Module 2 - Surveillance in Institutions by Dr. Waseem Akram
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Transcript of Module 2 - Surveillance in Institutions by Dr. Waseem Akram
SURVEILLANCE IN INSTITUTIONS
Prof. Dr. Waseem Akram, Head Research and Development Program on Dengue Punjab,
Chief Minister’s Secretariat
Synopsis of Module 2
Concept of Surveillance at institutional level
Mosquito trapsDesigning Traps (DT)Control Methods
Concept of Surveillance at Institutional Level
Larval surveys
• Larval surveys– Basic sampling unit is the house or premise, which is systematically
searched for water holding containers – Examination of containers for the presence of mosquito larvae and
pupae.
• Depending on the objective of the survey– Search may be terminated as soon as Aedes larvae are found– Continued until all containers have been examined.
• Collection of specimens for laboratory examination is necessary to confirm.
• Students must be taught to identify these mosquitoes
Basics to do VECTOR SURVEILLANCE
Four indices that are commonly used to monitor Aedes aegyptiinfection levels are:
• School index (Hl): percentage of school infected with larvae and/or pupaeHI = Number of schools infected/Number of schools inspected X100
• Container Index (Cl): percentage of water holding containers infected with larvae or pupae.
Cl = Number of positive containers/Number of containers inspected X100
• Breteau Index (Bl): number of positive containers per 100 schools inspectedBl: Number of positive containers/Number of schools inspected
X100
• Pupae Index (Pl): number of pupae per 100 schoolsPl = Number of pupae/Number of schools inspected X100
Designing various types of traps
Predicting population indices
Normal to Lethal economical traps
Designing the ovitraps and their installation
Preparing the Ovitraps
Pre
Step 1: Filling with Water
Step 2: Placing egg laying sheets
Step 3: Banding the strips
Making of Ovitrap
• Material Needed– A small container
– A ring mesh» 2
Making of Ovitrap
• Upper part of water bottle
• Lower part of water bottle with holes on both sides
• Inside water reservoir bottle
• Bottom hole
Making of Ovitrap
Assembling the Trap
Step A•Take the bowl and put the rounded mesh ring inside the bowl•Fill the bowl with water and observe the rounded mesh ring will rise in the bowl to the level of water.
Step B•Put the lower half of the bottle inside the bowl and press for short time till the lower half of bottle is filled with water.
Step CPut the inside water bottle filled with water inside the lower half of the bottle. This will help to supplement water incase its level drops down.
C
B
A
Assembling the Ovitrap
• Cover the lower half of the bottle with the upper half
• The trap is now ready for placement .
Traps Designed by
our Laboratory
Adult Surveys
Landing/biting collection: Landing/biting collection of humans is a sensitive means of detecting low level
infestations of Ae aegypti, but are very labour intensive. Because adult males have low dispersal rates, their presence can be a reliable
indicator of clear proximity to hidden larvae habitats. It is usually expressed in terms of landing/biting counts per man hour.
Resting collection: During periods of inactivity, adult mosquitoes typically rest indoors, especially in
classrooms and mostly in dark places, such as laboratories and other sheltered sites.
Resting collection requires systematic searching of these sites for adult mosquitoes with the aid of flashlight.
Following a standard timed collection routine in selected rooms of schools, densities are recorded as the number of adults per school or number of adults per man hour of human efforts.
Oviposition traps Ovitraps are devices used to
detect the presence of Ae aegypti where the population density is low and larval surveys are largely unproductive (when the Breteau index is less than 5) as well as normal conditions.
The ovitrap is used for Ae aegypti surveillance in urban areas to evaluate the impact of adulticidal space spraying on adult female population.
