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Peña-García VH, Desiree LaBeaud A, Ndenga BA, Mutuku FM, Bisanzio DA, Mordecai EA, Andrews JR. Non-household environments make a major contribution to dengue transmission: Implications for vector control. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.08.24301016. [PMID: 38260355 PMCID: PMC10802645 DOI: 10.1101/2024.01.08.24301016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Aedes-borne pathogens have been increasing in incidence in recent decades despite vector control activities implemented in endemic settings. Vector control for Aedes-transmitted arboviruses typically focuses on households because vectors breed in household containers and bite indoors. Yet, our recent work shows a high abundance of Aedes spp. vectors in public spaces. To investigate the impact of non-household environments on dengue transmission and control, we used field data on the number of water containers and abundance of Aedes mosquitoes in Household (HH) and Non-Household (NH) environments in two Kenyan cities, Kisumu and Ukunda, from 2019-2022. Incorporating information on human activity space, we developed an agent-based model to simulate city-wide conditions considering HH and five types of NH environments in which people move and interact with other humans and vectors during peak biting times. We additionally evaluated the outcome of vector control activities implemented in different environments in preventive (before an epidemic) and reactive (after an epidemic commences) scenarios. We estimated that over half of infections take place in NH environments, where the main spaces for transmission are workplaces, markets, and recreational locations. Accordingly, results highlight the important role of vector control activities at NH locations to reduce dengue. A greater reduction of cases is expected as control activities are implemented earlier, at higher levels of coverage, with greater effectiveness when targeting only NH as opposed to when targeting only HH. Further, local ecological factors such as the differential abundance of water containers within cities are also influential factors to consider for control. This work provides insight into the importance of vector control in both household and non-household environments in endemic settings. It highlights a specific approach to inform evidence-based decision making to target limited vector control resources for optimal control.
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Affiliation(s)
- Victor Hugo Peña-García
- Department of Biology, Stanford University, Stanford, CA, USA
- School of Medicine, Stanford University, Stanford, CA, USA
| | | | | | - Francis M Mutuku
- Department of Environmental and Health Sciences, Technical University of Mombasa, Mombasa, Kenya
| | | | - Erin A Mordecai
- Department of Biology, Stanford University, Stanford, CA, USA
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Montenegro-Quiñonez CA, Louis VR, Horstick O, Velayudhan R, Dambach P, Runge-Ranzinger S. Interventions against Aedes/dengue at the household level: a systematic review and meta-analysis. EBioMedicine 2023; 93:104660. [PMID: 37352828 PMCID: PMC10333437 DOI: 10.1016/j.ebiom.2023.104660] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 05/25/2023] [Accepted: 06/02/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Because the evidence for the role of structural housing and combinations of interventions (domestic or peri-domestic) against Aedes mosquitoes or dengue is still lacking, this systematic review and meta-analysis aimed to analyse and synthesize research focusing on the household as the unit of allocation. METHODS We searched MEDLINE, LILACS, and Web of Science databases until February 2023 using three general keyword categories: (1) "Aedes" or "dengue"; (2) structural housing interventions including "house", "water", or "drainage"; and (3) vector control interventions of potential relevance and their combinations. We performed a qualitative content analysis and a meta-analysis for 13 entries on dengue seroconversion data. FINDINGS 14,272 articles were screened by titles, 615 by abstracts, 79 by full-text. 61 were selected. Satisfactory data quality allowed for detailed content analysis. Interventions at the household level against the immature mosquito stages (21 studies, 34%) showed positive or mixed results in entomological and epidemiological outcomes (86% and 75% respectively). Combined interventions against immature and adult stages (11 studies, 18%) performed similarly (91% and 67%) while those against the adult mosquitoes (29 studies, 48%) performed less well (79%, 22%). A meta-analysis on seroconversion outcomes showed a not-statistically significant reduction for interventions (log odds-ratio: -0.18 [-0.51, 0.14 95% CI]). INTERPRETATION No basic research on housing structure or modification was eligible for this systematic review but many interventions with clear impact on vector indices and, to a lesser extent, on dengue were described. The small and not-statistically significant effect size of the meta-analysis highlights the difficulty of proving effectiveness against this highly-clustered disease and of overcoming practical implementation obstacles (e.g. efficacy loss, compliance). The long-term success of interventions depends on suitability, community commitment and official support and promotion. The choice of a specific vector control package needs to take all these context-specific aspects into consideration. FUNDING This work was funded by a grant from the World Health Organization (2021/1121668-0, PO 202678425, NTD/VVE).
