Environmental information systems for the control of arthropod vectors of disease

The oral repellent - science fiction or common sense? Insects, vector-borne diseases, failing strategies, and a bold proposition

Over the last decades, unimaginable amounts of money have gone into research and development of vector control measures, repellents, treatment, and vaccines for vector borne diseases. Technological progress and scientific breakthroughs allowed for ever more sophisticated and futuristic strategies. Yet, each year, millions of people still die or suffer from potentially serious consequences of malaria or dengue to more recent infections, such as zika or chikungunya, or of debilitating consequences of neglected tropical diseases. This does not seem value for money. In addition, all current vector control strategies and personal protection methods have shortcomings, some serious, that are either destructive to non-target species or unsatisfactory in their effectiveness. On the other hand, the rapid decline in insect populations and their predators reflects decades-long aggressive and indiscriminate vector control. This major disruption of biodiversity has an impact on human life not anticipated by the well-meaning killing of invertebrates. The objective of this paper is to re-examine current control methods, their effectiveness, their impact on biodiversity, human and animal health, and to call for scientific courage in the pursuit of fresh ideas. This paper brings together topics that are usually presented in isolation, thereby missing important links that offer potential solutions to long-standing problems in global health. First, it serves as a reminder of the importance of insects to human life and discusses the few that play a role in transmitting disease. Next, it examines critically the many currently employed vector control strategies and personal protection methods. Finally, based on new insights into insect chemo-sensation and attractants, this perspective makes a case for revisiting a previously abandoned idea, the oral repellent, and its use via currently successful methods of mass-application. The call is out for focused research to provide a powerful tool for public health, tropical medicine, and travel medicine.

SYSTEMATIC REVIEW OF LEISHMANIASIS IN PAKISTAN: EVALUATING SPATIAL DISTRIBUTION AND RISK FACTORS

Both cutaneous (zoonotic cutaneous leishmaniasis [ZCL] and anthroponotic cutaneous leishmaniasis [ACL]) and visceral leishmaniasis (VL) are prevalent in Pakistan, although the cutaneous form is comparatively more widespread. The present study aimed to spatially map different forms of leishmaniasis in Pakistan. In addition, the risk for acquiring leishmaniasis was assessed in different locations of the country. Previously published literature on leishmaniasis distribution and associated risk factors in Pakistan was obtained from PubMed/NCBI and GoogleScholar using specific keywords. Further, 50 articles that focused on geographical distribution and risk factors of the disease in Pakistan were obtained and systematically reviewed. Data regarding location (used in ArcGIS for spatial analysis), number of cases, and risk factors were identified. The present study revealed a high burden of cutaneous leishmaniasis in the northern and western foci of Pakistan. Leishmania major, chiefly a causative agent of ZCL, was observed to be prevalent in the arid and semi-arid climatic zones of the country with elevations between 45 and 2,837 m (maximum number at low elevation). Leishmania tropica cases, associated with ACL, were recorded at elevations ranging from 551 to 2,837 m (majority cases at high elevation). Visceral leishmaniasis (VL) (reportedly caused by Leishmania infantum) was sporadically distributed in the northern areas at elevations 1,432-2,873 m. For VL, particularly, mountainous communities, farming communities, and the presence of dogs were the most commonly reported risk factors. On the other hand, poor preventive measures, migration, presence of domesticated animals, presence of cattle dung, living in mud houses, and outdoor sleeping habits were the principal risk factors associated with cutaneous leishmaniasis (CL). This investigation can guide the health experts and medical entomologists toward targeted and cost-effective surveillance and control of leishmaniasis in Pakistan.

A holistic model to assess risk factors of fasciolosis in Ankole cattle

In recent decades, remote sensing (RS) technology and geographical information systems (GIS) were increasingly used as tools for epidemiological studies and the control of zoonotic diseases. Fasciolosis, a zoonotic disease caused by a trematode parasite (Fasciola spp.), is a good candidate for the application of RS and GIS in epidemiology because it is strongly influenced by the environment, i.e. the habitat of the intermediate host. In this study, we examined variables which may increase the fasciolosis risk of Ankole cattle in the degraded and overgrazed Mutara rangelands of north-eastern Rwanda. The risk variables considered included three environmental variables (normalized difference vegetation index, NDVI; normalized difference moisture index, NDMI; normalized difference water index, NDWI), two landscape metric variables (rangeland proportion, building density), two geological variables (poorly-drained soil proportion, elevation) and three animal husbandry variables (herd size, adult proportion and the body condition score). Fasciola spp. prevalence was used as the dependent variable, sampling season as a fixed factor and four principal components (PCs, condensed from the ten risk variables) as covariates in a univariate General Linear Model. Fasciola spp. prevalence was positively correlated to rangeland proportion, cattle herd size in rural areas, adult proportion and individual body condition. Moreover, high Fasciola spp. prevalence was found in densely vegetated areas with high moisture (high values of NDVI and NDMI), in combination with large proportions of poorly-drained soil at low elevations. Future investigations should focus on increased sampling across the Mutara rangelands to prepare a predictive, spatial fasciolosis risk map that would help to further improve sustainable land-use management.

Landscape effects on the abundance of Lutzomyia longipalpis and Migonemyia migonei (Diptera: Psychodidae: Phlebotominae) in Corrientes city, northern Argentina

We analyses the relationship between landscape and environmental variables estimated from high-resolution satellite images with the temporal variation of the abundance of Lutzomyia longipalpis and Migonemyia migonei, vectors of leishmaniasis, in Corrientes city. At 8 collection sites, 14 samples were conducted between March 2012 to February 2014. Proportion of land cover classes derived from high resolution satellite images as: water, bare soil, urban areas, low vegetation and high vegetation, as well as average, maximum and minimum values of Normalized Difference Vegetation Index and Normalized Difference Water Index) in buffer areas of 50 m, 100 m and 150 m were used to characterize and identify suitable environmental conditions for the development of sand flies through Generalized Linear Mixed Models. The most frequently collected species during the sampling period was Lu. longipalpis and followed by Mg. migonei. The models showed that high Lu. longipalpis abundance were related to low proportion of high vegetation coverage, while a negative association was among Mg. migonei abundance and with values of Normalized Difference Water Index and with the interaction between urban areas and minimum values of Normalized Difference Water Index, and a positive association with the interaction between low vegetation and average values of Normalized Difference Water Index.

