Evolutionary Analysis of Culex Species

Evolutionary Analysis of Culex Species INTRODUCTION: Culex, a mosquito belongs to the phylum Arthopoda, is an important factor causing filariasis [1] St. Louis encephalitis [2]West Nile virus [3] Avion malaria (4). C.quinquefasciatus also called the Southern house mosquito is extensively studied as it transmits crucial diseases [5]. C. pipiens found in the urbans (6) is because of swift urbanization uncanny city growth which eventually resulted in the progression the disease transmittors (7,8,9). Lymphatic filariasis is spread worldwide, affecting 120 million people  [10]. They bite on the foot regions of humans  (11) causing skin allergy associated with irritation  (12).Since 1979 there are reports Japanese encephalitis in India, AP and was again reported in 2003  [13]. Known as a cosmopolitan mosquito, acts as vector for protozoan parasites (14 ),filarial worms (15), and for arboviruses(16 ,17). Cx. quinquefasciatus is the prime vector in India causing filariasis  (18) which involve 91% caused by Wuchereria bancroftiCobbold   [19] Hence, therefore, it is very important to eradicate this for the human welfare for which it is very essential to understand them at their molecular levels. The genome sequence of Culex quienquefasciatus  [20]triggered a new hope for the researchers. However, the researchers are still involved in identifying and characterization of these species causing diseases  (21). The objective of the present article is to access the evolutionary relationship among the culex species with the DNA barcoding and to assess the evolutionary relationship with Tamura 3 Parameter. To accomplish the objective, it is important to use the advanced techniques like the computerized data assessments (22) which could have an immense impact on the health care S. Morio, Computers in Biology and Medicine, 9: 295 (1989)(BOOK) (23) system as the data could be accurate (22). The use of DNA barcoding has been in practice over the conventional 16s ribosomal DNA (24) which is more advantageous and promising (25) by playing a pivotal role in identification between the species (26). 2. MATERIALS AND METHODS: 2.1 Larvae collection and Characterization: Culex larvae were sampelled from various parts of Hyderabad during the breeding season from different locations, say stagnant water, coconut shells, tires etc. Thus collected larvae were reared and were identified morphologically for Culex quienquefasciatus under the microscope. Microscopic analysis revealed the following characteristics, Short and stout head, yellow long mouth brushes. It was also observed that the abdomen has eight segments, the saddle and the siphon, which is four times longer that its width, securing the larvae to be Culex quinquefasciatus. The larvae were allowed to grow into an adult (27). Further study was performed from the F1 generation of the pure culture after they were identified morphologically for adult. 2.2 DNA EXTRACTION: From the 4th instar larvae, the total DNA was extracted and was then finely ground in 50  µl of homogenate buffer (28). The homogenate was left in the thermo cycler for 30 minutes at 60oC with a quick addition of 7  µl of 8M CH3COOK. Incubate the tubes in ice for 30 minutes and centrigugate them for at a maximum speed for 15 minutes. Transfer the supernatant into fresh tubes. To precipitate the DNA, incubate the tubes for 15minutes after adding 100  µl of 95 % ethanol. DNA pellet was collected after a rapid centrifugation for 15 minutes at maximum speed and decay the supernatant. Air dry the pellet and suspend it in Tris buffer. Store it at 20oC till further experimental procedure is carried. COI Partial sequencing, amplification, Sequencing and Alignment: The isolated DNA was further amplified on PCR by mitochondrial Cytochrome c Oxidase I (COI) gene, which can differentiate between the diversity of taxa . The mitochondrial COI gene of ~ 500 bp was amplified by forward and reverse primers (28) which were developed on the spanning, ~700 bp of Aedes aegypti, Anapheles stepfheni and Cx. Quienquefasciatus. The reaction mixture, 25  µl, consisting of 10-50 ng of DNA template, 200 µM of dNTPS’ 1U of Taq DNA polymerase, 1X assay buffer and 5p mol of primer was then subjected to amplification for 2 minutes at 94o C initiation, denaturation of DNA template for 35 cycles for 30 seconds at 95 o C, followed by primer aliening -30 seconds at 55 o C, extension- 70 o C for 30 seconds and final extension at 70 o C for 10 minutes. The amplified sequence ,thus, was run on Agarose gel electrophoresis and then the sequencing was perfoemed by Bioserver Biotechnologies Pvt. Ltd. The sequence was submitted to NCBI. The accession number assigned was JX08870 (501bp). Further multiple sequence alignment was performed for partial COI gene sequence of 501bp with the default parameters. Sequence alignment studies elucidate the similarity and differences among different species in India along with other parts of the world. Further, the results of the DNA barcoding were made increasingly vivid with the phylogenetic analysis by the construction of phylogenetic tree. The analysis of the phylogeny was attained by maximium likelihood method (29) with the deletion of gaps and missing data. Bootstrap replication was used to validate the tree. RESULTS AND DISCUSSIONS: Known as the ‘Southern House Mosquito’, Cx. Quienquefasciatus a vector which played a prime role in filariasis and the incidences have seen in different parts of the world. Hence, there is an utmost need to address this problem with priority. In order to snub the prognosis of this vector, it is very essential to take certain control measures. To attain this, the mosquito larvae were collected and grown into an adult. The DNA was isolated and amplified and run on the agarose gel electrophoresis. The agarose wells comprised of sample from different locations along with 200bp marker DNA. The amplicons were seen between 400bp and 600bp of the DNA marker and were then subjected to sequencing. It was noted that the sequence was identified to be novel and was submitted to NCBI-gene bank nucleotide database and the accession number assigned was JX088701. Further, the multiple sequence alignment was performed to understand the evolutionary relationship among the species of the world.. Using the Maximum Likelihood Method, which creates a tree of highest Likelihood from the given data. The Maximum Likelihood tree elucidates that the Culex species of Hyderabad was closely related to the UK species and hence both emerged as out group in the phylogenetic tree. CONCLUSION: The medium sized brown mosquito, Culex quinquefasciatus, predominantly exists all through the tropics acts as a vector causing several parasitic diseases. Usually active at night, it is an opportunistic blood feeder which allows the parasites to use the humans as hosts. It is hence important to address their control with priority. The present article the DNA sequence was successfully isolated, sequenced and was submitted to NCBI-Gen Bank nucleotide database. Further, to understand its evolutionary relationship the phylogenetic analysis was performed. It was noticed that the DNA sequence of Hyderabad Culex quinquefasciatus was different from other species and can be used as DNA barcode to identify the organism REFERENCES: Deepak Kumar, Rakesh Chawla, P. Dhamodaram, and N. Balakrishnan Journal of Parasitology Research. http://dx.doi.org/10.1155/2014/236838. Ary Farajollahi, Dina M. Fonseca, Laura D. Kramer, and A. Marm Kilpatrick â€Å"BIRD BITING† MOSQUITOES AND HUMAN DISEASE: A REVIEW OF THE ROLE OF CULEX PIPIENS COMPLEX MOSQUITOES IN EPIDEMIOLOGY Infect Genet Evol. 2011 October ; 11(7): 1577–1585. doi:10.1016/j.meegid.2011.08.013. Linda M. Styer et al Mosquito Saliva Causes Enhancement of West Nile Virus Infection in Mice JOURNAL OF VIROLOGY, Feb. 2011, p. 1517–1527 doi:10.1128/JVI.01112-10. Fabrice Lalubin et al Temporal changes in mosquito abundance (Culex pipiens), avian malaria prevalence and lineage composition Parasites Vectors 2013, 6:307 doi:10.1186/1756-3305-6-307. Emilie Dumas et al Population structure of Wolbachia and cytoplasmic introgression in a complex of mosquito species Evolutionary Biology 2013 13:181. doi:10.1186/1471-2148-13-181 P. F. MATTINGLY Population Increases in Culex pipiens fatigans Wiedemann 1962, 27, 579-584. D. SINGH The Culex pipiens.fatigans Problem in South-East Asia 1967, 37,239-243. Sharma, V.P. et al., ed. Community participation for disease vector control. Proceedings of an ICMR/WHO Workshop,February 1986, New Delhi, India. Roberta Bivins The English Disease† or â€Å"Asian Rickets†? Medical Responses to Postcolonial Immigration Bull. Hist. Med., 2007, 81 : 533–568 E.A. Ottesen, Bulletin of the World Health Organization, 1997, 75 (6): 491-503. Oduola AO,Awe OO Behavioural biting preference of Culex quinquefasciatus in human host in Lagos metropolis Nigeria J Vector Borne Dis.2006 Mar;43(1):16-20. Bhoopendra SINGH et al Interdiscip Toxicol. 2012; Vol. 5(4): 184–191. doi: 10.2478/v10102-012-0031-4 Repon C. Paul et al A Novel Low-Cost Approach to Estimate the Incidence of Japanese Encephalitis in the Catchment Area of Three Hospitals in Bangladesh Am. J. Trop. Med. Hyg., 85(2), 2011, pp. 379–385 doi:10.4269/ajtmh.2011.10-0706. C. van Riper III, S. G. van Riper,M. L. Goff, and M. Laird, â€Å"The epizootiology and ecological significance of malaria in Hawaiian land birds,† Ecology Monograph, vol. 56, pp. 327–344, 1986. S. M. M. Ahid, P. S. Da Silva Vasconcelos, and R. Lourenc ¸ode- Oliveira, â€Å"Vector competence of Culex quinquefasciatus Say fromdifferent regions of Brazil to Dirofilaria immitis,† Memorias do Instituto Oswaldo Cruz, vol. 95, no. 6, pp. 769–775, 2000. S. Sucharit, K. Surathin, and S. R. Shrestha, â€Å"Vectors of Japanese encephalitis virus (JEV): species complexes of the vectors,† The Southeast Asian Journal of Tropical Medicine and PublicHealth, vol. 20, no. 4, pp. 611–621, 1989. G. Molaei, T.G. Andreadis, P.M. Armstronget al., â€Å"Host feeding pattern of Culex quinquefasciatus (Diptera: Culicidae) and its role in transmission ofWestNile virus inHarris County, Texas,† American Journal of Tropical Medicine andHygiene, vol. 77, no. 1, pp. 73–81, 2007. Sarkar M et al Insecticide resistance and detoxifying enzyme activity in the principal bancroftian filariasis vector, Culex quinquefasciatus, in northeastern India Med Vet Entomol.2009 Jun;23(2):122-31. doi: 10.1111/j.1365-2915.2009.00805.x. http://shodhganga.inflibnet.ac.in/bitstream/10603/12579/5/05_chapter%201.pdf ( BOOK) Peter Arensburger Sequencing of Culex quinquefasciatus establishes a platform for mosquito comparative genomics Science. 