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Affiliation(s)
- Carlos Alberto Montenegro-Quiñonez
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany; Instituto de Investigaciones, Centro Universitario de Zacapa, Universidad de San Carlos de Guatemala, Guatemala.
| | - Valérie R Louis
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany.
| | - Olaf Horstick
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany.
| | - Raman Velayudhan
- Department of Control of Neglected Tropical Diseases (NTD), World Health Organization, Switzerland.
| | - Peter Dambach
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany.
| | - Silvia Runge-Ranzinger
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany.
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Neira M, Erguler K, Ahmady-Birgani H, Al-Hmoud ND, Fears R, Gogos C, Hobbhahn N, Koliou M, Kostrikis LG, Lelieveld J, Majeed A, Paz S, Rudich Y, Saad-Hussein A, Shaheen M, Tobias A, Christophides G. Climate change and human health in the Eastern Mediterranean and Middle East: Literature review, research priorities and policy suggestions. ENVIRONMENTAL RESEARCH 2023; 216:114537. [PMID: 36273599 PMCID: PMC9729515 DOI: 10.1016/j.envres.2022.114537] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/29/2022] [Accepted: 10/06/2022] [Indexed: 05/17/2023]
Abstract
Human health is linked to climatic factors in complex ways, and climate change can have profound direct and indirect impacts on the health status of any given region. Susceptibility to climate change is modulated by biological, ecological and socio-political factors such as age, gender, geographic location, socio-economic status, occupation, health status and housing conditions, among other. In the Eastern Mediterranean and Middle East (EMME), climatic factors known to affect human health include extreme heat, water shortages and air pollution. Furthermore, the epidemiology of vector-borne diseases (VBDs) and the health consequences of population displacement are also influenced by climate change in this region. To inform future policies for adaptation and mitigation measures, and based on an extensive review of the available knowledge, we recommend several research priorities for the region. These include the generation of more empirical evidence on exposure-response functions involving climate change and specific health outcomes, the development of appropriate methodologies to evaluate the physical and psychological effects of climate change on vulnerable populations, determining how climate change alters the ecological determinants of human health, improving our understanding of the effects of long-term exposure to heat stress and air pollution, and evaluating the interactions between adaptation and mitigation strategies. Because national boundaries do not limit most climate-related factors expected to impact human health, we propose that adaptation/mitigation policies must have a regional scope, and therefore require collaborative efforts among EMME nations. Policy suggestions include a decisive region-wide decarbonisation, the integration of environmentally driven morbidity and mortality data throughout the region, advancing the development and widespread use of affordable technologies for the production and management of drinking water by non-traditional means, the development of comprehensive strategies to improve the health status of displaced populations, and fostering regional networks for monitoring and controlling the spread of infectious diseases and disease vectors.