Spatial Analysis of Infections by Toxoplasma gondii and Neospora caninum (Protozoa: Apicomplexa) in Small Ruminants in Northern Italy

The objectives of this study were: (i) To investigate possible geographical or environmental factors influencing the infections by Toxoplasma gondii and Neospora caninum in sheep and goats in northern Italy; (ii) to identify areas at risk of infection to set up preventive measures. Forty-three sheep and goat farms were included. Their locations were plotted and associated with T. gondii and N. caninum seroprevalence, then the distribution of farms' prevalence was evaluated by spatial analysis. Significant clusters for both low and high prevalence were obtained, and a generalized linear model with ordinal logistic regression was implemented to verify if spatial clustering could be due to climate factors (temperature, rainfall, and their interaction). Clusters of high (80.0%) and low prevalence (28.12%) resulted for T. gondii seroprevalence in sheep farms. No significant clusters resulted for goat farms. Clusters of high (38.68%) and low prevalence (21.23%) resulted for N. caninum seroprevalence in sheep farms. One high-prevalence cluster (15.62%) resulted for goat farms. For goats, spatial analysis and analysis on climatic data showed the absence of environmental significant risk factors associated with T. gondii or N. caninum infection. On the contrary, for sheep, annual temperature, rainfall, and their association affected the risk of T. gondii and N. caninum infection. Particularly, high temperatures and abundant rainfalls were related to T. gondii seroprevalence, while low temperatures and scarce rainfalls were related to N. caninum seroprevalence.

The influence of weather and weather variability on mosquito abundance and infection with West Nile virus in Harris County, Texas, USA

Early warning systems for vector-borne diseases (VBDs) prediction are an ecological application where data from the interface of several environmental components can be used to predict future VBD transmission. In general, models for early warning systems only consider average environmental conditions ignoring variation in weather variables, despite the prediction from Schmalhausen's law about the importance of environmental variability for biological systems. We present results from a long-term mosquito surveillance program from Harris County, Texas, USA, where we use time series analysis techniques to study the abundance and West Nile virus (WNV) infection patterns in the local primary vector, Culex quinquefasciatus Say. We found that, as predicted by Schmalhausen's law, mosquito abundance was associated with the standard deviation and kurtosis of environmental variables. By contrast, WNV infection rates were associated with 8-month lagged temperature, suggesting environmental conditions during overwintering might be key for WNV amplification during summer outbreaks. Finally, model validation showed that seasonal autoregressive models successfully predicted mosquito WNV infection rates up to 2 months ahead, but did rather poorly at predicting mosquito abundance, a result that might reflect impacts of vector control for mosquito population reduction, geographic scale, and other artifacts generated by operational constraints of mosquito surveillance systems.

Risk Mapping of Visceral Leishmaniasis: A Spatial Regression Model for Attica Region, Greece

Visceral Leishmaniasis (VL) is endemic to the Attica region of Greece. The geographical distribution of VL cases was analyzed employing methods of spatial analysis in a GIS environment. A geographic database was constructed including data for the disease cases and environmental factors, such as land cover types, stray dog population, and socioeconomic factors. Classic and spatial regression models are presented that suggest the factors contributing most to the incidence of leishmaniasis are green urban areas and the population of stray dogs in the municipalities of Attica region. The results of the spatial regression model were more accurate, thus were used to produce a disease risk map. This map indicates the high-risk municipalities in which surveillance for the control of leishmaniasis is necessary.

Geospatial and Climatic Patterns Associated With the Distribution of Sand Fly (Diptera: Psychodidae) Vectors of Leishmaniasis in Pakistan

We provide a comprehensive and updated review on the effects of elevation and climatic factors on distribution of sand fly (Diptera: Psychodidae) vectors of cutaneous leishmaniasis (CL) and visceral leishmaniasis (VL) across Pakistan. Our study was undertaken in view of the increasing risk of leishmaniasis, particularly resulting from climatic deviations and political instability in the region. Literature (published and unpublished) on suspected vectors of CL (Phlebotomus sergenti Parrot and Phlebotomus papatasi Scopoli) and VL (Phlebotomus major Yakimoff and Schokhor and Phlebotomus hindustanicus Theodor) was collected, sorted, and utilized in geospatial analysis. P. papatasi and P. sergenti co-occurred in majority of the referenced localities and were generally distributed toward the western and southern parts across a wide range of elevation, whereas P. major and P. hindustanicus were limited to high elevation in cool and humid northern areas of Pakistan. Conversely P. papatasi and P. sergenti exploited diverse ecological settings across the country, being particularly abundant in warm/hot and arid regions.

Environmental Determinants of the Distribution of Chagas Disease Vector Triatoma dimidiata in Colombia

Triatoma dimidiata (Hemiptera: Reduviidae) is a secondary vector of Trypanosoma cruzi in Colombia and represents an important epidemiological risk mainly in the central and oriental regions of the country where it occupies sylvatic, peridomestic, and intradomestic ecotopes, and because of this complex distribution, its distribution and abundance could be conditioned by environmental factors. In this work, we explored the relationship between T. dimidiata distribution and environmental factors in the northwest, northeast, and central zones of Colombia and developed predictive models of infestation in the country. The associations between the presence ofT. dimidiata and environmental variables were studied using logistic regression models and ecological niche modeling for a sample of villages in Colombia. The analysis was based on the information collected in field about the presence ofT. dimidiata and the environmental data for each village extracted from remote sensing images. The presence of Triatoma dimidiata(Latreille, 1811) was found to be significantly associated with the maximum vegetation index, minimum land surface temperature (LST), and the digital elevation for the statistical model. Temperature seasonality, annual precipitation, and vegetation index were the variables that most influenced the ecological niche model ofT. dimidiata distribution. The logistic regression model showed a good fit and predicted suitable habitats in the Andean and Caribbean regions, which agrees with the known distribution of the species, but predicted suitable habitats in the Pacific and Orinoco regions proposing new areas of research. Improved models to predict suitable habitats forT. dimidiata hold promise for spatial targeting of integrated vector management.

Seasonal patterns of horse fly richness and abundance in the Pampa biome of southern Brazil

Fluctuations in seasonal patterns of horse fly populations were examined in rainforests of tropical South America, where the climate is seasonal. These patterns were evaluated with robust analytical models rather than identifying the main factors that influenced the fluctuations. We examined the seasonality of populations of horse flies in fields and lowland areas of the Pampa biome of southern Brazil with generalized linear models. We also investigated the diversity of these flies and the sampling effort of Malaise traps in this biome over two years. All of the 29 species had clear seasonality with regard to occurrence and abundance, but only seven species were identified as being influenced by temperature and humidity. The sampling was sufficient and the estimated diversity was 10% more than observed. Seasonal trends were synchronized across species and the populations were most abundant between September and March and nearly zero in other months. While previous studies demonstrated that seasonal patterns in population fluctuations are correlated with climatic conditions in horse fly assemblages in South America rainforests, we show a clear effect of each factor on richness and abundance and the seasonality in the prevalence of horse fly assemblages in localities of the Pampa biome.