2010 October 1; 330(6000): 86–88. doi:10.1126/science.1191864. U.Suryanarayana Murty Rule-based system for the fast identification of species of Indian Anopheline mosquitoes Comput Appl Biosci(1996)12(6):491-495.doi:10.1093/bioinformatics/12.6.491 Upadhyayula Suryanarayana Murty Rapid identification of female Culex mosquito species using Expert System in the South East Asian region Bioinformation 1(2): 40-41 (2005). S. Morio, Computers in Biology and Medicine, 9: 295 (1989)(BOOK) Setti A, Devi TP, Pawar SC, Rajesh G, Srikanth S, Kalyan S.Molecular evolution of pathogenic bacteria based on rrsA gene, 2012 Hebert PD Biological identifications through DNA barcodes Proc Biol Sci.2003 Feb 7;270(1512):313-21. Saied Reza Naddaf et al Confirmation of Two Sibling Species among Anopheles fluviatilis Mosquitoes in South and Southeastern Iran by Analysis of Cytochrome Oxidase I Gene J Arthropod-Borne Dis, 2012, 6(2): 144–150. Eugene JG. Manual for mosquito rearing and experimental techniques. Am Mosq Control Assoc INC, 1970, Bulletin No.5, 7-27 Sambashiva Daravath, Aravind Setti, Yuvo singh, Swarnagowreeswari G, Madhavi Yadav M, Smita C Pawar, Reddya Naik B. DNA barcode of COI genetic marker of the Indian Aedes albopictus (Skuse) (Insecta: Diptera: Culicidae). Medical Science, 2014, 5(15), 21-25. Koichiro Tamura et al MEGA5: molecular evolutionary genetics analysis using maximum likelihood, evolutionary distance, and maximum parsimony methods. Molecular biology and evolution, 2011, 28 (10), 2731-9 Ref without PMC ID: C. van Riper III, S. G. van Riper,M. L. Goff, and M. Laird, â€Å"The epizootiology and ecological significance of malaria in Hawaiian land birds,† Ecology Monograph, vol. 56, pp. 327–344, 1986. S. M. M. Ahid, P. S. Da Silva Vasconcelos, and R. Lourenc ¸ode- Oliveira, â€Å"Vector competence of Culex quinquefasciatus Say fromdifferent regions of Brazil to Dirofilaria immitis,† Memorias do Instituto Oswaldo Cruz, vol. 95, no. 6, pp. 769–775, 2000. S. Sucharit, K. Surathin, and S. R. Shrestha, â€Å"Vectors of Japanese encephalitis virus (JEV): species complexes of the vectors,† The Southeast Asian Journal of Tropical Medicine and PublicHealth, vol. 20, no. 4, pp. 611–621, 1989. G.Molaei, T.G. Andreadis, P.M. Armstronget al., â€Å"Host feeding pattern of Culex quinquefasciatus (Diptera: Culicidae) and its role in transmission ofWestNile virus inHarris County, Texas,† American Journal of Tropical Medicine andHygiene, vol. 77, no. 1, pp. 73–81, 2007. Setti A, Devi TP, Pawar SC, Rajesh G, Srikanth S, Kalyan S.Molecular evolution of pathogenic bacteria based on rrsA gene, 2012 Eugene JG. Manual for mosquito rearing and experimental techniques. Am Mosq Control Assoc INC, 1970, Bulletin No.5, 7-27 Sambashiva Daravath, Aravind Setti, Yuvo singh, Swarnagowreeswari G, Madhavi Yadav M, Smita C Pawar, Reddya Naik B. DNA barcode of COI genetic marker of the Indian Aedes albopictus (Skuse) (Insecta: Diptera: Culicidae). Medical Science, 2014, 5(15), 21-25

American US Alignment

This research essay looks at the Latin American alignment with United States in the post cold-war era. Latin America has been associated with Soviet Union from the 1960s until the 1980s. Thus we will take a look on patterns in which US alignment has taken, taking in consideration political economic military and cultural connections.The essay illustrates factors reinforcing and causing tension for US-Latin America connection. Further will take look at the nature and extent of Latin America shift to leftward in the past decade as well as discuss the emerging alliances. From the findings it can be noted that United States hegemonic and coercive control transited to partnership and cooperation as a result of changes in the international system and limited resources of the United States.The factors contributing to this alignment include natural and human resources of Latin America; geophysical proximity and scarcity of resources in the world. It is concluded that this alignment have both beneficial and side effects to both involved. PATTERNS OF LATIN AMERICAN-US ALIGNMENT IN THE POST COLD-WAR ERA, CONSIDERING POLITICAL, ECONOMIC, MILITARY AND CULTURAL CONNECTIONSAccording to Klaveren (1992) Latin America has been viewed as a marginalized and abandoned continent. It has had little or distant influence on global politics due its geo-physical isolation. The region has been relatively been calm except during the Central American crisis of the 1980s. Klaveren (1992) elaborates that although Latin America has been peaceful externally it has had a history of internal conflicts in which foreign countries have not been involved except the United States.Due to interdependence and emergence of new rules in the global arena, there has been a change in redefinition of security concept. The United States redefines it in terms of drug trafficking, environmental protection and migration flow (Klaveren, 1992, p.29). Klaveren (1992) notes that geographical, cultural and political pro ximity of Latin America to US makes it player in supply of specialized and non-specialized labor to the aging population of United States. As a result they alleviate labor shortage to the later and aggravate brain drain in the former (Klaveren, 1992, p.30).Latin America has had good political ties and values with United States for a long time since World War 2. However there has been shortcoming in relation to human rights violation and democracy (Klaveren, 1992, 30). Economically Latin America trades with United States on several commodities, whereby the U.S. is a major market for Latin America motor vehicle parts, capital commodities and agricultural products (Klaveren, 1992, 27).There have been cultural ties between the U.S. and Latin America. Currently there is an influx of migrants from Latin America. They are progressively becoming large population in the U.S., which definitely has effect on U.S. life (Klaveren, 1992, 30).FACTORS THAT REINFORCE AND CAUSE TENSIONS IN THE LATIN AMERICAN CONNECTIONS WITH THE USLatin America possesses vast natural resources, for instance, Brazil is ranked among 10 top most powerful economies of the world while Mexico is in the second lot (Klaveren, 1992, 26). Latin America is endowed with mineral resources such as oil that is critical to world economy. Since Latin America has relatively developed industrial sector it is able to exports products to U.S. with the likes of Brazil and Mexico. More so, because of geo-physical proximity to U.S. they are able to supply specialized and non-specialized work force to them (Klaveren, 1992, 26).On the other hand a couple of factors cause tension with the U.S. one being the diversification of Latin American economies with inclusion of Japan and other developing countries. The lack of effective security measures in Latin America brings into fore the security concerns of U.S. with the increase of drug trafficking and proliferation of small arm (Klaveren, 1992, 26).THE NATURE AND EXTENT OF LATIN AMERICA’S SHIFT LEFTWARD OVER THE PAST DECADE.Latin America was formerly under American system from early 1960s but due to changes in the global economy it has moved from â€Å"natural segmentation to institutional integration based on geographic specialization† and has created their own niche so as to offer specialized services to the receiving end of the technological flow (Klaveren, 1992, 22, 27).Since the end of cold war, the influence of Soviet Union to Latin America  Ã‚   has declined. This resulted to difference in structural institutions of Latin America. For instance Brazil and Columbia had different positions on the liberalization of services in Uruguay Round (Klaveren, 1992, 39).Also, Klaveren (1992) notes that Brazil and Chile developed different alternatives to solve debt crisis after the 1980s Central American crisis. This gives us the complexity nature of Latin America in the post cold war era. The internal issues are as different as is the exter nal. Therefore, only a collective action based on concrete and common interest (Klaveren, 1992, 39).Latin America internal issue could only be dealt on specific case by case and by sector to sector.This is observed when looking at how in the UN General Assembly, Latin America votes with other developing countries or in the third world. However, there is differentiation within the Third World countries that could make variation in the pattern of how Latin America will play in global power (Klaveren, 1992, 39).A number of challenges are yet to be tackled by Latin America such as â€Å"pleas for solidarity and just international order† which will seem to be unnoticed and changes in the international system will have a direct and long term effect on Latin America (Klaveren, 1992, 41). Thus the influence of the region to international system will depend on specific strategies, internal, economic and political environment in which the strategies will be based upon (Klaveren, 1992, 41).Each country will have to mobilize economic, political and strategic resources so as to impact the global system otherwise they will be isolated (Klaveren, 1992, 41). The individual country foreign policy must adapt to changing international system and that scarcity of resources demands careful and selective decisions on approaches and choices to make (Klaveren, 1992, 41). It is worth noting that although sound external strategies are good; they must be backed with domestic conditions for them to flourish (Klaveren, 1992, 41).THE EMERGING REALIGNMENT BETWEEN THE US AND LATIN AMERICA AND WITHIN THE LATIN AMERICAN COUNTRIESThe new emergence in realignment comes in the wake of global changes and the different administration of the US over time. Varas (1992) explain that the gradual integration of Canada, Mexico and some Caribbean economies in the North American geo-economics space led to erosion of single Latin American region.The post Latin American will be characterized with sub region system with different economic, political and strategic weight. There foreign policy, he adds, that was once useful for hegemonic alliance is now obsolete and new paradigm is necessary to address regional and international changes (Varas, 1992, p.48). Within the Latin American countries should use broad based approach, which takes account of political, economic and cultural orientations.   