Control Methods Status of Mosquitoes during 2012
Research and Development
Current Status• Establishment of Office at
IPH
• Hiring of Entomologists
• Research trials on susceptibility being initiated
• Research collaborations and discussions with foreign delegates at IPH and UAF
Dengue and the commitment of Punjab government
The epidemic of 2011 brought strong commitment and over a period of one year following improvements were made
Phase I– Use of Insecticides
• Fogging• IRS
Phase 2– Provincial policy– Development of strategic policy on urgent basis– Social mobilization (COMBI) – Intra-sectoral collaboration – Environmental concerns– Mechanical tactics– Vector understanding
• Biology• Ecology• Behavior
– Indices – Biological options – Chemicals
Government Commitment
Phase 3• Continuity of Phase 2• Advancement in Environmental friendly
approaches– Physical Barriers (Polydimethylsiloxane PDMS)– Bio-technologies
• Bacteria– Bti– W. b
• Fungus
– Predators• DNA Based
Town Aedes Culex Remarks Total samples collected
Fogging requested
Measures Taken
Iqbal Town Negative INDOOR Positive OUTDOOR VH 0/400 No
Aziz Bhatti Positive INDOOR Positive OUTDOOR Low VH 6/300 One street fogged MC+IRS
Data Gunj Positive INDOOR Positive OUTDOOR VH VH 5/275 One fogging on 6/3/2012
MC+IRS+Fogging
Gulberg Positive INDOOR Positive OUTDOOR Low VH Target fogging MC+IRS
Samanabad Positive INDOOR Positive OUTDOOR Low VH 7/200 No fogging MC+IRS
Shalamar Positive INDOOR Positive OUTDOOR Medium VH 8/320 No fogging MC+IRS
Wahga Positive INDOOR Positive OUTDOOR Low VH 5/320 No fogging MC+IRS
Ravi Positive INDOOR Positive OUTDOOR Low 4/300 No fogging MC+IRS
Nister Positive INDOOR L-M-H 15/300 Two fogging MC+IRS+ 1 Fogging on 3-3-2012+ Fogging
Status and Measures taken to prevent the spread of mosquitoes during the 2012
Population status of Aedes till May, 2012
Town Aedes Site Total samples collected
Sample Measures Taken
Water tank Remarks
E 1st 2nd 3rd 4th P A
Iqbal Town
Aziz Bhatti √ √ √ Indoor MC+IRS Plastic blue + fridge tray
Fogging in street
Data Gunj √ √ √ Indoor MC+IRS Plastic blue
Gulberg √ √ √ Indoor MC+IRS Plastic blue + cement tank
All drained
Samanabad 25 34 14 30 25 Indoor 2 dips IPH MC+IRS Plastic blue + money plant + fridge tray
Cleared
Shalamar √ √ √ Indoor + outdoor
MC+IRS Plastic blue +fridge tray + pitcher in Nan shop
Wahga √ √ √ Indoor MC+IRS Plastic + cemented
Ravi √ √ Indoor MC+IRS Plastic blue
Nister √ √ √ √ √ √ Indoor+ outdoor
MC+IRS Plastic blue + Bird drinking pot
Adults seen fogging in huts
Point of Concern
• Breeding sites detected indoor• Most may go undetected• Public showing negligence in clearing the
breeding spots• Plastic buckets most potential breeding spots
of Aedes aegypti
Impact of over night Rain• Indoor surveillance specially in areas where vector
breeding has been reported should be monitored and standing water must be removed from roof tops, water coolers and other sites
• Out door surveillance should closely monitor – tire shops– room cooler shops – bird feeding pots– Grave yards
Research lines and the developing
world
Future of vaccines
Biological lines
COMBI
Future of vaccines
• Stage one• Stage two• Stage 3• Stage 4
Biological Lines
• Larvivorous fish are recommended for control of Ae. aegypti in large water bodies or large water containers.
• Endotoxin-producing bacteria, Bacillus thuringiensis serotype H-14 (Bt H-14) has been found an effective mosquito control agent.
• Copepods• Stable Isotopes
Products and their status
Sr. # Product Name
Group Nature Physical nature
Action Company Price
1 Sumilarv Pyriproxyfen IGR Granular Molting inhibitor
Sumitomo $48/kg
2 Aquatain AMF Silicone based polymer
Polymer Liquid Physical barrier
Australian ????
3 Mousticide Mosquito protein +bacteria
TMOF-Bti Powder Starvation HIMONT ????
4 Bactivec Bacteria Bti Liquid Starvation Cuban Government
????
5 Dunk Bacteria Bti Solid Starvation Summit $2.8/dunk
6 Soil Conditioner Bacteria B. laterosporous
Granular Starvation Local ????
The following products from different companies were taken for laboratory studies and field evaluations
A WAY FORWARD
Test Results with Alternatesto Chemicals
Mosquito Dunks
Experiment at UAF
Application of DUNKS
Experiment at UAF
Application of DUNKS
A WAY FORWARD
Bactivec
• Bti and effective against Aedes and other mosquitoes
• Can be applied as aerial• Price not quoted • Sample under going
testing
Field Trials with Aquatain AMF
Sites • Classified both as Indoor and Out door
– Disposal tanks (1), – Tires (2), – Open garbage (3), – Hospital outlet (4), – Disposal areas of hospital’s (5) where most of
the hospitals used items were dumped are effective breeding sites of day time biting mosquitoes.
– Hedges around the homes (6), – kitchen nursery (7), – bins (8), – garage (9)
Parks and Temples
• This site generally included the mosquitoes from – old temples, – pools, – small dark caves – Vegetation– water reservoirs with
standing to flowing water.
Collection places
Bamboo stumps in houses
Automobile tyres kept inside the houses
Adult Trapping
• CDC miniature, bio-sentinal and magnetic light traps
• Traps with human clothing odors to attract the mosquitoes to the vicinity of the trap.
• Traps were placed 5-6 ft. off the ground on a tree branch in protected area.