To understand how climate might affect the incidence of vector-borne diseases, one must first examine the life cycles of the diseases and the environmental parameters associated with each stage A vector-borne disease is one in which the pathogenic microorganism is transmitted from an infected individual to another individual by an arthropod or other agent, sometimes with other animals serving as intermediary hosts. The transmission depends upon the attributes and requirements of at least three different living organisms: - the pathologic agent, -the vector, and the human host. intermediary hosts such as domesticated and/or wild animals often serve as a reservoir for the pathogen until susceptible human populations are exposed We recommend proactive planning more surveillance of direct impacts, such as changes in the reproduction rate of the vector or the agent, the biting frequency of the vector, and the amount of time the host is exposed to the vector due to changes in temperature, rainfall, humidity, or storm patterns. Even less information is available to evaluate the impacts of societal and individual activities on the transmission of vector-borne diseases. Changes in hydrology, agriculture, forestry, and infrastructure in response to global warming may also indirectly affect the interrelationship among the disease agent, vectors, and hosts

1. Vector Borne Infectious Diseases
in the face of climate change-
Demands for Laboratory Frontiers for surveillance
and diagnosis in Lesotho
Sejojo Phaaroe M.T; C.T(I.A.C); M.I.B.M.S (UK) , AHMP ( YALE)
Biomedical Scientist, a Cytotechnologist of International Academy of Cytologists * 6467
, and EU FP7/ Horizon 2020 NCP
www.thinktank.wozaonline.co.za
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Plaxo
Vidadeo

2. Outline presentation
• Problem statements and Proactive health
Management systems for vector borne diseases
• Defination of vector borne diseases
• Societal challenges – MDG’s,
• Climate change as accelerator of vector borne
diseases
• Malaria, Bacterial VBD- Ehrlichiosis,
• Rickettsae
• Viral hemolytic fever-VHF
• Helminthes diseases
• Laboratory diagnosis for each
• Recommendations for the future

3. Problem statement
• 20th
century – YF, Dengue fever, Plague, louse-borne typhus,
MALARIA – Caused explosive epidemic, to HUMAN, and
DOMESTIC ANIMALS
• 1960 – Advert of insecticides, drugs, vaccines
• Now the general perception is that Vector borne diseases are
no longer important Public health problem
• There is geographical extension of well known diseases
• Changing epidemiology of several VBD’S
• CLIMATE CHANGE
• Drug resistance , pesticide- DOOM , and rodentcide
resistance- RETEX , counterfeit medicines
• No Public Health Laboratory in Lesotho
• GENETIC ENGINEERING OF NEW ANIMALS, PLANTS AND
ORGANISMS

5. Health systems and programs

6. MDG’s
1. To eradicate extreme poverty and hunger
2. To achieve universal primary education
3. To promote gender equality and empower women
4. To reduce child mortality
5. To improve maternal health
6. To combat HIV/AIDS, malaria and other diseases
( to include VBD’s)
7. To ensure environmental sustainability
8. To develop a global partnership for development
There is need for integration with objectives of poverty
reduction, food security and disease reduction in

7. Research and development paradigm shift for collaboration in combating VBD’s

8. Vector-borne diseases• To understand how climate might affect the incidence of
vector-borne diseases, one must first examine the life cycles
of the diseases and the environmental parameters associated
with each stage
• A vector-borne disease is one in which the pathogenic
microorganism is transmitted from an infected individual to
another individual by an arthropod or other agent, sometimes
with other animals serving as intermediary hosts.
• The transmission depends upon the attributes and
requirements of at least three different living organisms:
- the pathologic agent,
-the vector, and the human host.
• intermediary hosts such as domesticated and/or wild animals
often serve as a reservoir for the pathogen until susceptible
human populations are exposed

9. causes of re-emerging vector borne
diseases
• Climate change- ;Increase pathogens, organism
_ spread ; Pathology
_modified regional biodiversity patterns
• rDNA- technology ( introduction of new-virus
amplification host/efficient vector in to area
( GMO’s)
• Travel patterns , planes, ship, train
• Industrialization ; C02, Ionizing radiation ,
• Building large dams , town planning
• Changes in Land use + expansion of human
habitation ( urbanization )

10. Vector- Taxonomy
Bucks
Fleas
1. Arthropods
Arachnids
Acarina
2. Insects
Diptera
Hemiptera
Anoplura
Siphonaptera
Flies
Lice
Invertebrates for genus PHYLUM with an
exoskeleton
Ticks and
Mites

11. Other vectors• Rodents
• multimammate rat
• cotton rat
• deer mouse
• house mouse
Avian-
Swine- HINI

12. Facilities and Safety - Module 2 12

13. • To some others, arthropods are biters and
stingers; bees, wasps, ants, termites, scorpions.
• To some arthropods are jumpers: fleas,
crickets, grasshoppers,
• To some people arthropods are singers:
crickets, cicadas…
• Arthropods to some others are sign of good
luck: fly, June beetle,
• To others, they are sign of evil eyes: black
beetle.

14. The truth is that arthropods are vectors
Agents Transmitted By this Vectors
1. Viruses
2. Rickettsiae
3. Bacteria
4. Protozoa-
5. Helminths-
6. PRIONS – nv_CJD ‘s
7. Toxins –chemical toxicology

15. Factors contributing to vector borne diseases
• PESTEL- Analysis
• Climate change
• Bio-economics; Mass production by rDNA technology/
biotechnology – anti-malaria GM Mosquito , GM-rodents/rats
/ GM-Animals/ GMO’s
• Poor GMO’s- Bio-security , bio-safety, bioterrorism –
• Famine,
• drought,
• food insecurity,
• Poor waste management, recycling issues
• Poor Water management , drug , pesticide, rodentcide
resistance, counterfeiting
• ionizing radiation
• Poor Biodiversity degradation mitigation and awareness

16. PESTEL – analysis
• Political- VBD’s less on the political
agenda/Public health concern
• Economical-Industrialization, urbanization,
GMO’S
• Social demographic trends- mobility, travel
• Technological-
• Ecological
• Legal

17. • Strange worms – Leribe, Koro-Koro 2011
• Cyclone
• Cockroaches – Ministry of Health
• Hurricane
• Floods
•

18. Climate Change as AN agent of VBD
• In the atmosphere, gases such as water vapour,
carbon dioxide, ozone, and methane act like the
glass roof of a greenhouse by trapping heat and
warming the planet.
• These gases are called greenhouse gases.
• The natural levels of these gases are being
supplemented by emissions resulting from human
activities, such as the burning of fossil fuels, farming
activities and land-use changes.
• As a result, the Earth’s surface and lower
atmosphere are warming, and this rise in
temperature is accompanied by many other changes
to include patterns is ecosystem and re-emergence
of vector borne diseases

19. Why is the Climate Changing?
Natural variability
Climate change is a normal part of the Earth’s natural variability, which is related to
interactions among the atmosphere, ocean, and land, as well as changes
in the amount of solar radiation reaching the earth.
The geologic record includes significant evidence for large-scale climate changes in
Earth’s past.

22. • According to the Intergovernmental Panel on Climate Change
(IPCC) Working Group I (WGI) Fourth Assessment Report,
from 1850 to 2005, the average global temperature increased
by about 0.76ºC and global mean sea level rose by 12 to 22
cm during the last century
• Climate change is already forcing biodiversity to adapt either
through shifting habitat, changing life cycles, or the
development of new physical traits.
• ecosystems play a key role in the global carbon cycle and in
adapting to climate change, while also providing a wide range
of ecosystem services that are essential for human well-being
and the achievement of the Millennium Development Goals.