The United States have now transited from a hegemonic and coercive control to partnership and cooperation control. In this regard, according to Varas (1992) the U.S. was no longer  Ã‚   dominant in the international system as well as had limited resources to control and support the hemispheric countries.Thus policies of free trade and decision-making were determined bilaterally in this new system. While the Latin America was agitating for liberalized world trade the U.S., advocated for open trade and cooperative approaches to international problems such as weapon proliferation, terroris m, international violence and environmental degradation (Varas, 1992, 51). The U.S. cooperation with Latin America is on security matters where it seeks to establish credible defense systems, which are effective in peaceful conflict resolution (Varas, 1992, 56). The U.S. is also helping to strengthen democratic institutions and human rights although democracy is still elusive (Varas, 1992, 67). More so U.S. is strengthening its ties with Latin America on socioeconomic issues, especially when considering immigrants to US.CONCLUSIONThe long-term effect of these developments will not lack the merits and limitation for either side. To the U.S. they will be consolidating their presence in Latin America and use low cost measures in ensuring security to its nationals especially when dealing with drug trafficking, greenhouse effect, terrorism and global violence. However, this is threatened by the increasing immigrants from Latin America to U.S. The U.S. will have to depend on immigrants fo r labor because of its low fertility rate and aging population. The Latin America will suffer brain drain although such scenario would provide employment opportunities for its emigrants. The Latin American countries will definitely have economy growth due to direct foreign investment, just international trade and transfer of technology. The emergence of new developed economies like Japan, China Korea and Taiwan add to long-term effects to Latin America. REFERENCEKlaveren, A. (1992). L. America & international system. In   J.Hartlyn, L. Schoultz, & A. Varas. (Eds.). The US & Latin America in the 1990s and beyond (pp. 22-41). Latin America. UNC PressVaras, A. (1992). From coercion to partnership: a new paradigm for security cooperation in theNorthern Hemisphere. In J. Hartlyn, L. Schoultz, & A. Varas. (Eds.).   United States and L.   America. (pp. 48-67). Latin America. UNC Press.

Social Marketing Company (Smc)

Social Marketing: A Success Story in Bangladesh Mahbubur Rahman, MA, MBA 1 and Toslim Uddin Khan, MA, MSS, MBA 2 Social Marketing Company (SMC) is the largest privately managed social marketing organization in the world for a single country. It is a significant contributor to the reproductive and child health services in Bangladesh. The on-going social marketing programs of SMC include family planning, child health, disease prevention and maternal and neonatal health.SMC's mission is to improve the quality of lives of vulnerable and less privileged population primarily in public health issues through sustainable social marketing efforts in collaboration with national and international governments and donors. Social marketing is the application of commercial management techniques for popularizing and selling products and services that offer clear benefits to the people at prices they can buy. Thus, easy accessibility through wide availability and high affordability forms the key eleme nt of social marketing.The model of social marketing SMC adopted and continues to practice has two components – multi-strategy communications for initiating desired behavior change, and suitable, affordable, readily accessible product and service for sustaining the changed behavior using the techniques of commercial marketing. Because of its remarkable success and its sheer size, social marketing in Bangladesh has become a model of best practices and attracted international attention.Two premier USA based graduate schools of business included the case study on social marketing program in Bangladesh in their curricula, which is an entire chapter of the renowned book titled â€Å"Let Every Child Be Wanted: How Social Marketing Is Revolutionizing Contraceptive Use Around the World† written by Philip D. Harvey. The case on SMC is also included in the â€Å"Asian Marketing Casebook† written by Noel Capon and Wilferied R. Vanhonacker. SMC is ISO 9001-2000 certified co mpany.The company is awarded International Star Award for Leadership in Quality (ISLQ) in 2008 by the Business Initiative Directions (BID) a Madrid-based business organization committed to build better business reputation worldwide. Contribution of SMC to the National Program Social marketing of contraceptives and ORS has proven to be a major contributor to achievement of the health and population objectives of the Government of Bangladesh. Population science experts used three critical measures of contraceptive effectiveness – Total Fertility Rate (TFR)3, Couple Year of Protection (CYP)4 and Contraceptive Prevalence Rate (CPR)5.Between 1975 and 2007, the total fertility rate of the country dropped from 6. 3 to 2. 7, and the overall contraceptive prevalence rate among currently married women rose from 8 percent to 56 percent, with modern contraceptive use at 48 percent (BDHS, 2007). SMC is significantly contributing in the modern contraceptive methods to achieve national cont raceptive goals. BDHS shows that 35 percent of the modern contraceptive users use SMC brand contraceptives (four out of ten pill users, six out of 1 Head of Marketing, Social Marketing Company Head or Research and MIS, Social Marketing Company The average number of children that would be born alive to a woman (group of women) during her lifetime 4 It is estimated that one CYP is provided by 150 condoms or 15 oral pill cycles or 4 vials of injectables. 5 Contraceptive prevalence rate is defined as the percent of Married Women of Reproductive Age using family planning method. 