ObjectivesKyrgyzstan is one of the 27 high multidrug-resistant tuberculosis (MDR-TB) burden countries listed by the WHO. In 2012, Médecins Sans Frontières (MSF) started a drug-resistant tuberculosis (DR-TB) project in Kara Suu District. A qualitative study was undertaken to understand the perception of TB and DR-TB in order to improve the effectiveness and acceptance of the MSF intervention and to support advocacy strategies for an ambulatory model of care.MethodsThis paper reports findings from 63 interviews with patients, caregivers, health care providers and members of communities. Data was analysed using a qualitative content analysis. Validation was ensured by triangulation and a ‘thick’ description of the research context, and by presenting deviant cases.ResultsFindings show that the general population interprets TB as the ‘lungs having a cold’ or as a ‘family disease’ rather than as an infectious illness. From their perspective, individuals facing poor living conditions are more likely to get TB than wealthier people. Vulnerable groups such as drug and alcohol users, homeless persons, ethnic minorities and young women face barriers in accessing health care. As also reported in other publications, TB is highly stigmatised and possible side effects of the long treatment course are seen as unbearable; therefore, people only turn to public health care quite late. Most patients prefer ambulatory treatment because of the much needed emotional support from their social environment, which positively impacts treatment concordance. Health care providers favour inpatient treatment only for a better monitoring of side effects. Health staff increasingly acknowledges the central role they play in supporting DR-TB patients, and the importance of assuming a more empathic attitude.ConclusionsHealth promotion activities should aim at improving knowledge on TB and DR-TB, reducing stigma, and fostering the inclusion of vulnerable populations. Health seeking delays and adherence problems will be countered by further implementation of shortened treatment regimens. An ambulatory model of care is proposed when convenient for the patient; hospitalisation is favoured only when seen as more appropriate for the respective individual.
Radiobiological investigations on the reproductive behavior of female Spodoptera litura (Fabr.) were conducted with the aim of determining the suitable radio-sterilizing dose for females in order to release them along with sub-sterile males for effective implementation of the Inherited Sterility technique against this pest. Calling and copulation duration significantly increased, while mating success, oviposition, fertility and longevity significantly decreased with increasing radiation dose (100–200 Gy) compared to control. In view of the effect of irradiation on mating behavior and reproductive viability of female S. litura, 130 Gy was identified as a suitable radio-sterilization dose. Further molecular studies were conducted to corroborate this dose for female sterilization, along with a higher dose of 200 Gy in order to validate the gradational response of ionizing radiation. GC-MS analysis indicated decreased sex pheromone titer at 130 Gy, which was more pronounced at 200 Gy. Pheromone-associated genes, PBAN and PBAN-R showed decreased expression at 130 Gy, and were drastically reduced at 200 Gy. The fertility-related Vg gene also showed a negative correlation with radiation exposure. Based on these radiation responses of female S. litura, 130 Gy might be considered a suitable dose for complete female sterility and its inclusion in sterile insect programs against S. litura.
Mass rearing of insects of high biological quality is a crucial attribute for the successful implementation of sterile insect release programs. Various ontogenetic stages of Spodoptera litura (Fabr.) were treated with a range of low doses of ionizing radiation (0.25–1.25 Gy) to assess whether these gamma doses could elicit a stimulating effect on the growth and viability of developing moths. Doses in the range of 0.75 Gy to 1.0 Gy administered to eggs positively influenced pupal weight, adult emergence, and growth index, with a faster developmental period. The enhanced longevity of adults derived from eggs treated with 0.75 Gy and 1.0 Gy, and for larvae and pupae treated with 1.0 Gy, indicated a hormetic effect on these life stages. Furthermore, the use of these hormetic doses upregulated the relative mRNA expression of genes associated with longevity (foxo, sirtuin 2 like/sirt1, atg8) and viability/antioxidative function (cat and sod), suggesting a positive hormetic effect at the transcriptional level. These results indicated the potential use of low dose irradiation (0.75–1 Gy) on preimaginal stages as hormetic doses to improve the quality of the reared moths. This might increase the efficiency of the inherited sterility technique for the management of these lepidopteran pests.
In this study various factors, viz., male irradiation, its mating status and post mating interval were studied on the remating propensity, insemination quality and reproductive behaviour of a noctuid pest Spodoptera litura (F.) that may govern the efficacy of radiation mediated inherited sterility (IS) technique proposed to control this pest. The male irradiation (substerilizing 130 Gy and sterilizing 250 Gy) affected the copulation duration, mating success and sperm transfer during mating. Multiple matings of male significantly depleted the sperm in fully sterile male followed by substerile male than control. During remating with virgin female, the reproductive performance of mated irradiated male, was more affected at 24 hr than at 48 hr inter mating interval, which might be due to associated physiological impact on mating behaviour and insemination quality. This study might be crucial in simulation modelling and optimization of successful implementation of IS programme.
In this study, the effect of ionizing radiation was studied on the pheromone biosynthesis activating neuropeptide (PBAN) gene expression in female moths of a noctuid pest Spodoptera litura (F.), that would trigger pheromone production and its release needed for calling behaviour. The PBAN gene expression in the radiosterilized female moths (at 130 Gy) showed a decline with respect to control (unirradiated moths), and PBAN expression was drastically reduced at higher dose, 200 Gy. The photosensitivity and diel rhythm of PBAN gene expression, indicating higher expression during peak hours of scotophase and lowest expression during photophase was maintained at 130Gy, which deemed this gamma dose a suitable sterilizing dose for female moths which seemed to retain reproductive competence. This study might support the radiosterilized female moths for their combined release with substerilized males, using 130Gy to effectively operate the F1 sterility technique proposed to control S. litura
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