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INTRODUCTION

BACKGROUND OF THE STUDY:


Dengue is an acute viral infection with potential fatal complications. Dengue
fever was first referred as water poison associated with flying insects in a
Chinese medical encyclopedia in 992 from the Jin Dynasty (265-420 AD). The
word dengue is derived from the Swahili phrase Ka-dinga pepo, meaning
cramp-like seizure. The first clinically recognized dengue epidemics occurred
almost simultaneously in Asia, Africa, and North America in the 1780s. The first
clinical case report dates from 1789 of 1780 epidemic in Philadelphia is by
Benjamin Rush, who coined the term break bone fever because of the
symptoms of myalgia and arthralgia (quoted
from www.globalmedicine.nl/index.php/dengue-fever). The term dengue fever
came into general use only after 1828. Dengue viruses (DV) belong to
family Flaviviridae and there are four serotypes of the virus referred to as DV-1,
DV-2, DV-3 and DV-4. DV is a positive-stranded encapsulated RNA virus and is
composed of three structural protein genes, which encode the nucleocapsid or
core (C) protein, a membrane-associated (M) protein, an enveloped (E)
glycoprotein and seven non-structural (NS) proteins. It is transmitted mainly
by Aedes aegypti mosquito and also by Ae. albopictus. All four serotypes can
cause the full spectrum of disease from a subclinical infection to a mild self
limiting disease, the dengue fever (DF) and a severe disease that may be fatal,
the dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS). The WHO
2009 classification divides dengue fever into two groups: uncomplicated and
severe1, though the 1997 WHO classification is still widely used 2. The 1997
classification divided dengue into undifferentiated fever, dengue fever (DF), and
dengue haemorrhagic fever (DHF) 1. Four main characteristic manifestations of
dengue illness are (i) continuous high fever lasting 2-7 days; (ii) haemorrhagic
tendency as shown by a positive tourniquet test, petechiae or
epistaxis; (iii) thrombocytopoenia (platelet count <10010 9/l); and (iv) evidence
of plasma leakage manifested by haemoconcentration (an increase in
haematocrit 20% above average for age, sex and population), pleural effusion
and ascites, etc. Excellent work has been done at some of the centres in India on
molecular epidemiology of dengue immunopathology and vaccine development.
This paper reviews the work done in this country. The key words dengue/India
reflected 784 papers in PubMed. Only some of the representative papers could
be cited here due to constraint of space.

Dengue is a growing health concern in the Philippines. Outbreaks were reported


in1926 [1], [2], and the first recorded epidemic in Southeast Asia occurred in Manila in
1954 [3], [4]. Further epidemics occurred in 1966, 1983, and 1998, with increasing reported
cases of dengue disease [5][8]. The 1998 epidemic had the highest recorded incidence rate
(60.9 cases per 100,000 population) and case fatality rate (CFR; 2.6%) [5]. The rising
incidence of dengue disease can be explained by several factors. Dengue is caused by one of
four dengue viruses (DENV-1, -2, -3, or -4) transmitted primarily by the Aedes
aegypti (Linnaeus) mosquito, which breeds in open water containers, and can survive year
round in tropical and subtropical climates. During World War II, the movement of people and
equipment expanded the geographic distribution of Ae. Aegypti and dengue disease in
Southeast Asia [3]. Since then, virus propagation in the region has been facilitated by rapid
urbanization, environmental degradation, the lack of a reliable water supply, and improper
management and disposal of solid waste [3], [9]. In the Philippines, the percentage of the
population living in urban areas increased from 27.1% in 1950 to 58.5% in 2000 [10].

Dengue has been a notifiable disease in the Philippines since 1958 [11]. During the review
period the Philippines employed both passive (outpatient and inpatient) and sentinel
surveillance across all ages [12]. Prior to 2006, the National Epidemic Sentinel Surveillance
System, managed by the National Epidemiology Center (NEC) of the Department of Health
(DoH), maintained surveillance of notifiable diseases, including dengue disease. The National
Epidemic Sentinel Surveillance System monitored the total number of hospital cases and
deaths that were admitted to 250400 selected sentinel hospitals throughout the Philippines
and, up until 2005, did not differentiate between dengue fever (DF), dengue haemorrhagic
fever (DHF), or dengue shock syndrome (DSS). To improve surveillance, in 2005, the system
changed to separate reporting of DF, DHF, and DSS. In 2007, the Sentinel Surveillance
System was expanded to include up to 1662 disease reporting units (including sentinel
hospitals, private hospitals, and rural health facilities) to develop an all-case (suspected and
probable) reporting system (Philippines Integrated Disease Surveillance and Response
System). In addition, virological surveillance of dengue disease was implemented in
2008 [13]. The Field Health Surveillance Information System, also managed by the NEC of
the DoH, is a passive reporting system that consolidates public health statistics due to
notifiable diseases, including dengue disease, from all levels of government health facilities
in the Philippines.

BUTUAN CITY -- Health officials here in Caraga region reports 17 deaths due to the dreaded
mosquito-borne dengue disease, as suspected cases here in the region climbed by 7 percent.

Sunshine Alipayo, DOH RO XIII information officer, in a press forum Friday afternoon said that
based on the DOH Regional Epidemiology and Surveillance Unit (RESU) dengue fever update
(30th Morbidity Week, July 20-26, 2014), a total of 2,983 cases were admitted to different
disease reporting units region wide from January 1 to July 26, 2014.

The figure of suspected cases, Alipayo said, is 7 percent higher compared to the same period
last year, which has 2,016.

A clustering of cases was also noted at Barangay Poblacion, Tabon and Mangagoy, Bislig City;
Barangay Bunyasan, Malimono and Barangay Ipil and Magsaysay in Placer, Surigao del Norte;
and Barangay Cagniog in Surigao City. According to Alipayo that clustering of cases is defined as
having more than 2 or more cases in a particular area, time, and date.

By geographic distribution, the suspected dengue cases by province and city shows Agusan del
Sur still at the top with 729 suspected cases, followed by Butuan City (725); Surigao del Sur
(330); Surigao del Norte (249); Agusan del Norte (213); Bayugan City (182); Surigao City (179);
Bislig City (155); Cabadbaran City (106); Tandag City (100), and Dinagat Island Province with 15.

The 17 deaths reported region wide from January 1 to July 26, 2014 showed that the seven
deaths were from Butuan City: two from Barangay Ambago; and one each from Barangays
Amparo, Ampayon, Baan Riverside, Silongan, and Pangabugan; two from Barangay Poblacion 3,
Buenavista in Agusan del Norte; one from Barangay Poblacion, Bislig City; two from Barangay
Poblacion (Bahbah) Prosperidad and Barangay Libuac in Rosario, Agusan del Sur; three from
Barangays Cabinet, 4, and Puting Bato in Cabadbaran City; and two from Barangay Gamut,
Barobo and Barangay Palo Alto, Lingig in Surigao del Sur.

The ages of cases ranged from less than one month old to 90 years old. The distribution of cases
is greater among males at 51 percent than females at 49 percent. Forty-one percent of the cases
belonged to 0 to 10 years age group.

Caraga has a case fatality rate (CFR) of .56 percent.

STATEMEN OF THE STUDY:

1. Is there any difference between commercialize product and lemon skin extract as
repellant?

HYPHOTHESSES (HA HO):

1. There is a significant difference between commercialized product and lemon skin extract as
repellant.

2. There is no significant difference between commercialized product and lemon skin extract as
repellant?

SIGNIFICANCE OF THE STUDY:

Dengue fatalities in the Philippines are up, nearly doubling the number in 2015 to date, 207 versus
129 deaths respectively. Dengue is a viral infection transmitted by the bite of an infected mosquito.
There are four closely related but antigenically different serotypes of the virus that can cause dengue.

This study is important because it provides the community a cheaper alternative cure in dengue and
other diseases cause by the bite of infected mosquito.