2 1 ten condom users and two out of ten injectables users use SMC brand). According to the Consumers Retail Audit, SMC brand condoms have 81 percent share of the retail market while SMC brand OCP have 90 percent of retail market share (ACNielsen, 2008).SMC distributes approximately 100 million pieces of condoms, 40 million cycles of oral pills and one million vials of injectables annually through out the country. ORSaline was launched in late 1985 to enhance the availability of ORS to address mortality and morbidity due to diarrhea among under 5 children in Bangladesh. The usage of packaged ORS in diarroheal cases among the under five children has increased from 61 percent in 2000 to 77 percent in 2007 (BDHS, 2007). According to the Consumers Retail Audit, ORSaline-N brand of SMC is the market leader of ORS retail market with more than 59 percent share (ACNielsen, 2008).SMC distributes approximately 180 million sachets of ORS yearly throughout the country. Evolution of Social Marketing Company The concept of social marketing came to Bangladesh in 1974 when the social marketing project was initiated to challenge rapid population growth by making contraceptive products widely accessible at a price affordable to the general people. The project was initiated by a US-based non-profit organization Population Services International (PSI) in agreement with the Government of Bangladesh (GOB), and wi th funding from United States Agency for International Development (USAID).In 1990, the project transformed into Social Marketing Company – a not-for-profit private limited company, and since being operated under a voluntary Board of Directors consisting of eminent personalities with private and public sector expertise in different fields. From 1997, SMC had been the social marketing partner in the USAID funded National Integrated Population and Health Program (NIPHP) under a Cooperative Agreement. After end of NIPHP, SMC signed a new Cooperative Agreement with USAID as a partner of USAID Bangladesh Health and Population Program (UBHPP) effective from January 2008.Sales and Distribution Network SMC has one of the most established, extensive and efficient distribution networks in Bangladesh. Nationwide coverage is carried out through twelve offices located in major division and district towns of the country. This enables SMC’s a little over 100 men-strong sales force to distribute products to the far-flung outlet promptly and regularly. On an average, about 223,000 outlets are served by SMC sales force each year of which approximately 35 percent are pharmacies and the rest are nonpharmacies including grocery stores and kiosks.Stocks at the sales offices are replenished through large delivery trucks at scheduled intervals. The sales force cover the territory by SMC’s fleet of delivery vans, motorbikes and boats whenever necessary. In order to ensure efficient and secured storage of all SMC products, SMC has constructed a central warehouse (CWH) and a packaging unit located at Bhaluka, Mymensingh in 2008. The CWH is constructed with necessary warehousing needs like adequate passageway for transporting goods, ventilation, natural light or scope for increasing artificial lighting, optimum space areas for stacking goods as per standard storing guidelines.The widespread sales and distribution efforts of SMC contributed to make its products widely available in the retail outlets across the country. The product availability study showed that 84 percent of the retail pharmacy outlets have at least one SMC brand of Oral Contraceptive Pill (OCP) while 82 percent pharmacy outlets have at least one SMC brand of condom and 91 percent pharmacy outlets have at least one SMC brand of ORS. In addition to pharmacy outlets, SMC sales condom and ORS in 2 he non-pharmacy outlets as a strategy to increase accessibility and availability of the products. One in every five non-pharmacy retail outlets of the country has SMC brand condom and more than two in every five non-pharmacy retail outlets have SMC brand ORS countrywide (Pathway, 2007). The Table 1 shows the availability of SMC products in the retail outlets. Table 1: Availability of SMC Brand OCP, Condom and ORS by Pharmacy and Non-pharmacy Retail Outlets (in percentage) Brand Pharmacy Non-pharmacy At least one SMC brand OCP 84 na At least one SMC brand Condom 2 21 At least one SMC brand ORS 91 44 Number of Outlets 2400 4800 Use of Innovative Communication Channel for Strategic Behavior Change When social marketing began in Bangladesh, many were skeptical about the feasibility of large-scale information dissemination and advertising of contraceptive products. They were skeptical mostly for three reasons. First, Bangladesh is predominantly Muslim society in which reproductive health was not openly discussed. Second, much of the population was illiterate at that time with limited access to media.Third, the majority of the population was very poor and there were doubts that people could be persuaded to purchase contraceptives when these supplies were available free from other sources. To address the prevailing formidable situation in the mid seventies, SMC launched a strong and innovative communication program to facilitate and sustain behavior changes towards family planning and contraceptive use. The program is now recognized worldwide for its creative use of innova tive channels to communicate generic family planning and health messages and to promote sales of branded products.All modern mass media communication channels including regional and national