Spatial-temporal variation and primary ecological drivers of Anopheles sinensis human biting rates in malaria epidemic-prone regions of China

BACKGROUND

Robust malaria vector surveillance is essential for optimally selecting and targeting vector control measures. Sixty-two vector surveillance sites were established between 2005 and 2008 by the national malaria surveillance program in China to measure Anopheles sinensis human biting rates. Using these data to determine the primary ecological drivers of malaria vector human biting rates in malaria epidemic-prone regions of China will allow better targeting of vector control resources in space and time as the country aims to eliminate malaria.

METHODS

We analyzed data from 62 malaria surveillance sentinel sites from 2005 to 2008. Linear mixed effects models were used to identify the primary ecological drivers for Anopheles sinensis human biting rates as well as to explore the spatial-temporal variation of relevant factors at surveillance sites throughout China.

RESULTS

Minimum semimonthly temperature (β = 2.99; 95% confidence interval (CI) 2.07- 3.92), enhanced vegetation index (β =1.07; 95% CI 0.11-2.03), and paddy index (the percentage of rice paddy field in the total cultivated land area of each site) (β = 0.86; 95% CI 0.17-1.56) were associated with greater An. Sinensis human biting rates, while increasing distance to the nearest river was associated with lower An. Sinensis human biting rates (β = -1.47; 95% CI -2.88, -0.06). The temporal variation (σ(s0)(2) = 0.83) in biting rates was much larger than the spatial variation (σ(t)(2) = 1.35), with 19.3% of temporal variation attributable to differences in minimum temperature and enhanced vegetation index and 16.9% of spatial variance due to distance to the nearest river and the paddy index.

DISCUSSION

Substantial spatial-temporal variation in An. Sinensis human biting rates exists in malaria epidemic-prone regions of China, with minimum temperature and enhanced vegetation index accounting for the greatest proportion of temporal variation and distance to nearest river and paddy index accounting for the greatest proportion of spatial variation amongst observed ecological drivers.

CONCLUSIONS

Targeted vector control measures based on these findings can support the ongoing malaria elimination efforts in China more effectively.

Vectorborne diseases in West Africa: geographic distribution and geospatial characteristics

This paper provides an overview of the methods in which geographic information systems (GIS) and remote sensing (RS) technology have been used to visualise and analyse data related to vectorborne diseases (VBD) in West Africa and to discuss the potential for these approaches to be routinely included in future studies of VBDs. GIS/RS studies of diseases that are associated with a specific geographic landscape were reviewed, including malaria, human African trypanosomiasis, leishmaniasis, lymphatic filariasis, Loa loa filariasis, onchocerciasis, Rift Valley fever, dengue, yellow fever, borreliosis, rickettsioses, Buruli ulcer and Q fever. RS data and powerful spatial modelling methods improve our understanding of how environmental factors affect the vectors and transmission of VBDs. There is great potential for the use of GIS/RS technologies in the surveillance, prevention and control of vectorborne and other infectious diseases in West Africa.

Multisensor monitoring system for assessment of locust hazard risk in the Lake Balkhash drainage basin

Satellite and ground-based data were combined in a monitoring system to quantify the link between climate conditions and the risk of locust infestations in the southern part of Lake Balkhash's drainage basin in the Republic of Kazakhstan. In this monitoring system, the Normalized Difference Vegetation Index (NDVI), derived from the SPOT-VGT satellite, was used for mapping potential locust habitats and monitoring their area throughout 1998 to 2007. TOPEX/Poseidon and Jason 1 altimeter data were used to track the interannual dynamics of water level in Balkhash Lake. Climate conditions were represented by weather records for air temperature and precipitation during the same period. The classification procedure, based on an analysis of multitemporal dynamics of SPOT-VGT NDVI values observed by individual vegetation classes, generated annual areas of ten land-cover types, which were then categorized as areas with low, medium, and high risk for locust infestation. Statistical analyses showed significant influences of the climatic parameters and the Balkhash Lake hydrological regime on the spatial extend of annual areas of potential locust habitats. The results also indicate that the linkages between locust infestation risk and environmental factors are characterized by time lags. The expansion of locust risk areas are usually preceded by dry, hot years and lower water levels in Balkhash Lake when larger areas of reed grass are free from seasonal flooding. Years with such conditions are favourable for locust outbreaks due to expansion of the habitat areas suitable for locust oviposition and nymphal development. In contrast, years with higher water levels in Balkhash Lake and lower temperature decrease the potential locust habitat area.

Use of a mixture statistical model in studying malaria vectors density

Vector control is a major step in the process of malaria control and elimination. This requires vector counts and appropriate statistical analyses of these counts. However, vector counts are often overdispersed. A non-parametric mixture of Poisson model (NPMP) is proposed to allow for overdispersion and better describe vector distribution. Mosquito collections using the Human Landing Catches as well as collection of environmental and climatic data were carried out from January to December 2009 in 28 villages in Southern Benin. A NPMP regression model with “village” as random effect is used to test statistical correlations between malaria vectors density and environmental and climatic factors. Furthermore, the villages were ranked using the latent classes derived from the NPMP model. Based on this classification of the villages, the impacts of four vector control strategies implemented in the villages were compared. Vector counts were highly variable and overdispersed with important proportion of zeros (75%). The NPMP model had a good aptitude to predict the observed values and showed that: i) proximity to freshwater body, market gardening, and high levels of rain were associated with high vector density; ii) water conveyance, cattle breeding, vegetation index were associated with low vector density. The 28 villages could then be ranked according to the mean vector number as estimated by the random part of the model after adjustment on all covariates. The NPMP model made it possible to describe the distribution of the vector across the study area. The villages were ranked according to the mean vector density after taking into account the most important covariates. This study demonstrates the necessity and possibility of adapting methods of vector counting and sampling to each setting.

Utilization of combined remote sensing techniques to detect environmental variables influencing malaria vector densities in rural West Africa

Introduction

The use of remote sensing has found its way into the field of epidemiology within the last decades. With the increased sensor resolution of recent and future satellites new possibilities emerge for high resolution risk modeling and risk mapping.

Methods

A SPOT 5 satellite image, taken during the rainy season 2009 was used for calculating indices by combining the image's spectral bands. Besides the widely used Normalized Difference Vegetation Index (NDVI) other indices were tested for significant correlation against field observations. Multiple steps, including the detection of surface water, its breeding appropriateness for Anopheles and modeling of vector imagines abundance, were performed. Data collection on larvae, adult vectors and geographic parameters in the field, was amended by using remote sensing techniques to gather data on altitude (Digital Elevation Model = DEM), precipitation (Tropical Rainfall Measurement Mission = TRMM), land surface temperatures (LST).

Results

The DEM derived altitude as well as indices calculations combining the satellite's spectral bands (NDTI = Normalized Difference Turbidity Index, NDWI Mac Feeters = Normalized Difference Water Index) turned out to be reliable indicators for surface water in the local geographic setting. While Anopheles larvae abundance in habitats is driven by multiple, interconnected factors - amongst which the NDVI - and precipitation events, the presence of vector imagines was found to be correlated negatively to remotely sensed LST and positively to the cumulated amount of rainfall in the preceding 15 days and to the Normalized Difference Pond Index (NDPI) within the 500 m buffer zone around capture points.

Conclusions

Remotely sensed geographical and meteorological factors, including precipitations, temperature, as well as vegetation, humidity and land cover indicators could be used as explanatory variables for surface water presence, larval development and imagines densities. This modeling approach based on remotely sensed information is potentially useful for counter measures that are putting on at the environmental side, namely vector larvae control via larviciding and water body reforming.

Abiotic Determinants to the Spatial Dynamics of Dengue Fever in Guangzhou

Dengue fever (DF) is a mosquito-borne disease that significantly endangers the well-being of people in most tropical Asia-Pacific areas. The transmission of DF is inherently a spatial process, requiring susceptible humans encountering infectious mosquito. The relationships between humans, mosquito and environment underpin the dynamics and patterns of the epidemic. In this article, the objective is to find out the key abiotic factors in the spatial dynamics of DF. An interdisciplinary study has been carried out by taking advantage of statistics, geographical information science, and remote sensing technologies. The case study is the DF outbreak in the Chinese city of Guangzhou throughout the year of 2002—the most serious DF outbreak in the recent decade. This study shows that the presence and abundance of DF cases can be associated with ( a) socioeconomic factors relating to urbanization and ( b) meteorological factors favoring mosquito survival.

Monitoring bluetongue disease (BTV-1) epidemic in southern Spain during 2007

On the 25th of July 2007, bluetongue virus (BTV) serotype 1 was detected in Andalusia, southern Spain for the first time. A total of 4436 farms infected with BTV-1 were confirmed during that year: 3162 in sheep flocks, 113 in goat flocks, 7 in cattle herds and 1154 in mixed farms (sheep, goat and/or cattle in the same farm). The most common clinical signs were: fever, depression, lethargy, facial edema, and salivation (observed in more than 70% of the infected farms). Lesions in oral mucosa, lameness and dyspnea were also frequently observed. Median morbidity rate in sheep and goat flocks were 6.3% and 2.7% respectively. Median mortality rate was 2.2% in sheep flocks and 1.2% in goat flocks. Median case fatality rate was 29.8% in sheep flocks and 45% in goat flocks. Morbidity and mortality rates were not significantly higher in sheep flocks than in goat flocks (p>0.05), whereas case fatality rate was significant higher in goat flocks compared to sheep flocks (p<0.05). Neither clinical signs nor mortality were observed in cattle herds. The spatial distribution of the risk of BTV infection over Andalusia by municipality was evaluated by means of a hierarchical Bayesian model. The results evidenced that the risk was not homogeneous over the territory, being higher in the western part of the region. The likelihood of BTV infection was increased between 1.01 and 1.16 times by an increase of 10,000 domestic ruminants, and between 1.01 and 1.69 times by the presence of red deer (Cervus elaphus) in the municipality.

Epidemiological investigation of bovine ephemeral Fever outbreaks in Israel

Outbreaks of bovine ephemeral fever (BEF) occurred in Israel in 1990, 1999, and 2004. The main patterns of BEF spread were similar in the 1990 and in 1999 epidemics, and the BEF virus was probably carried in vectors transported by air streams across the Rift Valley and the Red Sea. In the 2004 outbreak, the primary focus of the disease was the southern Mediterranean coastal plain and the disease agent was apparently brought by infected mosquitoes carried from their breeding site in the Nile Delta by the south-western winds. The disease broke out under optimal ecological conditions, among a vulnerable cattle population and spread rapidly; it showed essentially a spring-summer herd incidence and terminated soon after the night average ambient temperature fell below 16°C in late autumn. The herd incidence of the disease reached 78.4%, 97.7%, and 100% in 1990, 1999, and 2004, respectively. The highest herd incidence, morbidity, and case fatality rates were noted in dairy cattle herds in the Jordan Valley, with morbidity of 20%, 38.6%, and 22.2%, and case fatality rate among affected animals of 2%, 8.6%, and 5.4% in 1990, 1999, and 2004, respectively. The average sero-positivity to BEF in 1999 was 39.5%, which matched the morbidity rate. Comparison among the various age groups showed that the lowest morbidity rates were observed in the youngest age group, that is, heifers up to 1 year, with 3.2%, 3.6%, and 4.2% in 1990, 1999, and 2004, respectively. In heifers from 1 year to calving, the morbidity rates were 13.8%, 14.9%, and 28%, respectively, in first calvers 30.8%, 31.6%, and 28.3%, respectively, and in cows 34.3%, 35.7%, and 27.2%, respectively. All affected cattle were over the age of 3 months. It is hypothesized that mosquitoes and not Culicoides spp. are the vectors of the BEF virus in Israel.

Field site selection: getting it right first time around

The selection of suitable field sites for integrated control of Anopheles mosquitoes using the sterile insect technique (SIT) requires consideration of the full gamut of factors facing most proposed control strategies, but four criteria identify an ideal site: 1) a single malaria vector, 2) an unstructured, relatively low density target population, 3) isolation of the target population and 4) actual or potential malaria incidence. Such a site can exist in a diverse range of situations or can be created. Two contrasting SIT field sites are examined here: the desert-flanked Dongola Reach of the Nile River in Northern State, Sudan, where malaria is endemic, and the island of La Reunion, where autochthonous malaria is rare but risk is persistent. The single malaria-transmitting vector at both sites is Anopheles arabiensis. In Sudan, the target area is a narrow 500 km corridor stretching from the rocky terrain at the Fourth Cataract--just above the new Merowe Dam, to the northernmost edge of the species range, close to Egypt. Vector distribution and temporal changes in density depend on the Nile level, ambient temperature and human activities. On La Reunion, the An. arabiensis population is coastal, limited and divided into three areas by altitude and exposure to the trade winds on the east coast. Mosquito vectors for other diseases are an issue at both sites, but of primary importance on La Reunion due to the recent chikungunya epidemic. The similarities and differences between these two sites in terms of suitability are discussed in the context of area-wide integrated vector management incorporating the SIT.

Land cover, landscape structure, and West Nile virus circulation in southern France

The transmission of West Nile virus (WNV) is strongly influenced by environmental factors. In France, two endemic areas for WNV have been identified: Camargue and Var. The objective of our study was to test whether landscape characteristics could be associated with the risk of endemic circulation of WNV in these two ecologically different areas. Equine serological data collected during outbreaks in Var (2003) and Camargue (2004) were used. Both areas were marked out in cells of 5 km(2), and data were aggregated for each cell. Sixteen cells, classified as "high" level viral circulation, and 28 cells, classified as "low" level viral circulation were used for the analysis. The Corine Land Cover database (European Environment Agency) was used to evaluate, for each geographic cell, the area covered by 12 land cover classes, as well as the value of 5 landscape metrics (patch richness and density, edge density, the Shannon's diversity index, and interspersion and juxtaposition index (IJI). Multivariate linear generalized regression showed that IJI as well as the surface covered by heterogeneous agricultural areas were significantly higher in high level WNV circulation cells than in low level ones (p = 0.01 and 0.05 respectively). Both variables are indicators of a complex spatial biotope configuration that may favor the co-existence of competent vectors and reservoir hosts: the structure of the landscape thus appeared as a key element in WNV circulation. An internal validation was performed and the model was used to compute a risk map for the French Mediterranean coast. Cells with a probability > 0.8 of having a high level of viral circulation were found near Aix-en-Provence, Beziers, and Perpignan, areas where no serological study has yet been conducted. Equine cases reported in 2006 were all located in the neighborhood of cells having a > 0.8 probability for high WNV circulation status.

Use of geographic information systems to assess the feasibility of ground- and aerial-based adulticiding for West Nile virus control in British Columbia, Canada

Geographic Information Systems (GIS) analysis of 34 forecasted high West Nile virus (WNV) risk communities in British Columbia (BC), Canada was useful to assess feasibility and planning of the operational logistics of an emergency spray event in advance of a WNV outbreak. The geographic coverage and operational time required to perform ground- and aerial-based ultra-low volume (ULV) adulticiding were calculated using GIS. The mean geographic coverages of the ground-, aerial-, and combination of ground- and aerial-based adulticiding strategies were 39%, 61%, and 69%, respectively. The driving distance, driving time, and number of treatment nights required to perform ground-based spraying of an entire community were also calculated. Due to the large variability of treatment coverage estimates within and among the communities, no single treatment method was identified as the best strategy for province-wide ULV adulticiding in BC. Instead, the strategy for each community should be examined individually with local knowledge and expertise.

Use of high spatial resolution satellite imagery to characterize landscapes at risk for bluetongue

The recent and rapid spread in the Mediterranean Basin of bluetongue, a viral disease of ruminants transmitted by some species of Culicoides (biting midges), highlights the necessity of determining the conditions of its emergence. This study uses high spatial resolution satellite imagery and methods from landscape ecology science to identify environmental parameters related to bluetongue occurrence in Corsica, a French Mediterranean island where the disease occurred for the first time in 2000. A set of environmental variables recorded in the neighborhood of 80 sheep farms were related to case occurrence through a logistic regression model computed within three subsequent buffer distances of 0.5, 1 and 2 km. The results reveal the role of landscape metrics, particularly those characterizing land-use units such as prairies and woodlands, as well as farm type, latitude and sunshine to explain the presence of bluetongue. Internal and external validation both indicate that the best results are obtained with the 1 km buffer size model (area under Receiver Operating Characteristic curve = 0.9 for internal validation and 0.81 for external validation). The results show that high spatial resolution remote sensing (i.e. 10 m pixels) and landscape ecology approaches contribute to improving the understanding of bluetongue epidemiology.

Retrospective epidemiological investigation of an outbreak of bovine ephemeral fever in 1991 affecting dairy cattle herds on the Mediterranean coastal plain

From August to October 1991 bovine ephemeral fever (BEF) occurred sporadically in two localities in Israel. The morbidity and mortality rates reached 2.6% and 0.1%, respectively. Only 12/50 dairy cattle herds were clinically infected with BEF in the dairy community. The total morbidity rate reached 0.8%. The lowest morbidity rate was recorded in young heifers (5.5%) and the highest in adult cows (75%). Only heifers over the age of three months were clinically affected. The spread of the disease apparently followed the local prevailing night winds, which blow from east to west, i.e., from the land toward the sea. The morbidity period lasted 61 days. The low incidence and morbidity rates were possibly due to the low virulence of the virus strain involved in the 1991 epidemic. Retrospective analysis indicates that vectors - apparently mosquitoes - infected with BEF virus could have been overwintering.

Remote sensing based identification of environmental risk factors associated with West Nile disease in horses in Camargue, France

Geographic information system and remote sensing technologies were used to identify landscape features associated with risk of West Nile virus transmission as defined by the presence of confirmed horse cases. SPOT-4 images of Camargue area were used to generate a map of landscape categories of epidemic foci and the geographic information system was employed to determine the proportion of landscape components surrounding 10 horse case sites and 17 control sites. The spatio-temporal analysis of the cases outbreak gave the best results for a spatial window of 9 km and a temporal window of 18 days. Two clusters were identified (relative risk=3.35), both in the wet area of Camargue, near the town "Les Saintes Maries de la Mer". The first one was 4 km radius, the second 9 km. The relationships between the presence of cases and proportions of landscape categories were analyzed using generalized linear model. The best model indicated that rice fields and dry bushes, wet "sansouire" and open water were the major components of the landscape that were associated with the presence of West Nile virus cases.

Mapping malaria transmission in West and Central Africa

We have produced maps of Plasmodium falciparum malaria transmission in West and Central Africa using the Mapping Malaria Risk in Africa (MARA) database comprising all malaria prevalence surveys in these regions that could be geolocated. The 1846 malaria surveys analysed were carried out during different seasons, and were reported using different age groupings of the human population. To allow comparison between these, we used the Garki malaria transmission model to convert the malaria prevalence data at each of the 976 locations sampled to a single estimate of transmission intensity E, making use of a seasonality model based on Normalized Difference Vegetation Index (NDVI), temperature and rainfall data. We fitted a Bayesian geostatistical model to E using further environmental covariates and applied Bayesian kriging to obtain smooth maps of E and hence of age-specific prevalence. The product is the first detailed empirical map of variations in malaria transmission intensity that includes Central Africa. It has been validated by expert opinion and in general confirms known patterns of malaria transmission, providing a baseline against which interventions such as insecticide-treated nets programmes and trends in drug resistance can be evaluated. There is considerable geographical variation in the precision of the model estimates and, in some parts of West Africa, the predictions differ substantially from those of other risk maps. The consequent uncertainties indicate zones where further survey data are needed most urgently. Malaria risk maps based on compilations of heterogeneous survey data are highly sensitive to the analytical methodology.

