Sustained reduction of the dengue vector population resulting from an integrated control strategy applied in two Brazilian cities

Contexts motivating protective behaviours related to Aedes-borne infectious diseases in Curaçao

BACKGROUND

Aedes aegypti, the vector of arboviral diseases such as dengue and Zika virus infections, is difficult to control. Effective interventions must be practicable, comprehensive, and sustained. There is evidence that community participation can enhance mosquito control. Therefore, countries are encouraged to develop and integrate community-based approaches to mosquito control to mitigate Aedes-borne infectious diseases (ABIDs). Health professionals must understand the contexts motivating individuals' behaviour to improve community participation and promote behavioural change. Therefore, this study aimed to determine how contexts shaped individuals' protective behaviours related to ABIDs in Curaçao.

METHODS

From April 2019 to September 2020, a multi-method qualitative study applying seven (n = 54) focus group discussions and twenty-five in-depth interviews with locals was performed in Curaҫao. The study was designed based on the Health Belief Model (HBM). Two cycles of inductive and deductive coding were employed, and Nvivo software was used to manage and analyse the data.

RESULTS

In this study, low media coverage (external cue to action) and limited experience with the symptoms of ABIDs (internal cue to action) were linked with a low perceived susceptibility and severity of ABIDs (low perceived threat). The low perceived threat was linked with reduced health-seeking behaviour (HSB) to prevent and control ABIDs. We also found that the perceived barriers outweigh the perceived benefits of ABID prevention and control interventions, obstructing HSB. On the one hand, insufficient knowledge reduced self-efficacy but contrary to expected, having good knowledge did not promote HSB. Lastly, we found that our participants believe that they are responsible for preventing ABIDs (internal locus of control) but at the same time indicated that their success depends on the efforts of the community and the health system (external locus of control).

CONCLUSIONS

This study used the HBM to explain individual changes in HSB concerning ABIDs prevention and control in Curaçao. We can conclude that the perceived threat (perceived susceptibility and severity) and perceived barriers played an essential role in changing HSB. Health professionals must consider these two concepts' implications when designing a bottom-up approach for ABIDs control; otherwise, community participation will remain minimal.

Evaluation of superabsorbent polymer (SAP) in oviposition traps used in the integrated control of Aedes aegypti (Linnaeus, 1762) and Aedes albopictus (Skuse, 1894) (Diptera:Culicidae)

BACKGROUND

Egg collection traps have been studied to assist in the integrated control of arbovirus vectors. Many enhancements have been made over the years.

METHODS

This study evaluated the use of a hydrated superabsorbent polymer (SAP) in the egg collection of Aedes aegypti and Aedes albopictus in ovitraps. An experiment was conducted in the laboratory to determine the minimum concentration of the product to be used in traps in the field to prevent the development of larvae into adults. In the field, the use of polymers has been evaluated using a traditional model of ovitraps. The positive ovitrap index and mean number of eggs per trap indicator were calculated.

RESULTS

In the laboratory, the larvae did not successfully develop to the adult stage, even at the lowest SAP concentration. In the field, the results showed that ovitraps with SAP proved to be effective for egg collection from both species. It was possible to identify sites with the highest concentration of species and expose the ovitraps for a longer period without larval development.

CONCLUSIONS

There is a need for studies on the adequacy of this technology for control programs. However, the results showed that ovitraps with hydrogel were potentiated to capture eggs, configuring themselves as another tool for vector control.

Surveillance of Aedes aegypti and Aedes albopictus (Diptera: Culicidae) as a Method for Prevention of Arbovirus Transmission in Urban and Seaport Areas of the Southern Coast of Brazil

Entomological surveillance is a traditional method to measure presence, distribution, and seasonal variation of vectors in urban areas, and is essential to targeted control activities to prevent arbovirus transmission. Ovitraps as one of the main components of surveillance programs, enable determination of female oviposition behavior, as well as identification of seasonal variations of the vector. The goals of this study were 1) to detect the mosquitos (Aedes aegypti Linnaeus) and (Aedes albopictus Skuse) (Diptera:Culicidae), in Paranaguá city, 2) to assess ovitrap positive index (OPI), egg density index (EDI), and their relationship with meteorological variables, and 3) to evaluate the vertical transmission of dengue, Zika, and chikungunya in Ae. aegypti and Ae. albopictus. The study was carried out in urban areas of Paranaguá city, an important port region of Brazil, from June 2017 to November 2018. The city was divided into 16 area-clusters. Three-hundred and thirty-one ovitraps were installed monthly, remaining for four days in selected places. Kernel density maps were done to compare the spatiotemporal distribution of collected eggs. Areas which maintained constant oviposition associated with vector activity were identified and were found to overlap the area-clusters with the highest EDI. As viral RNA was not detected, vertical transmission was likely not a maintenance mechanism of arbovirus circulation in Ae. aegypti and Ae. albopictus vectors. This study reiterates the importance, efficiency, and feasibility of ovitraps to monitor the presence and dynamics of Aedes spp. populations.