23. Human-induced change
Greenhouse Gases
Certain naturally occurring gases, such as carbon dioxide (CO2) and water vapor
(H2O), trap heat in the atmosphere causing a greenhouse effect.
Burning of fossil fuels, like oil, coal, and natural gas is adding CO2 to the
atmosphere.
The current level is the highest in the past 650,000 years.
The Fourth Assessment Report of the Intergovernmental Panel
on Climate Change concludes, “that most of the observed increase in the globally
averaged temperature since the mid-20th century is very likely due to the observed
increase in anthropogenic greenhouse gas concentrations.”

24. Cloning
• Cloning for livestock : About 300 bulls have
been cloned, with the aim of improving the
quality of breeding stock
• clone done directly for meat breeding .

25. VECTOR ECOLOGY CYCLE

26. Malaria VBD
• malaria is the most prevalent vector-borne disease,
with over 2.4 billion people around the world at risk of
contracting this disease and more than 275 million
cases reported every year
• 225 million annual cases worldwide, 212 million in
Africa
• • Close to 800,000 deaths each year
• • 90 % of malaria-related deaths occur in sub-Saharan
part of Africa, the majority of deaths are young
children
• Estimated deaths from malaria per 1000 population,
2006 (source: WHO World Malaria Report 2008).

27. Laboratory Diagnosis of Malaria
• Malaria is a serious, fatal disease resulting from
infection with Plasmodium spp., transmitted by the
bite of Anopheline mosquitoes..
• The clinical diagnosis, where malaria is suspected
based on the history, symptoms and clinical findings
must always be confirmed by a laboratory diagnosis.
• Laboratory diagnosis of malaria involves
identification of malaria parasite or its
antigens/products in the blood of the patient.
• Microscopy: Microscopy is gold standard for
laboratory confirmation of malaria

28. MALARIA ENDEMIC PATTERNS
• Endemic malaria, population movements, and
foreign travel all contribute to the malaria diagnostic
problems faced by the laboratory that may not have
appropriate microscopy expertise available.
• There is Changing patterns of accepted
morphological appearances of malaria species,
• due to drug resistance, strain variation, or
approaches to blood collection,
• These have created diagnostic problems that cannot
easily be resolved merely by reference to an atlas of
parasitology.

29. Cont
• Fortunately, new technology provides
additional diagnostic options, which can be
reviewed and compared to more traditional
methods.
• Concurrently the World Health Organization
(WHO) has begun a dialogue with scientists,
clinicians, and manufacturers of malaria
diagnostic test devices regarding the realistic
possibilities for developing accurate, sensitive,
and cost-effective rapid diagnostic tests for
malaria.

30. Table 1. Morphological features of the different stages of
Plasmodia by species in stained thin blood film
P. falciparum P. vivax P. ovale P. malariae
TrophozoitesAlways present in
peripheral blood.
Ring-shaped, small to
medium size in dimension
(Æ = 2-4 mm) depending
on maturation. Young
form may lay in marginal
position. Polyparasitism
and double chromatin dots
possible.
Polymorphous in
shape from large
ring forms younger
forms) to ameboid
mass occupying
the entire red
blood cell (mature
forms).
Polymorphous in
shape from ring
forms often showing
a central clear
vacuole surrounded
by regular
cytoplasm (younger
forms) to large
ameboid masses
(mature forms).
Their
dimensions are
slightly inferior to P.
vivax.
Ring form,small and
regular in shape, with no
pseudopodes.
Older forms may be
large, with vacuole
Occasionally,
equatorial band form
present
Schizonts Solely present in more
severe infections.
Small and compact,
containing 15 to 30
merozoites and a dense
dark brown pigmented
residual body.
Normally present
in peripheral
blood. Large (Æ =
12-16 mm),
round bodies
containing 12 to
24 merozoites and
loose golden
brown residual
pigmentation
Normally present in
peripheral blood.
Large (Æ = 10-12
mm),
round bodies
containing 4 to
12 merozoites and
dark
pigmentation
Compact, rosetta-like
forms with 8-10
merozoites
surrounding a central
pigmented area
GametocytesPresent in the second
phase of the erythrocytic
cycle. Crescent-shaped
with coarse rice-like
granules and pigment. The
female is blue in
colour and granules are in
central position, while the
male form is violet and
Round regular
bodies with a
single voluminous
nucleus (dense
and red purple in
female
gametocytes,
loose
and pink in male
Round regular
bodies with a
single voluminous
nucleus (dense and
red purple in
female
gametocytes, loose
and pink in male
forms).
Compact large single
dense purple nucleus
(female form) or
loose violet nucleus
(male form). Scattered
coarse pigment granules
are present
s

31. s
pigmentation
Gametocyt
es
Present in the second
phase of the
erythrocytic cycle.
Crescent-shaped with
coarse rice-like
granules and pigment.
The female is blue in
colour and granules
are in
central position, while
the
male form is violet
and
granules are scattered
over
the parasite
Round regular
bodies with a
single
voluminous
nucleus (dense
and red purple
in
female
gametocytes,
loose
and pink in
male forms).
Round regular
bodies with a
single
voluminous
nucleus (dense
and red purple in
female
gametocytes,
loose and pink in
male forms).
Their dimensions
are usually
inferior than in P.
vivax
Compact large single
dense purple nucleus
(female form) or
loose violet nucleus
(male form).
Scattered coarse
pigment granules are
present
Parasitic
density
may be very high
(average 20-500.000,
max 2.000.000)
intermediate
level
(average
20.0000, max
50.000)
usually moderate
(average 9.000,
max 30.000)
usually very low
(average 6.000, max
20.000)

32. Plasmodium vivax- Malaria

33. Plasmodium Fulciparim

34. P. Ovale

35. Plasmodium malariae

36. • Northern blot

37. • PCR methods can give valuable information when difficult
morphological problems arise during attempts to identify
parasites to the species level.
• A number of PCR assays have been developed for the
detection of malaria DNA from whole blood as either single or
multiplex.
• These assays have been used for the initial diagnosis,
following the response to treatment, and as sensitive
standards

38. Bacterial VB diseases
• Ehrlichiosis is the general name used to describe several
bacterial diseases that affect animals and humans
• The symptoms caused by infection with these Ehrlichia species
usually develop 1-2 weeks after being bitten by an infected tick.
• The following is a list of symptoms commonly seen with this
disease, however, it is important to note that the combination of
symptoms varies greatly from person to person.
• Fever , Headache
• Chills, Malaise
• Muscle pain
• Nausea / Vomiting / Diarrhea
• Confusion, Conjunctival injection (red eyes)
• . Severe clinical presentations may include difficulty breathing,
or bleeding disorders

39. Bartonella- tick transmitted
• Bartonella are intracellular parasites that generally show
preference for erythrocytes and endothelial cells in humans.
• The organisms are found in a wide range of both wild and
domestic mammals,
• including cattle,
• rodents,
• dogs and cats.
• The various Bartonella species appear to be adapted to specific
hosts.
• Cats are the main reservoir for B. henselae, which causes
approximately 20,000 reported cases of cat scratch disease per
year in the United States

40. Tick bite life cycle

41. Laboratory Detection
During the acute phase of illness, a sample of whole blood can be tested by
polymerase chain reaction (PCR) assay to determine if a patient has ehrlichiosis
Figure 1
• Morulae detected in a monocyte on a peripheral blood
smear, associated with Ehrlichiosis. chaffeensis infection
• The type of blood cell in which morulae are observed may
provide insight into the infecting species: E. chaffeensis most
commonly infects monocytes, whereas E. ewingii more
commonly infect granulocytes

42. LABORATORY FOR Ehrlichiosis
• The gold standard serologic test for diagnosis of ehrlichiosis is
the indirect immunofluorescence assay (IFA) using E.
chaffeensis antigen, performed on paired serum samples to
demonstrate a significant (four-fold) rise in antibody titers
• 1 DEXX: point of care equipment for screening Pets
• The SNAP® 4Dx® Plus Test raises the standard of care for
annual parasite screening. It provides an accurate result in
just 8 minutes. But the benefits of vector-borne disease
screening go far beyond the well-being of an individual pet.
• DNA - PCR