Spatially targeting Culex quinquefasciatus aquatic habitats on modified land cover for implementing an Integrated Vector Management (IVM) program in three villages within the Mwea Rice Scheme, Kenya

BACKGROUND

Continuous land cover modification is an important part of spatial epidemiology because it can help identify environmental factors and Culex mosquitoes associated with arbovirus transmission and thus guide control intervention. The aim of this study was to determine whether remotely sensed data could be used to identify rice-related Culex quinquefasciatus breeding habitats in three rice-villages within the Mwea Rice Scheme, Kenya. We examined whether a land use land cover (LULC) classification based on two scenes, IKONOS at 4 m and Landsat Thematic Mapper at 30 m could be used to map different land uses and rice planted at different times (cohorts), and to infer which LULC change were correlated to high density Cx. quinquefasciatus aquatic habitats. We performed a maximum likelihood unsupervised classification in Erdas Imagine V8.7 and generated three land cover classifications, rice field, fallow and built environment. Differentially corrected global positioning systems (DGPS) ground coordinates of Cx. quinquefasciatus aquatic habitats were overlaid onto the LULC maps generated in ArcInfo 9.1. Grid cells were stratified by levels of irrigation (well-irrigated and poorly-irrigated) and varied according to size of the paddy.

RESULTS

Total LULC change between 1988-2005 was 42.1 % in Kangichiri, 52.8 % in Kiuria and and 50.6 % Rurumi. The most frequent LULC changes was rice field to fallow and fallow to rice field. The proportion of aquatic habitats positive for Culex larvae in LULC change sites was 77.5% in Kangichiri, 72.9% in Kiuria and 73.7% in Rurumi. Poorly - irrigated grid cells displayed 63.3% of aquatic habitats among all LULC change sites.

CONCLUSION

We demonstrate that optical remote sensing can identify rice cultivation LULC sites associated with high Culex oviposition. We argue that the regions of higher Culex abundance based on oviposition surveillance sites reflect underlying differences in abundance of larval habitats which is where limited control resources could be concentrated to reduce vector larval abundance.

Epidemiology of visceral leishmaniasis through spatial analysis, in Belo Horizonte municipality, state of Minas Gerais, Brazil

The geographic information system approach has permitted integration between demographic, socio-economic and environmental data, providing correlation between information from several data banks. In the current work, occurrence of human and canine visceral leishmaniases and insect vectors (Lutzomyia longipalpis) as well as biogeographic information related to 9 areas that comprise the city of Belo Horizonte, Brazil, between April 2001 and March 2002 were correlated and georeferenced. By using this technique it was possible to define concentration loci of canine leishmaniasis in the following regions: East; Northeast; Northwest; West; and Venda Nova. However, as for human leishmaniasis, it was not possible to perform the same analysis. Data analysis has also shown that 84.2% of the human leishmaniasis cases were related with canine leishmaniasis cases. Concerning biogeographic (altitude, area of vegetation influence, hydrographic, and areas of poverty) analysis, only altitude showed to influence emergence of leishmaniasis cases. A number of 4673 canine leishmaniasis cases and 64 human leishmaniasis cases were georeferenced, of which 67.5 and 71.9%, respectively, were living between 780 and 880 m above the sea level. At these same altitudes, a large number of phlebotomine sand flies were collected. Therefore, we suggest control measures for leishmaniasis in the city of Belo Horizonte, giving priority to canine leishmaniasis foci and regions at altitudes between 780 and 880 m.

A web-based multimedia spatial information system to document Aedes aegypti breeding sites and dengue fever risk along the US-Mexico border

This paper describes a web-based multimedia spatial information system used to support a study of the re-invasion of Aedes aegypti, the mosquito vector for dengue fever, in the deserts of the southwest United States/northwest Mexico. The system was developed applying Open Geospatial Consortium and World Wide Web Consortium Open Specifications and using Open Source Software. The system creates a sensory-rich environment, one which allows users to interact with the system to explore connections among data (maps, remotely sensed images, text, graphs, 360 degree panoramas and photos), visualize information, formulate their own interpretations, generate hypotheses and reach their own conclusions.

Remote sensing and spatial statistical analysis to predict the distribution of Oncomelania hupensis in the marshlands of China

Remote sensing and spatial statistical analysis were employed to predict the distribution of Oncomelania hupensis, the intermediate host snail of Schistosoma japonicum, in the marshlands of Jiangning county in China. Surrogate indices related to environmental factors in the marshlands were derived from a Landsat 7 ETM+ image, and the relationship between environmental covariates and the density of O. hupensis was analyzed by stepwise regression models and ordinary kriging. Although stepwise regression demonstrated that O. hupensis densities of live snails in the marshlands related significantly to the modified soil-adjusted vegetation index, wetness and land surface temperature, the correlation coefficient was low (0.282). Therefore, spatial patterns of the regression residual were investigated by the semi-variogram method, and the spatial variation of O. hupensis density attributed to the spatial autocorrelation was estimated by ordinary kriging. The regression model of the snail density and ordinary kriging of its spatial variation were then combined with the aim of improving the prediction of O. hupensis. Following this approach, the prediction indeed improved considerably (0.852). Our results show that it is possible to predict the distribution of O. hupensis in these marshlands by using remotely sensed environmental indices, and that spatial statistical analyses are capable of improving prediction accuracy. These findings are of relevance for mapping and prediction of schistosomiasis japonica in China, and hence the national control programme.

Habitat characterization and spatial distribution of Anopheles sp. mosquito larvae in Dar es Salaam (Tanzania) during an extended dry period

Introduction

By 2030, more than 50% of the African population will live in urban areas. Controlling malaria reduces the disease burden and further improves economic development. As a complement to treated nets and prompt access to treatment, measures targeted against the larval stage of Anopheles sp. mosquitoes are a promising strategy for urban areas. However, a precise knowledge of the geographic location and potentially of ecological characteristics of breeding sites is of major importance for such interventions.

Methods

In total 151 km² of central Dar es Salaam, the biggest city of Tanzania, were systematically searched for open mosquito breeding sites. Ecologic parameters, mosquito larvae density and geographic location were recorded for each site. Logistic regression analysis was used to determine the key ecological factors explaining the different densities of mosquito larvae.

Results

A total of 405 potential open breeding sites were examined. Large drains, swamps and puddles were associated with no or low Anopheles sp. larvae density. The probability of Anopheles sp. larvae to be present was reduced when water was identified as "turbid". Small breeding sites were more commonly colonized by Anopheles sp. larvae. Further, Anopheles gambiae s.l. larvae were found in highly organically polluted habitats.

Conclusions

Clear ecological characteristics of the breeding requirements of Anopheles sp. larvae could not be identified in this setting. Hence, every stagnant open water body, including very polluted ones, have to be considered as potential malaria vector breeding sites.

Terra and Aqua: new data for epidemiology and public health

Earth-observing satellites have only recently been exploited for the measurement of environmental variables of relevance to epidemiology and public health. Such work has relied on sensors with spatial, spectral and geometric constraints that have allowed large-area questions associated with the epidemiology of vector-borne diseases to be addressed. Moving from pretty maps to pragmatic control tools requires a suite of satellite-derived environmental data of higher fidelity, spatial resolution, spectral depth and at similar temporal resolutions to existing meteorological satellites. Information derived from sensors onboard the next generation of moderate-resolution Earth-observing sensors may provide the key. The MODIS and ASTER sensors onboard the Terra and Aqua platforms provide substantial improvements in spatial resolution, number of spectral channels, choices of bandwidths, radiometric calibration and a much-enhanced set of pre-processed and freely available products. These sensors provide an important advance in moderate-resolution remote sensing and the data available to those concerned with improving public health.