SCOPE AND LIMITATION:

This study only focuses on the effects of lemon skin extract towards the mosquito. Only the skin of
lemon will be used in the experiment. The said study will be conducted within three months.

DEFINITION OF TERMS:

Lemon: An acid fruit is botanically a many seeded-pale yellow oblong berry producted by a small
thorny citrus tree (Citrus Limon) and that has a rind from which which an aromatic oil is extracted.

Skin: The outer covering


Extract: To move by pulling it out or cutting out

Mosquito: Any of a family (Culicade) of dipteran, flies with females that have a set of slender organs in
the proboscis adapted to puncture the skin of animals and to suck their blood and that are in some
cases vectors of serious diseases.

Repellant: Keeping something out or away

REVIEW OF RELATED LITERATURE (RRL):

Citrus limon, lemon, is a small tree in the Rutaceae (citrus family) that originated in Asia (likely India and
Pakistan) and is now grown commercially worldwide in tropical, semi-tropical, and warm temperate countries,
including the Mediterranean region, for the fruit, which is used fresh and in beverages and cooking, and is also
used as a preservative due to its anti-oxidant properties.

C. limon is thought to have arisen as a hybrid between other Citrus species; some studies suggest lineage
including lime (C. aurantifolia or C. latifolia), pomelo (C. maxima), and citron (C. medica), while other studies
suggest that is a hybrid between sour orange (C. aurantium) and citron. It has a long history of cultivation in
Southeast Asia and China, but arrived the Mediterranean during Roman times, and was brought to the New
World in the 16th century. In commercial cultivation, C. limon is often grafted onto rootstock of the hardy rough
lemon, C. jambhiri.

The lemon tree grows to 6 m (20 ft) tall, and has stout spines. The leaves are dark green, leathery, and
evergreen, oblong, elliptical, or oval and up to 14 cm (4 in) long; in contrast to several other citrus species, the
petioles (leaf stems) are not winged or only narrowly winged. Flower buds are purplish but flowers open to have 5
white petals, up to 5 cm across. Fruits are globose to oblong, 7.5 to 12.5 cm long, and ripen to yellow, with
smooth to bumpy rinds dotted with oil glands.

Lemon fruits can be highly acidic (although non-acid varieties are also cultivated), and are high in citric acid and
vitamin C. Their tart flavor is popular in beverages (lemonades and iced teas as well as many cocktails), ice
creams and desserts, salad dressings, and many meat and vegetable dishes. Lemons have antioxidant
properties, so lemon juice is often added to fresh fruit to prevent oxidation and browning. Lemon peel or zest (the
outer peel) is used as a flavoring or candied. Lemon oil, obtained from the peel, is used as a wood cleaner and
polish, and as a non-toxic pesticide. Traditional medicinal uses for the fruit, peels, oil, and oil obtained from the
seeds include treating fever and colic, and as an astringent and diuretic.

REVIEW OF RELATED STUDY (RRS):

ABSTRACT

Dengue virus belongs to family Flaviviridae, having four serotypes that spread by
the bite of infected Aedes mosquitoes. It causes a wide spectrum of illness from
mild asymptomatic illness to severe fatal dengue haemorrhagic fever/dengue
shock syndrome (DHF/DSS). Approximately 2.5 billion people live in dengue-risk
regions with about 100 million new cases each year worldwide. The cumulative
dengue diseases burden has attained an unprecedented proportion in recent
times with sharp increase in the size of human population at risk. Dengue
disease presents highly complex pathophysiological, economic and ecologic
problems. In India, the first epidemic of clinical dengue-like illness was recorded
in Madras (now Chennai) in 1780 and the first virologically proved epidemic of
dengue fever (DF) occurred in Calcutta (now Kolkata) and Eastern Coast of India
in 1963-1964. During the last 50 years a large number of physicians have
treated and described dengue disease in India, but the scientific studies
addressing various problems of dengue disease have been carried out at limited
number of centres. Achievements of Indian scientists are considerable; however,
a lot remain to be achieved for creating an impact. This paper briefly reviews the
extent of work done by various groups of scientists in this country.