43. Rickettsae vector born diseases
• Typhus
• LICE
• LABORATORY DIAGNOSIS
• Weilfelix test
• IFA
• ELISA
• PCR

44. What carries viruses that cause viral hemorrhagic
fevers?
• Viruses associated with most VHFs are zoonotic.
• These viruses naturally reside in an animal reservoir host or
arthropod vector.
• They are obligate intracellular , and totally dependent on
their hosts for replication and overall survival.
• For the most part, rodents and arthropods are the main
reservoirs for viruses causing VHFs.
• The multimammate rat, cotton rat, deer mouse, house
mouse, and other field rodents are examples of reservoir
hosts.
• Arthropod ticks and mosquitoes serve as vectors for some of
the illnesses. However, the hosts of some viruses remain
unknown -- Ebola and Marburg viruses are well-known
examples.

45. What needs to be done to address the threat of viral
hemorrhagic fevers?
• Scientists and researchers are challenged with
developing containment, treatment, and vaccine
strategies for these diseases.
• Another goal is to develop immunologic and
molecular tools for more rapid disease diagnosis, and
to study how the viruses are transmitted and exactly
how the disease affects the body (pathogenesis).
• A third goal is to understand the ecology of these
viruses and their hosts in order to offer preventive
public health advice for avoiding infection.

46. Cases
• people usually become infected only in areas where the host
lives, occasionally people become infected by a host that has
been exported from its native habitat.
• For example, the first outbreaks of Marburg hemorrhagic
fever, in Marburg and Frankfurt, Germany, and in Yugoslavia,
occurred when laboratory workers handled imported
monkeys infected with Marburg virus.

47. CASES
• a person becomes infected in an area where the virus occurs
naturally and then travels elsewhere.
• If the virus is a type that can be transmitted further by
person-to-person contact, the traveler could infect other
people. For instance, in 1996, a medical professional treating
patients with Ebola hemorrhagic fever (Ebola HF) in Gabon
unknowingly became infected.
• When he later traveled to South Africa and was treated for
Ebola HF in a hospital, the virus was transmitted to a nurse.
She became ill and died.
• Because more and more people travel each year, outbreaks
of these diseases are becoming an increasing threat in places
where they rarely, if ever, have been seen before

48. Lifestyles and Income
diversification
•Chesanyama- raw meat
•Change in food systems
affect both health and
health ecosystem-
Chinese eat crabs,
mushroom
•Travel –Patterns
•Hygiene on preparing
food in streets and
markets

49. HELMINTH Diseases
• Schistosomiasis is a tropical disease caused by a parasitic
infection with worms from the Schistosomatidae family.
• About 200 million people are infected with schistosomiasis
worldwide.
• Schistosomiasis can be 'acute' or 'chronic'.
• Many people do not develop symptoms of acute
schistosomiasis,
• or their symptoms may be mild and go unrecognised.
• Chronic schistosomiasis can produce symptoms months or
years after infection.
• Diagnosis is usually made by testing your urine or poo (faeces)
or through a blood test or cytology / histology .
• Treatment is with a medicine called praziquantel.