Effectiveness of Aedes-borne infectious disease control in Latin America and the Caribbean region: A scoping review

Background

Aedes aegypti and Aedes albopictus are primary vectors of emerging or re-emerging arboviruses that threaten public health worldwide. Many efforts have been made to develop interventions to control these Aedes species populations. Still, countries in the Latin America and the Caribbean (LAC) region struggle to create/design/develop sustainable and effective control strategies. This scoping review synthesises evidence concerning the effectiveness of Ae. aegypti and Ae. albopictus prevention and control interventions performed in LAC (2000–2021). The findings can be used to evaluate, compare and develop more effective control strategies.

Methodology

The review is based on the methodology by Joanna Briggs Institute for conducting a scoping review. The MEDLINE (via PubMed and Web of Science), Cochrane Library, Scopus, EMBASE and ScienceDirect databases were used to search for articles. Grey literature was searched from governmental and non-governmental organisation websites. Four reviewers independently screened all titles and abstracts and full-text of the articles using the Rayyan web application, based on pre-defined eligibility criteria.

Results

A total of 122 publications were included in the review. Most studies focused on dengue virus infection and data on Ae. aegypti. Entomological data were mainly used to determine the intervention’s effectiveness. An integrated control intervention was the most commonly employed strategy in both regions. Biological control measures, environmental management, and health education campaigns on community participation achieved more sustainable results than an intervention where only a chemical control measure was used. Challenges to implementing interventions were insufficient financial support, resources, workforce, intersectoral collaboration and legislation.

Conclusions

Based on the synthesised data, an integrated vector (Aedes) management focused on community participation seems to be the most effective approach to mitigate Aedes-borne infectious diseases. Maintaining the approach’s effect remains challenging as it requires multisectoral and multi-disciplinary team engagement and active community participation. Future research needs to address the barriers to program implementation and maintenance as data on this topic is lacking.

Spatial and Temporal Dynamics of Aedes albopictus Populations in Rural and Agricultural Areas in Chania, Greece, After Its Invasion

Aedes albopictus, also known as the Asian tiger mosquito, is an aggressive invasive mosquito species that transmits parasites that cause several major human diseases such as dengue, Chikungunya, and Zika. Its recent establishment in many European countries and the reported autochthonous cases of Aedes-transmitted arboviral diseases highlight the importance of effective surveillance programs to plan and implement efficient mosquito-control interventions. Aedes albopictus invaded the Greek island of Crete in 2014 and rapidly spread throughout; however, there are no comprehensive population-related data yet available. Our study focused on spatial and temporal dynamics of Ae. albopictus populations in rural and agricultural areas in Chania (western part of the Crete Island). An oviposition surveillance network, consisting of 51 ovitraps, was established in 2017 and systematically inspected for 2 years. Thirty ovitraps were established in rural areas and 21 in the surrounding agricultural areas. Eggs were collected weekly and transferred to the laboratory for counting and assessment of hatching rates. The spatial and temporal egg distribution was assessed by using geographical information systems and spatial statistical analysis tools. Kernel density and hot spot analysis were employed to identify clusters of high populations of eggs. Oviposition activity (eggs in traps) was recorded during April–May and December (of both years), while the maximum egg-laying rates were observed during September–October. The proportion of traps with eggs was similar between rural and agricultural areas, while the higher number of eggs was recorded in rural compared to agricultural areas during 2017. Egg hatch rates were high (>90%) until the end of September. The proportion of diapausing non-hatched eggs rapidly increased at the end of November. All hatched larvae were identified as Ae. Albopictus, indicating a negative effect of the invasion on the population of the local species Ae. cretinus. This was a systematic attempt to monitor the seasonal and spatial patterns of the Asian tiger mosquito in the island of Crete, the southernmost area of Europe, and a study in Europe that assessed temporal and spatial dynamics of Ae. albopictus soon after its invasion and establishment in an area.

Field trials reveal the complexities of deploying and evaluating the impacts of yeast-baited ovitraps on Aedes mosquito densities in Trinidad, West Indies

The use of lure-and-kill, large-volume ovitraps to control Aedes aegypti and Aedes albopictus populations has shown promise across multiple designs that target gravid females (adulticidal) or larvae post-oviposition (larvicidal). Here we report on a pilot trial to deploy 10 L yeast-baited ovitraps at select sites in Curepe, Trinidad, West Indies during July to December, 2019. Oviposition rates among ovitraps placed in three Treatment sites were compared to a limited number of traps placed in three Control areas (no Aedes management performed), and three Vector areas (subjected to standard Ministry of Health, Insect Vector Control efforts). Our goal was to gain baseline information on efforts to saturate the Treatment sites with ovitraps within 20–25 m of each other and compare oviposition rates at these sites with background oviposition rates in Control and Vector Areas. Although yeast-baited ovitraps were highly attractive to gravid Aedes females, a primary limitation encountered within the Treatment sites was the inability to gain access to residential compounds for trap placement, primarily due to residents being absent during the day. This severely limited our intent to saturate these areas with ovitraps, indicating that future studies must include plans to account for these inaccessible zones during trap placement.

Culex quinquefasciatus predominance during integrated mosquito surveillance in an urban area of the Brazilian Amazon

Abstract The presence and establishment of Culicidae in urban areas increase the transmissibility of tropical diseases, since some species can participate as vectors of pathogens. Thus, this study aimed to evaluate the indoor and outdoor abundance of immature and adult populations of Culicidae at the urban area of Porto Velho, Rondônia. Mosquitoes were captured using electric aspirators and ovitraps in September and December 2018 in 27 households spread over nine neighborhoods. A total of 2,342 specimens were collected, distributed among five species, of which Culex quinquefasciatus (Say, 1823), Aedes aegypti (Linnaeus, 1762) and Aedes albopictus (Skuse, 1894) were the most abundant. Considering the sum total obtained by both techniques, more mosquitoes were captured indoors than outdoors. However, the GLM estimates for the ovitrap technique showed that immature Ae. aegypti, Ae. albopictus and Cx. quinquefasciatus were significantly more abundant in the outdoors, on average. The opposite result was observed for electrical aspiration, in which Ae. aegypti and Cx. quinquefasciatus adults were more abundant indoors. The average number of winged Ae. albopictus showed no significant difference between indoors and outdoors. Our findings corroborate the data on the abundance and incidence of these three species in other regions of Brazil, highlighting the need for continuous surveillance due to their importance in disease transmission to humans. We also demonstrated that the ovitrap is a sensitive device to monitor Cx. quinquefasciatus larvae and wild species that occasionally frequent urban areas, and thus can be used for surveillance, especially when there are budgetary constraints. Therefore, we emphasize that the combination of techniques, in addition to identifying which species and which stage of development are more frequent inside and outside households, also allows for the implementation of specific and integrated control measures.

Aedes aegypti continuously exposed to Bacillus thuringiensis svar. israelensis does not exhibit changes in life traits but displays increased susceptibility for Zika virus

Background

Aedes aegypti can transmit arboviruses worldwide, and Bacillus thuringiensis svar. israelensis (Bti)-based larvicides represent an effective tool for controlling this species. The safety of Bti and lack of resistance have been widely reported; however, little is known regarding the impact of the extensive use of these larvicides on the life traits of mosquitoes. Therefore, this study investigated biological parameters, including susceptibility to arbovirus, of an Ae. aegypti strain (RecBti) subjected to 29 generations of exposure to Bti compared with the RecL reference strain.

Methods

The biological parameters of individuals reared under controlled conditions were compared. Also, the viral susceptibility of females not exposed to Bti during their larval stage was analysed by oral infection and followed until 14 or 21 days post-infection (dpi).

Results

RecBti individuals did not display alterations in the traits that were assessed (fecundity, fertility, pupal weight, developmental time, emergence rate, sex ratio and haematophagic capacity) compared to RecL individuals. Females from both strains were susceptible to dengue serotype 2 (DENV-2) and Zika virus (ZIKV). However, RecBti females showed significantly higher rates of ZIKV infection compared with RecL females at 7 (90% versus 68%, Chi-square: χ² = 7.27, df = 1, P = 0.006) and 14 dpi (100% versus 87%, Chi-square: χ² = 7.69, df = 1, P = 0.005) and for dissemination at 7 dpi (83.3% versus 36%, Fisher’s exact test: P < 0.0001, OR = 0.11, 95% CI 0.03–0.32). Quantification of DENV-2 and ZIKV viral particles produced statistically similar results for females from both strains.

Conclusions

Prolonged exposure of Ae. aegypti larvae to Bti did not alter most of the evaluated biological parameters, except that RecBti females exhibited a higher vector susceptibility for ZIKV. This finding is related to a background of Bti exposure for several generations but not to a previous exposure of the tested females during the larval stage. This study highlights mosquito responses that could be associated with the chronic exposure to Bti in addition to the primary larvicidal effect elicited by this control agent.

Graphical abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s13071-021-04880-6.

Bacterial Toxins Active against Mosquitoes: Mode of Action and Resistance

Larvicides based on the bacteria Bacillus thuringiensis svar. israelensis (Bti) and Lysinibacillus sphaericus are effective and environmentally safe compounds for the control of dipteran insects of medical importance. They produce crystals that display specific and potent insecticidal activity against larvae. Bti crystals are composed of multiple protoxins: three from the three-domain Cry type family, which bind to different cell receptors in the midgut, and one cytolytic (Cyt1Aa) protoxin that can insert itself into the cell membrane and act as surrogate receptor of the Cry toxins. Together, those toxins display a complex mode of action that shows a low risk of resistance selection. L. sphaericus crystals contain one major binary toxin that display an outstanding persistence in field conditions, which is superior to Bti. However, the action of the Bin toxin based on its interaction with a single receptor is vulnerable for resistance selection in insects. In this review we present the most recent data on the mode of action and synergism of these toxins, resistance issues, and examples of their use worldwide. Data reported in recent years improved our understanding of the mechanism of action of these toxins, showed that their combined use can enhance their activity and counteract resistance, and reinforced their relevance for mosquito control programs in the future years.

Impact of a community-based intervention on Aedes aegypti and its spatial distribution in Ouagadougou, Burkina Faso

Background

Several studies highlighted the impact of community-based interventions whose purpose was to reduce the vectors’ breeding sites. These strategies are particularly interesting in low-and-middle-income countries which may find it difficult to sustainably assume the cost of insecticide-based interventions. In this case study we determine the spatial distribution of a community-based intervention for dengue vector control using different entomological indices. The objective was to evaluate locally where the intervention was most effective, using spatial analysis methods that are too often neglected in impact assessments.

Methods

Two neighbourhoods, Tampouy and Juvenat in Ouagadougou, Burkina Faso, were chosen among five after a survey was conducted, as part of an assessment related to the burden of dengue. As part of the community-based intervention conducted in Tampouy between August and early October 2016, an entomological survey was implemented in two phases. The first phase consisted of a baseline entomological characterization of potential breeding sites in the neighbourhood of Tampouy as well as in Juvenat, the control area. This phase was conducted in October 2015 at the end of the rainy season. The mosquito breeding sites were screened in randomly selected houses: 206 in Tampouy and 203 in Juvenat. A second phase took place after the intervention, in October 2016. The mosquito breeding sites were investigated in the same yards as during the baseline phase. We performed several entomological analyses to measure site productivity as well as before and after analysis using multilevel linear regression. We used Local Indicators of Spatial Association (LISAs) to analyse spatial concentrations of larvae.

Results

After the intervention, it is noted that LISAs at Tampouy reveal few aggregates of all types and the suppression of those existing before the intervention. The analysis therefore reveals that the intervention made it possible to reduce the number of concentration areas of high and low values of pupae.

Conclusions

The contribution of spatial methods for assessing community-based intervention are relevant for monitoring at local levels as a complement to epidemiological analyses conducted within neighbourhoods. They are useful, therefore, not only for assessment but also for establishing interventions. This study shows that spatial analyses also have their place in population health intervention research.

Infestation of an endemic arbovirus area by sympatric populations of Aedes aegypti and Aedes albopictus in Brazil

BACKGROUND Aedes aegypti and Aedes albopictus are the most important arbovirus vectors in the world. OBJECTIVES This study aimed to investigate and compare the infestation pattern of these species in a neighbourhood of Recife, Brazil, endemic for arboviruses in 2005 (T1) and 2013 (T2). METHODS Infestation, distribution and relative abundance of these sympatric species were recorded by egg collection using a network of 59 sentinel ovitraps (s-ovt) at fixed sampling stations for 12 months in T1 and T2. FINDINGS A permanent occupation pattern was detected which was characterised by the presence of egg-laying females of one or both species with a high ovitrap positivity index (94.3 to 100%) throughout both years analysed. In terms of abundance, the total of eggs collected was lower (p < 0.005) in T2 (146,153) than in T1 (281,103), although ovitraps still displayed a high index of positivity. The spatial distribution showed the presence of both species in 65.1% of the 148 s-ovt assessed, while a smaller number of traps exclusively contained Ae. aegypti (22%) or Ae. albopictus (13.2%) eggs. MAIN CONCLUSIONS Our comparative analysis demonstrated the robustness of the spatial occupation and permanence of Ae. aegypti and Ae. albopictus populations in this endemic urban area.