Mapping the distribution of Loa loa in Cameroon in support of the African Programme for Onchocerciasis Control

Background

Loa loa has recently emerged as a filarial worm of significant public health importance as a consequence of its impact on the African Programme for Onchocerciasis Control (APOC). Severe, sometimes fatal, encephalopathic reactions to ivermectin (the drug of choice for onchocerciasis control) have occurred in some individuals with high Loa loa microfilarial counts. Since high density of Loa loa microfilariae is known to be associated with high prevalence rates, a distribution map of the latter may determine areas where severe reactions might occur. The aim of the study was to identify variables which were significantly associated with the presence of a Loa microfilaraemia in the subjects examined, and to develop a spatial model predicting the prevalence of the Loa microfilaraemia.

Methods

Epidemiological data were collected from 14,225 individuals living in 94 villages in Cameroon, and analysed in conjunction with environmental data. A series of logistic regression models (multivariate analysis) was developed to describe variation in the prevalence of Loa loa microfilaraemia using individual level co-variates (age, sex, μl of blood taken for examination) and village level environmental co-variates (including altitude and satellite-derived vegetation indices).

Results

A spatial model of Loa loa prevalence was created within a geographical information system. The model was then validated using an independent data set on Loa loa distribution. When considering both data sets as a whole, and a prevalence threshold of 20%, the sensitivity and the specificity of the model were 81.7 and 69.4%, respectively.

Conclusions

The model developed has proven very useful in defining the areas at risk of post-ivermectin Loa-related severe adverse events. It is now routinely used by APOC when projects of community-directed treatment with ivermectin are examined.

Spatial analysis for epidemiology

Remote sensing, geographical information systems (GIS) and spatial analysis provide important tools that are as yet under-exploited in the fight against disease. As the use of such tools becomes more accepted and prevalent in epidemiological studies, so our understanding of the mechanisms of disease systems has the potential to increase. This paper introduces a range of techniques used in remote sensing, GIS and spatial analysis that are relevant to epidemiology. Possible future directions for the application of remote sensing, GIS and spatial analysis are also suggested.

Remote sensing as a tool to survey endemic diseases in Brazil

The objective of this study, based on a systematic literature review, is to present the characteristics and potentialities of remote sensing as a useful environmental surveillance tool for applied research in the control of endemics in Brazil. Onboard satellite sensors allow for monitoring the territory, furnishing spatial and temporal information on various scales and regions in the electromagnetic spectrum. Based on the literature review on the application of this technology to the study of endemics and the identification of the potential of new sensors with better spectral, spatial, and temporal resolutions, this study highlights perspectives for the use of remote sensing in the study of important endemics for Brazil.

Predicting geographic variation in cutaneous leishmaniasis, Colombia

Predicting Geographic Variation in ACL, Colombia

Approximately 6,000 cases of cutaneous leishmaniasis are reported annually in Colombia, a greater than twofold increase since the 1980s. Such reports certainly underestimate true incidence, and their geographic distribution is likely biased by local health service effectiveness. We investigated how well freely available environmental data explain the distribution of cases among 1,079 municipalities. For each municipality, a unique predictive logistic regression model was derived from the association among remaining municipalities between elevation, land cover (preclassified maps derived from satellite images), or both, and the odds of at least one case being reported. Land cover had greater predictive power than elevation; using both datasets improved accuracy. Fitting separate models to different ecologic zones, reflecting transmission cycle diversity, enhanced the accuracy of predictions. We derived measures that can be directly related to disease control decisions and show how results can vary, depending on the threshold selected for predicting a disease-positive municipality. The results identify areas where disease is most likely to be underreported.

Geographic Information System mapping of snakebite incidence in northern Ghana and Nigeria using environmental indicators: a preliminary study

Snakebite is an important health problem in many parts of rural West Africa where the carpet or sawscaled viper, Echis ocellatus, is responsible for most of the morbidity and mortality. Marked seasonal and geographical variation in the incidence of snakebite suggests an association with environmental factors that could potentially identify high-risk areas and inform health care decision making. This preliminary investigation describes a Geographic Information System (GIS) approach to risk mapping that identifies environmental variables potentially associated with variation in snakebite incidence rates at a number of health facilities in northern Ghana and Nigeria and which has been used to create a preliminary risk map of the potential probability of high snakebite incidence for West Africa. Detailed and extensive further studies will enable the more reliable estimation of snakebite incidence at a local level across the region.

Environmental risk and meningitis epidemics in Africa

Epidemics of meningococcal meningitis occur in areas with particular environmental characteristics. We present evidence that the relationship between the environment and the location of these epidemics is quantifiable and propose a model based on environmental variables to identify regions at risk for meningitis epidemics. These findings, which have substantial implications for directing surveillance activities and health policy, provide a basis for monitoring the impact of climate variability and environmental change on epidemic occurrence in Africa.

Mapping rice field anopheline breeding habitats in Mali, West Africa, using Landsat ETM+ sensor data

The aim of this study was to determine whether remotely sensed data could be used to identify rice-related malaria vector breeding habitats in an irrigated rice growing area near Niono, Mali. Early stages of rice growth show peak larval production, but Landsat sensor data are often obstructed by clouds during the early part of the cropping cycle (rainy season). In this study, we examined whether a classification based on two Landsat Enhanced Thematic Mapper (ETM)+ scenes acquired in the middle of the season and at harvesting times could be used to map different land uses and rice planted at different times (cohorts), and to infer which rice growth stages were present earlier in the season. We performed a maximum likelihood supervised classification and evaluated the robustness of the classifications with the transformed divergence separability index, the kappa coefficient and confusion matrices. Rice was distinguished from other land uses with 98% accuracy and rice cohorts were discriminated with 84% accuracy (three classes) or 94% (two classes). Our study showed that optical remote sensing can reliably identify potential malaria mosquito breeding habitats from space. In the future, these 'crop landscape maps' could be used to investigate the relationship between cultivation practices and malaria transmission.