50. LIFE CYCLE OF SCHISTOSOMA

51. Schistosoma on FNA cytology

53. • Schistosomiasis is a neglected tropical disease caused by blood
FLUKE
• No vaccines are available, and treatment relies on one drug,
praziquantel.
• Schistosoma haematobium has come into the spotlight as a
major cause of urogenital disease, as an agent linked to
bladder cancer
• and as a predisposing factor for HIV/AIDS
• The parasite is transmitted to humans from freshwater snails.
• Worms dwell in blood vessels and release eggs that become
embedded in the bladder wall to elicit chronic immune-
mediated diseaseand induce squamous cell carcinoma

54. Life cycle of Ecchinococus – hydatid diseases

55. • Praziquantel is used to treat diseases in humans, mammals, and fish that
are caused by infection with several types of internal/gastrointestinal, and
external parasites including the following:
• Salmon poisoning disease
• Hydatid disease caused by infection of various organs with larval stages of
tapeworms of the genus Echinococcus
• Cysticercosis caused by infection of the brain and/or muscles with the
eggs and larvae of the pork tapeworm Taenia solium (though it has been
judged less effective than albendazole in treatment of neurocysticercosis
• Feline taeniasis caused in cats by gastrointestinal infection with adult
tapeworms of the species Taenia taeniaeformis;
• Toxocariasis in cats and dogs whose gut is infected with the
roundworms/nematodes Toxocara cati or Toxocara canis
• Schistosomiasis caused by trematodes of the genus Schistosoma.
• Clonorchiasis brought on by the Chinese liver fluke Clonorchis sinensis
• Diplozoon paradoxum and other Trematoda infections of many fish
species.

56. Sleeping sickness-tryponosomiasis
• Tsetse flies are the sole vectors of human African trypanosomiasis throughout
sub-Saharan Africa.
• Both sexes of adult tsetse feed exclusively on blood and contribute to disease
transmission.
• Notable differences between tsetse and other disease vectors include
obligate microbial symbioses, viviparous reproduction, and lactation.
• Here, we describe the sequence and annotation of the 366-megabase
Glossina morsitans morsitans genome.
• Analysis of the genome and the 12,308 predicted protein–encoding genes led
to multiple discoveries, including chromosomal integrations of bacterial
(Wolbachia) genome sequences, a family of lactation-specific proteins,
reduced complement of host pathogen recognition proteins, and reduced
olfaction/chemosensory associated genes.
• These genome data provide a foundation for research into trypanosomiasis
prevention and yield important insights with broad implications for multiple
aspects of tsetse biology.

57. parasitic trypanosomes
• African sleeping sickness in humans (Human African
Trypanosomias – HAT) is a dreadful disease to contract, and
results in death.
• Sting infection occurs when the saliva of the tsetse fly
contains parasitic trypanosomes.
• There is no known vaccine to prevent the spread of infected
blood throughout the bloodstream.
• The early stages of the parasite infection in the host leads to
fever, headaches, and joint pain.
• If undetected, it attacks the lymphatic system
• Finally, the central nervous system is assailed by the infection
once its crosses the blood-brain barrier.

58. • When the host is at this stage of infection, the
sleep-cycle is affected. The patient is confused
and disoriented and experiences a disrupted
sleep pattern, with long sleep cycles by day
and fragmented periods of wakefulness and
delirium at night. There is no medically viable
course of treatment.

59. Life cycle of tryponasoma

60. Trypanosomiasis blood film

61. Recommendations
• Bio-climate modeling algorithms
• Human Population Density; Land Use
 - GIS Integrated models
 ICT- environmental Health integrated models
 Geographic Climate Models – Scenarios, Haiti,
Tsumami,
 Awareness , preparedness , strategies
 Risk Assessments ;( Bio-effect of Global
change: NEW RESEARCH AGENDA
 Biosecurity- linkage

62. Facilities and Safety - Module 2 62
Organization Personnel Equipment
Purchasing
&
Inventory
Process
Control
Information
Management
Documents
&
Records
Occurrence
Management Assessment
Process
Improvement
Customer
Service
Facilities
&
Safety
The Quality Management System

63. Improve Systems and programs – to address MDG’s ,
PRD’s, vector borne diseases and climate change
Information mgt ( I C T)

64. Recommendations
• by providing knowledge, increasing political will,
mobilizing resources, and catalyzing intense and
urgent action.
• Cyclone forcasts
• Salelite watch
• Metrology- collaboration
• Building a PUBLIC HEALTH LABORATORY
• Training of health professionals on Vector Borne
diseases , surveillance and diagnosis