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Affiliation(s)
- Marco Neira
- Climate and Atmosphere Research Center (CARE-C), The Cyprus Institute, Nicosia, Cyprus.
| | - Kamil Erguler
- Climate and Atmosphere Research Center (CARE-C), The Cyprus Institute, Nicosia, Cyprus
| | | | | | - Robin Fears
- European Academies Science Advisory Council (EASAC), Halle (Saale), Germany
| | | | - Nina Hobbhahn
- European Academies Science Advisory Council (EASAC), Halle (Saale), Germany
| | - Maria Koliou
- University of Cyprus Medical School, Nicosia, Cyprus
| | - Leondios G Kostrikis
- Department of Biological Sciences, University of Cyprus, Nicosia, Cyprus; Cyprus Academy of Sciences, Letters, and Arts, Nicosia, Cyprus
| | - Jos Lelieveld
- Climate and Atmosphere Research Center (CARE-C), The Cyprus Institute, Nicosia, Cyprus; Max Planck Institute for Chemistry, Mainz, Germany
| | - Azeem Majeed
- Department of Primary Care & Public Health, Imperial College London, London, United Kingdom
| | - Shlomit Paz
- Department of Geography and Environmental Studies, University of Haifa, Haifa, Israel
| | - Yinon Rudich
- Department of Earth and Planetary Sciences, The Weismann Institute of Science, Rehovot, Israel
| | - Amal Saad-Hussein
- Environment and Climate Change Research Institute, National Research Centre, Cairo, Egypt
| | - Mohammed Shaheen
- Damour for Community Development - Research Department, Palestine
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain
| | - George Christophides
- Climate and Atmosphere Research Center (CARE-C), The Cyprus Institute, Nicosia, Cyprus; Department of Life Sciences, Imperial College London, London, United Kingdom.
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Affiliation(s)
- Madeleine C Thomson
- From the Climate and Health Challenge Area, the Wellcome Trust, London (M.C.T.); and the Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, New York (L.R.S.)
| | - Lawrence R Stanberry
- From the Climate and Health Challenge Area, the Wellcome Trust, London (M.C.T.); and the Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, New York (L.R.S.)
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Kua KP. A multifactorial strategy for dengue prevention and control: A public health situation analysis. Trop Doct 2022; 52:367-371. [DOI: 10.1177/00494755221076910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Kok Pim Kua
- Puchong Health Clinic, Petaling District Health Office, Ministry of Health Malaysia, Puchong, Petaling, Selangor, Malaysia
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Manrique-Saide P, Herrera-Bojórquez J, Villegas-Chim J, Puerta-Guardo H, Ayora-Talavera G, Parra-Cardeña M, Medina-Barreiro A, Ramírez-Medina M, Chi-Ku A, Trujillo-Peña E, Méndez-Vales RE, Delfín-González H, Toledo-Romaní ME, Bazzani R, Bolio-Arceo E, Gómez-Dantés H, Che-Mendoza A, Pavía-Ruz N, Kirstein OD, Vazquez-Prokopec GM. Protective effect of house screening against indoor Aedes aegypti in Mérida, Mexico: A cluster randomised controlled trial. Trop Med Int Health 2021; 26:1677-1688. [PMID: 34587328 PMCID: PMC9298035 DOI: 10.1111/tmi.13680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the protective effect of house screening (HS) on indoor Aedes aegypti infestation, abundance and arboviral infection in Merida, Mexico. METHODS In 2019, we performed a cluster randomised controlled trial (6 control and 6 intervention areas: 100 households/area). Intervention clusters received permanently fixed fiberglass HS on all windows and doors. The study included two cross-sectional entomologic surveys, one baseline (dry season in May 2019) and one post-intervention (PI, rainy season between September and October 2019). The presence and number of indoor Aedes females and blood-fed females (indoor mosquito infestation) as well as arboviral infections with dengue (DENV) and Zika (ZIKV) viruses were evaluated in a subsample of 30 houses within each cluster. RESULTS HS houses had significantly lower risk for having Aedes aegypti female mosquitoes (odds ratio [OR] = 0.56, 95% CI 0.33-0.97, p = 0.04) and blood-fed females (OR = 0.53, 95% CI 0.28-0.97, p = 0.04) than unscreened households from the control arm. Compared to control houses, HS houses had significantly lower indoor Ae. aegypti abundance (rate ratio [RR] = 0.50, 95% CI 0.30-0.83, p = 0.01), blood-fed Ae. aegypti females (RR = 0.48, 95% CI 0.27-0.85, p = 0.01) and female Ae. aegypti positive for arboviruses (OR = 0.29, 95% CI 0.10-0.86, p = 0.02). The estimated intervention efficacy in reducing Ae. aegypti arbovirus infection was 71%. CONCLUSIONS These results provide evidence supporting the use of HS as an effective pesticide-free method to control house infestations with Aedes aegypti and reduce the transmission of Aedes-transmitted viruses such as DENV, chikungunya (CHIKV) and ZIKV.