radio, television, and print media were being utilized from the very beginning. The products have been advertised on billboards, signs, buildings, water tanks, shop boards and banners, rickshaws, shopping bags, at sporting events, and through free promotional distribution. Riverboats carried Raja Condom logos on their sails. The Mobile Film Program (MFP) is a hallmark of social marketing in Bangladesh, and a major factor in making SMC the largest social marketing program in the world.The mobile van fleet presents audio-visual shows that reach hundreds of thousands in rural areas with education on health issues and advertisements of SMC’s products. A recently conducted study on MFP showed that 63 percent of the MFP viewers have learned new information on family planning, 53 percent learned new information on STD/AIDS and 32 percent learned new information on women trafficking watching mobile film program (MRC-MODE, 2007). The pharmacists and non-graduate medical practitioners are one of the major sources of health information and prescriber of medicine, particularly in rural and semi-urban areas.As a part of the comprehensive communication strategy, SMC provides training to approximately 17,000 health providers annually to strengthen their knowledge and skill in order to offer better over-the-counter services including counseling. Brands as Demand Drivers Market segmentation, effective positioning and brand development efforts continue to be a major part of SMC’s strategies, and the company now provides a diverse range of pills and condoms targeted at 3 specific market segments and supported with brand-specific advertising and promotion.The efforts have significantly contributed to increase brand awareness and brand loyalty among the target population. For exa mple, Raja condom was introduced in 1976 and ultimately became synonymous with the word â€Å"condom† in Bangladesh with huge advertising and promotional efforts over the last 32 years. A study on Use of Contraceptive Among the Poor Couples in Bangladesh conducted by ACNielsen explored the reasons for using SMC OCP among the current SMC brand OCP users.About 61 percent SMC brand OCP contraceptive users mentioned the reason as it suits with body while 13 percent mentioned it is widely available, 8 percent mentioned that it is a good quality brand, 9 percent mentioned husband purchases it and 2 percent mentioned that they purchase it due to its lower price (ACNielsen, 2008). SMC sells its contraceptive product brands by positioning them at appropriate market segments. Target market for Raja and Hero condoms and Femicon and Femipil OCP are the lower income population. SOMA-JECT injectable and Panther condom are for the lower-mid level of the market, while Sensation nd U condoms, Minicon (progesterone only pill) and Nordette-28 oral pills are positioned at the slightly upper mid segment of the market. ORSaline-N, Monimix and safe delivery kit are positioned for all segments of the market. Table 2 shows different SMC brands with year of launching: Table 2: SMC brands, year of launching, and its positioning in the market. Products Brand Oral Contraceptive Nordette-28 Pill Femicon Femipill Minicon SOMA-JECT Injectable Condom ORS Micro nutrition Safe Delivery Kit Raja Panther Sensation U HERO ORSaline/ORSali ne-N ORSaline Fruity Monimix Safety Kit Year of Launch 1995 1976 1983 1992 2005 006 1983 Positioning Upper and middle segment Lower segment Lower segment All segments Lower and middle segment Lower segment Middle segment Upper segment Upper segment Lower segment All segments 2003 2008 2008 Upper segments All segments All segments 1996 2008 2000 1999 Knowledge Attitude Practice and Perception (KAPP) Study on OCP shows that the Married Women of Reproductive A ge (MWRA) have a wider level of awareness of SMC brand OCP. Eight out of ten MWRA know Femicon brand while about half of the MWRAs know Nordette-28 brand. Those couples who know the brand have a very high level of quality perception regarding brand.Eighty-five percent of the MWRA who know Femicon brand mentioned that the brand is either very good or good while 92 percent of the MWRA who know Nordette-28 brand told that it is either very good or good quality OCP (RCS, 2007). Table 3 shows the quality perception on SMC brand OCP among the MWRA who know the brand: 4 Table 3: Quality Perception on SMC Brand OCP among MWRA who know the brand OCP brand of SMC Response Femicon Nordette-28 Minicon Very good 14. 8 10. 6 30. 3 Good 71. 3 81. 3 36. 9 Not so good not so 5. 4 3. 3 12. 9 bad Not good 1. 9 0. 8 1. 0 Don’t Know 6. 4 4. 1 18. 8 Number of MWRA 2045 597 287 Blue Star Social Franchising Program: Involvement of the Private Practitioners in the Public Health Priority Areas The Blu e Star Program is an all out effort to bring the private sector health service providers (both graduate and non-graduate medical practitioners) into the public health program. The program works through a network of 3600 private medical practitioners. The purpose of this program is to address the unmet need of the target population by improving quality, awareness, accessibility, and affordability of priority public health services through the private health providers.SMC provide comprehensive training, commodity supply, promotional support and supervision & monitoring to these Blue Star Providers. A Program Evaluation Study interviewed 1379 private sector health service providers – half of them were Blue Star Providers and the rest half was not affiliated with the Blue Star Franchising. The study reveals that knowledge level on contraception of Blue Star Providers is significantly higher than the non Blue Star Providers.For example, around 41% of non Blue Star providers have n o knowledge on the side effect of injectable while the rate is less than one percent for Blue Star Providers (RCS, 2006). Currently injectable contraceptive is given along with other health services through this network. Next to the OCP, injectable is the most popular temporary contraceptive method in Bangladesh. According to Bangladesh Demographic and Health Survey (BDHS) 2007, 7% of the eligible couples are using Injectable contraceptive compared to 2. 