65. RECOMMENDATIONS
• We recommend proactive planning
• more surveillance of direct impacts, such as changes in the
reproduction rate of the vector or the agent, the biting
frequency of the vector, and the amount of time the host is
exposed to the vector due to changes in temperature, rainfall,
humidity, or storm patterns.
• Even less information is available to evaluate the impacts of
societal and individual activities on the transmission of vector-
borne diseases.
• Changes in hydrology, agriculture, forestry, and infrastructure
in response to global warming may also indirectly affect the
interrelationship among the disease agent, vectors, and hosts.

66. • Protect children against mosquito bites by eliminating
potential breeding sites in standing water and household
garbage.
• Use insecticide impregnated mosquito nets, screens on
windows and doors and appropriate clothing and mosquito
repellants.
• Promote early diagnosis by caregivers and learn at-home
VBDs and malaria management, using safe and effective
drugs.
• Promote collective efforts to eliminate vector breeding sites,
such as involving children in weekly clean-outs of water
holding containers and identifying other vector breeding
sites.
• Inform public and children of the risks of malaria and other
vector-borne diseases, how they are transmitted,
• There is need for integration with objectives of poverty

67. • how to protect oneself, symptoms of illness and first steps to
treat illness.
• Include health promotion and protection in school curricula,
including a focus on vector-borne diseases.
• Community leaders and health professionals can advocate to:
• Continue or begin to record incidence and other information
on vector-borne diseases.
• Provide immediate, effective treatment, as even a short time
can mean the difference between life
• and death to a child sick with malaria.
• Initiate periodic immunization campaigns where health
services are weak, such as for yellow fever.
• At the same time, local healthcare professionals can support
campaigns on other preventive medical
• treatments to reduce incidence of vector-borne diseases.

68. Cont
• Promote safer water management practices in
agricultural areas with help from community health
• workers teamed up with agricultural extension
workers.
• Conserving natural terrestrial, freshwater and marine
ecosystems and restoring degraded ecosystems
(including their genetic and species diversity) is
essential
• Perform risk assessment and management , using
the Cartagena protocol on biodiversity and biosafety
• Intesify SPS measures

69. Invest in research- Horizon 2020
• Paradigm shift
• Health-environment- agric- ICT-COMMUNITY related
Community Research
• Out of the ivory towers in to the Community
• Culture of Research
• Funding
• Academic in-cooperation of Medical Entomology in
Medical Curriculum
• There is no reason that people of different nations,
cultures, religions and philosophies cannot work
together in support of policies needed to protect our
common human future

70. REFERENCES
• 1.↵Baird, J. K., Purnomo, and T. R. Jones. 1992. Diagnosis of malaria in the field by
fluorescence microscopy of QBC capillary tubés. Trans. R. Soc. Trop. Med. Hyg.
86:3–5.
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Rimwungtragoon, and D. R. Wirth. 1992. A simple method to detect Plasmodium
falciparum infection in human patients: a comparison of the DNA probe method to
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• 3.↵Beadle, C., G. W. Long, W. R. Weiss, P. D. Meelroy, S. M. Maret, A. J. Oloo,
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• 4.↵Benito, A., J. Roche, R. A. Molina, C. Amela, and J. Altar. 1994. Application and
evaluation of QBC® malaria diagnosis in a holoendemic area. Appl. Parasitol.
35:266–272.
• 5.↵Bosch, I., C. Bracho, and H. A. Perez. 1996. Diagnosis of malaria by acridine
orange fluorescent microscopy in an endemic area of Venezuela. Mem. Inst.
Oswaldo Cruz 91:83–8
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Ponard, and P. Ambroise-Thomas. 2000. Diagnosis of malaria in non-endemic
countries by the Parasight-F test. Am. J. Trop. Med. Hyg. 63:150–152.

71. REFERENCES
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