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Affiliation(s)
- Pablo Manrique-Saide
- Unidad Colaborativa para Bioensayos Entomológicos, Campus de Ciencias Biológicas y Agropecuarias, Universidad Autónoma de Yucatán, Mérida, México
| | - Josué Herrera-Bojórquez
- Unidad Colaborativa para Bioensayos Entomológicos, Campus de Ciencias Biológicas y Agropecuarias, Universidad Autónoma de Yucatán, Mérida, México
| | - Josué Villegas-Chim
- Unidad Colaborativa para Bioensayos Entomológicos, Campus de Ciencias Biológicas y Agropecuarias, Universidad Autónoma de Yucatán, Mérida, México
| | - Henry Puerta-Guardo
- Unidad Colaborativa para Bioensayos Entomológicos, Campus de Ciencias Biológicas y Agropecuarias, Universidad Autónoma de Yucatán, Mérida, México
| | - Guadalupe Ayora-Talavera
- Laboratorio de Virología, Centro de Investigaciones Regionales 'Dr. Hideyo Noguchi', Universidad Autónoma de Yucatán, Mérida, México
| | - Manuel Parra-Cardeña
- Laboratorio de Virología, Centro de Investigaciones Regionales 'Dr. Hideyo Noguchi', Universidad Autónoma de Yucatán, Mérida, México
| | - Anuar Medina-Barreiro
- Unidad Colaborativa para Bioensayos Entomológicos, Campus de Ciencias Biológicas y Agropecuarias, Universidad Autónoma de Yucatán, Mérida, México
| | - Marypaz Ramírez-Medina
- Unidad Colaborativa para Bioensayos Entomológicos, Campus de Ciencias Biológicas y Agropecuarias, Universidad Autónoma de Yucatán, Mérida, México
| | - Aylin Chi-Ku
- Unidad Colaborativa para Bioensayos Entomológicos, Campus de Ciencias Biológicas y Agropecuarias, Universidad Autónoma de Yucatán, Mérida, México
| | - Emilio Trujillo-Peña
- Unidad Colaborativa para Bioensayos Entomológicos, Campus de Ciencias Biológicas y Agropecuarias, Universidad Autónoma de Yucatán, Mérida, México
| | | | - Hugo Delfín-González
- Unidad Colaborativa para Bioensayos Entomológicos, Campus de Ciencias Biológicas y Agropecuarias, Universidad Autónoma de Yucatán, Mérida, México
| | - María E Toledo-Romaní
- Departamento de Epidemiología, Instituto de Medicina Tropical 'Pedro Kourí', La Habana, Cuba
| | - Roberto Bazzani
- International Development Research Centre of Canada, Regional Office for Latin America and the Caribbean, Montevideo, Uruguay
| | | | - Hector Gómez-Dantés
- Centro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - Azael Che-Mendoza
- Unidad Colaborativa para Bioensayos Entomológicos, Campus de Ciencias Biológicas y Agropecuarias, Universidad Autónoma de Yucatán, Mérida, México
| | - Norma Pavía-Ruz
- Laboratorio de Hematología, Centro de Investigaciones Regionales 'Dr. Hideyo Noguchi', Universidad Autónoma de Yucatán, Mérida, México
| | - Oscar D Kirstein
- Department of Environmental Sciences, Emory University, Atlanta, Georgia, USA
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