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June 2018, Volume 68, Issue 6

Letter to the Editor

Comments on Khan SU et al (J Pak Med Assoc 2018; 68: 175-186) - Characterisation of breeding sites of anopheline mosquitoes in District Bannu, KPK, Pakistan

Asim Shaikh  ( Dow Medical College, Karachi )
Rohan Kumar Ochani  ( Dow Medical College, Karachi )
Choudhary Ahmed Hasan  ( Dow Medical College, Karachi )

Madam, the debilitating impact of malaria on public health cannot be overstated,1 hence we commend the stupendous efforts of Khan SU and Khan RA in determining possible factors affecting Anopheline mosquito breeding sites. 2 However, we believe that some crucial analysis has been omitted. Furthermore, the authors failed to mention any limitations faced in the study. Firstly, it mentions "man-made activities are impacting more on malaria incidence", "average rainfall during these months was low and resultantly the low larval density has been found" and "humidity has linear effect but due to low temperature the anopheline mosquitoes could not develop". The authors attempt to establish cause and effect relationships based on frequencies, however, to confidently establish these relationships, statistical tests should have been used to find statistical significance in comparisons. 3 We would recommend using tests like the chi-squared test or multivariate analysis to find which factor effects the mosquito population density the most. Secondly, there is no mention of how the selected breeding sites were standardized. We understand that they were randomly chosen, but how did the authors make sure that the comparison would be fair, for instance, it was extremely important to mention the size of the individual breeding sites in km2 or another unit. Finally, limitations have not been addressed and biases have not been reported. Researchers should always assume the existence of bias and it is their responsibility to report it. 4 Also, limitations are important for shaping future studies on the subject. 5

None to declared.
Conflict of Interest: None to declared.
Funding Disclosure: None to declared.


1.  Khatak AA, et al. Prevalence and distribution of Human Plasmodium infection in Pakistan. Malar J 2013; 12: 297.
2.  Khan SU, Khan RA. Characterisation of breeding sites of anopheline mosquitoes in District Bannu, KPK, Pakistan. J Pak Med Assoc. 2018; 68: 175.
3.  Nayak BK, Hazra A. How to choose the right statistical test? Indian J Ophthalmol 2011; 59: 85-6.
4.  Pannucci CJ, Wilkins EG. Identifying and avoiding bias in research. Plast Reconstr Surg 2010; 126: 619-25.
5.  Puhan MA, Akl EA, Bryant D, Xie F, Apolone G, Riet G Ter. Discussing study limitations in reports of biomedical studies- the need for more transparency. Health and Quality of Life Outcomes. 2012; 10: 23.

The author of the article with above comments did not provide any rejoinder.

Journal of the Pakistan Medical Association has agreed to receive and publish manuscripts in accordance with the principles of the following committees: