (ASM), C. Labarussiat, A. RecolinRapport

Etablissements ruraux antiques encadrés par deux voies (IIe-Ier s. av. n. è. au II e s. de n. è. et la seconde moitié du IIIe au VIe s. de n.è.): de l'inhumation dispersée au cimetière paroissial de l'église Sainte-Marie-Madeleine de Céderas (du VIIIe-début Xe s. à la fin XIIIe-début XVe s.) à Clermont-l'Hérault (34)

Dir. Agnès Bergeret et Richard DonatColl. P. Alessandri, S. Barbey, C. Jung (ASM), C. Labarussiat, A. RecolinRapport