Epidemiological investigations of outbreaks of bovine ephemeral fever in Israel

In two epidemics of bovine ephemeral fever (BEF) in Israel, one in 1990 and one in 1999, the virus was probably carried by vectors transported by air currents across the Rift Valley and through the Red Sea trough. The disease broke out under optimal ecological conditions among vulnerable cattle populations and spread rapidly; it developed in the spring and summer and ended soon after the daily average ambient temperature fell below 16 degrees C in late autumn. The proportion of herds affected reached 78.4 and 97.7 per cent in 1990 and 1999, respectively. The highest rates of incidence, morbidity and mortality were recorded in dairy cattle herds in the Jordan Valley, the initial focus of the outbreaks, with a morbidity of 20 and 38.6 per cent in 1990 and 1999, respectively, and mortality among the affected animals of 2 and 8.6 per cent in 1990 and 1999, respectively. In 1991, the disease recurred sporadically in the central and southern regions of Israel in only three herds, but in 2000 the disease returned on an epidemic scale, and 85 per cent of herds were affected, with morbidity and mortality rates of 4-3 and 0-3 per cent, respectively. In the 1999 epidemic, the morbidity rate decreased from 38-6 per cent on average in the Jordan Valley to 12.8 per cent in the inner valleys and 5.3 per cent on the Mediterranean coastal plain, but the mortality rate increased from 8-6 per cent in the Jordan Valley to 14-3 per cent in the inner valleys, and to 28 per cent on the Mediterranean coastal plain, where the outbreak declined. An average of 2-7 per cent of the animals experienced a second attack of the disease two to six weeks later. The epidemic in 2000 was milder and shorter than that in 1999. All the cattle affected in both outbreaks were more than three months old. The vector(s) is not known for certain but the available evidence indicates that mosquitoes, and not Culicoides species, are the natural vectors of BEF virus in Israel.

The development of Malaria Early Warning Systems for Africa

Current efforts to predict malaria epidemics focus on the role weather anomalies can play in epidemic prediction. Alongside weather monitoring and seasonal climate forecasts, epidemiological, social and environmental factors can also play a role in predicting the timing and severity of malaria epidemics. Such factors can be incorporated into a framework for malaria early warning.

Breeding of Anopheles mosquitoes in irrigated areas of South Punjab, Pakistan

As part of investigations on potential linkages between irrigation and malaria transmission, all surface water bodies in and around three villages along an irrigation distributary in South Punjab, Pakistan, were surveyed for anopheline mosquito larvae (Diptera: Culicidae) from April 1999 to March 2000. Samples were characterized according to exposure to sunlight, substratum, presence of vegetation, fauna, inorganic matter and physical water condition (clear/turbid/foul). Also water temperature, dissolved oxygen (DO), electroconductivity (EC) and pH of sites were recorded. A total of 37982 Anopheles larvae of six morphological types were collected from 2992 samples taken from irrigation/agricultural and village/domestic aquatic habitats. Anopheles subpictus Grassi sensu lato was by far the most abundant (74.3%), followed by An. culicifacies Giles s.l. (4.1%), An. stephensi Liston s.l. (2.6%), An. pulcherrimus Theobald (1.8%), An. peditaeniatus Leicester (0.3%) and An. nigerrimus Giles (0.1%). The four most abundant species were significantly associated with waterlogged fields and communal village drinking-water tanks. Habitat characteristics most correlated with occurrence of anophelines were the physical water condition and the absence/presence of fauna, particularly predators. Occurrence and abundance of Anopheles immatures were not significantly correlated with water temperature, DO, EC or pH. Malaria vectors of the Anopheles culicifacies complex occurred at relatively low densities, mainly in irrigated and waterlogged fields. In South Punjab, where rainfall is very low, it should be possible to reduce anopheline breeding through water management, as larvae develop mainly in water bodies that are directly or indirectly related to the extensive canal-irrigation system.

Vector-borne infections in the tropics and health policy issues in the twenty-first century

Over the past 2 decades scientific advances and evolving strategies have significantly contributed to improved tools for control of vector-borne infections. These are: diagnostics--rapid assessment methods, non-invasive or minimally so yet sensitive and specific; new chemotherapeutics; pyrethroid insecticides and biological insecticidal products; refined strategies, such as combination therapy, rotation of insecticides for resistance management, community-directed treatment, standardized monitoring and evaluation to define programme progress; better epidemiological knowledge through improved identification of parasites and vectors; GIS, remote sensing and climate models which provide tools for epidemic prediction, planning control programmes and permit effective policy analysis; greater involvement of NGDOs (non-governmental development organizations) and CSOs (civil society organizations) in control; advent of donation programmes which involve community-based or directed mass drug distribution. Future problems could be: (1) the over-emphasis on inflexible financing by the insistence of donors on SWAps (sector-wide investment), (2) the over-reliance on pyrethroid pesticides, (3) the over-expectation that basic research will provide new drugs and vaccines for resource-poor settings in the necessary time scales, and (4) the failure to recognize that biological processes have an inherent capacity for change which outstrips the capacity of health services to respond. Malaria is a paradigm of an 'emerging disease'. (5) The challenge of implementing a 'vertical' approach to disease control within national health programmes, in the face of significant donor opposition to such programmes is a challenge even when such approaches will secure a 'public good'.

Satellite mapping of Loa loa prevalence in relation to ivermectin use in west and central Africa

For many years, ivermectin has been widely distributed throughout west Africa for the safe and effective control of onchocerclasis. However, recent events in Loa-loa-endemic areas of Cameroon, where severe adverse reactions have occurred, now constrain the public-health use of this drug in the forest habitat of the L. loa vector. We have created a model of L. loa prevalence to identify areas where high endemicity may be associated with the occurrence of such reactions. The model results have been mapped and the areas of overlap between high L. loa prevalence and planned ivermectin distribution for onchocerciasis control identified.

Sampling methods for phlebotomine sandflies

A review is presented of methods for sampling phlebotomine sandflies (Diptera: Psychodidae). Among approximately 500 species of Phlebotominae so far described, mostly in the New World genus Lutzomyia and the Old World genus Phlebotomus, about 10% are known vectors of Leishmania parasites or other pathogens. Despite being small and fragile, sandflies have a wide geographical range with species occupying a considerable diversity of ecotopes and habitats, from deserts to humid forests, so that suitable methods for collecting them are influenced by environmental conditions where they are sought. Because immature phlebotomines occupy obscure terrestrial habitats, it is difficult to find their breeding sites. Therefore, most trapping methods and sampling procedures focus on sandfly adults, whether resting or active. The diurnal resting sites of adult sandflies include tree holes, buttress roots, rock crevices, houses, animal shelters and burrows, from which they may be aspirated directly or trapped after being disturbed. Sandflies can be collected during their periods of activity by interception traps, or by using attractants such as bait animals, CO2 or light. The method of trapping used should: (a) be suited to the habitat and area to be surveyed, (b) take into account the segment of the sandfly population to be sampled (species, sex and reproduction condition) and (c) yield specimens of appropriate condition for the study objectives (e.g. identification of species present, population genetics or vector implication). Methods for preservation and transportation of sandflies to the laboratory also depend on the objectives of a particular study and are described accordingly.