6% in 1991.As BDHS 2007 shows, one out of five injectable users collect their supplies from private medical sector – graduate and non-graduate medical practitioners and pharmacies, which are considered as the outlets of Blue Star Franchising Program. Social Marketing of Micronutrient Product: A New Avenue in Child Health Program SMC has launched its Micronutrition program in Bangladesh through introduction of †MoniMix† – a branded micronutrient powder for simple and convenient in-home food fortification of complementary food to address childhood Iron Deficiency Anemia (IDA) in May 2008.Objective of the micronutrient program is to help improve nutritional status of under-five children, particularly of those with childhood IDA, to increase knowledge and awareness among parents and health service providers about the importance of micronutrient containing food and adequate dietary intake, and to promote exclusive breastfeeding and proper complementary feeding of nutrition rich foods.A KAPP study on Home Fortification of Complementary Food among the parents and caregivers of the children under 5 years found that nearly half of the respondents (47 percent) mentioned that they are aware about IDA while the rest (53 percent) admitted their complete ignorance on the issue 5 (ACNielsen, 2008). The findings of the study strongly justify the comprehensive awareness creation campaign on Micronutrition in general and IDA in particular which SMC has started. SMC Factory: Manufacturing ORS to Ensure Product SecurityIn order to ensure the security of ever increasing demand of pre-packaged ORS, SMC has established its own very modern ORS manufacturing facility in 2004. This facility has certainly released SMC from complete dependency on contract manufacturers. The annual ORS production capacity of the factory is around 200 million sachets, and the factory produced 176 million sachets of ORSaline-N in FY 2007. The SMC factory complex is situated on 5. 9 acres of land at Bhaluka on the DhakaMymensingh highway.The factory complex includes raw materials and finished goods store, production unit, quality control labs, services and administration units. Machinery and equipments of the SMC factory are of latest technology and in particular, the sachet machine is state-of-art. The Future: Journey Towards Sustainability SMC is seeking to increase its contribution to the achievement of national health objectives through significant expansion in the services it provides and the products it sells, while enhancing its organizational sustainability through increased revenues and improved management.Over the past years, SMC has steadily improved its cost recovery, which was 74 percent in 2007. Eventually, SMC endeavors to become a self-reliant social marketing company with minimum level of donor assistance. However, the products that are positioned for the lower segment – one condom, one pill and one injectable – would continue as a part of SMC’s social commitment to serve the less privileged and vulnerable groups. Reference 1.ACNielsen Bangladesh, â€Å"Knowledge, Attitude Perception and Practice (KAPP) Study on Home Fortification of Complementary Food†, 2008, Conducted for Social Marketing Company 2. ACNielsen Bangladesh, â€Å"Retail Audit Report on OCP, Condom and ORS†, April 2008 Conducted for Social Marketing Company 3. ACNielsen Bangladesh, â€Å"Use of Contraceptive Among the Poor Couple of Bangladesh†, 2008 Conducted for Social Marketing Company 4. Eve, E. Epstein, â€Å"SMC Story: The History of Social marketing Company†, 2006 written for Social Marketing Company . Institute of Public Health and Nutrition (IPHN), Government of Bangladesh, â€Å"National Strategy for Anemia Prevention and Control in Bangladesh†, 2007 6. MRC-MODE Limited â€Å"Study on Mobile Film Program†, 2007, Conducted for Social Marketing Company 7. National Institute of Population Research and Training (NIPORT), Mitra and Associates, and ORC Macro, â€Å"Preliminary Report on Bangladesh Demographic and Health Survey 2007†, 2007. 8. Noel Capon and Wilfried R. Vanhonacker, â€Å"The Asian Marketing Casebook†, 1999 9.Philip D. Harvey, â€Å"Let Every Child Be Wanted: How Social Marketing Is Revolutionizing Contraceptive Use Around the World†, 1999 10. Pathway â€Å"Availability and Market Penetration Study of SMC Products†, 2007, Conducted for Social Marketing Company 11. Research a nd Computing Services (RCS) Limited, â€Å"Knowledge, Attitude Perception and Practice (KAPP) Study on Oral Contraceptive Pill among the Married Women of Reproductive Age† 2007, conducted for Social Marketing Company 6

The Stages Of Clinical Reasoning - 1149 Words

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