An Agent-Based Simulation of the Spread of Dengue Fever

Vector-borne diseases (VBDs) account for more than 17% of all infectious diseases, causing more than 700,000 annual deaths. Lack of a robust infrastructure for timely collection, reporting, and analysis of epidemic data undermines necessary preparedness and thus posing serious health challenges to the general public. By developing a simulation framework that models population dynamics and the interactions of both humans and mosquitoes, we may enable epidemiologists to analyze and forecast the transmission and spread of an infectious disease in specific areas. We extend the traditional SEIR (Susceptible, Exposed, Infectious, Recovered) mathematical model and propose an Agent-based model to analyze the interactions between the host and the vector using: (i) our proposed algorithm to compute vector density, based on the reproductive behavior of the vector; and (ii) agent interactions to simulate transmission of virus in a spatio-temporal environment, and forecast the spread of the disease in a given area over a period of time. Our simulation results identify several expected dengue cases and their direction of spread, which can help in detecting epidemic outbreaks. Our proposed framework provides visualization and forecasting capabilities to study the epidemiology of a certain region and aid public health departments in emergency preparedness.

Double BR-OVT: a new trap model for collecting eggs and adult mosquitoes from Culex quinquefasciatus and Aedes spp

The circulation of arboviruses throughout the world and the maintenance of lymphatic filariasis endemicity in tropical countries, combined with the lack of vaccines and specific treatments, highlight the importance of reducing the populations of mosquitoes involved in the transmission of these pathogens, Aedes aegypti and Culex quinquefasciatus. To contribute to the development of new strategies for monitoring and controlling these culicids, we evaluated the performance of the Double BR-OVT trap individually and in pairs, in the field. After 18 months, the Double BR-OVT traps captured a mean of 3.5 ± 7.4 and 1.8 ± 3.2 of Culex and Aedes /residence/cycle, respectively, in addition to 410 ± 588.3 Aedes eggs/residence/cycle. When installed in pairs, the Double BR-OVT traps collected three times more adult mosquitoes of C. quinquefasciatus (9.4 ± 8.3 Culex /residence/bimester) and two times more Aedes spp. (3 ± 3.2 Aedes /residence/bimester) in comparison with the traps installed individually (2.6 ± 7.1 and 1.5 ± 3.2 Culex and Aedes /residence/bimester, respectively) (p < 0.05). The Double BR-OVT trap has an exceptional advantage: it aggregates different functionalities into a single instrument, as this type of trap can concomitantly collect eggs and adult mosquitoes of C. quinquefasciatus and A. aegypti , a feature that makes it a potentially useful tool among the strategies for monitoring and controlling these mosquitoes.

Sandflies in an endemic area for Visceral Leishmaniasis in Northeastern Brazil

Abstract Phlebotomines of the genus Lutzomyia are important vector for species of Leishmania, the etiological agent of leishmaniasis. The aim of this study was to assess the diversity of sandflies in an endemic area for Visceral Leishmaniasis (VL). Sampling was performed in four localities on the coast of the municipality of Goiana, state of Pernambuco, Northeastern Brazil. Specimens were collected monthly on three consecutive nights, from November 2017 to October 2018. CDC light traps were installed at a height of 1.5 m above the ground, in two ecotypes (i.e. tree and animal facility), both in peridomestic areas. A total of 5,205 sandflies were collected, among which the species Lutzomyia longipalpis (99.85%; 5,197/5,205) was the most common, followed by Lutzomyia evandroi (0.13%; 07/5,205) and Lutzomyia whitmani (0.02%; 01/5,205). Specimens of L. longipalpis were collected throughout the study period and most of them were found near to the animal facilities. The findings from this research indicate that vectors for Leishmania infantum are present in the study area throughout the year, along with occurrences of vectors relating to Cutaneous Leishmaniasis (CL). Preventive vector control measures need to be implemented in Goiana to reduce the risk of infection for the human and animal populations.

Spatial distribution of Aedes aegypti (Diptera: Culicidae) in vulnerable areas for the transmission of arboviruses

INTRODUCTION

Areas at risk of transmission of arboviruses have been monitored using ovitraps. This study aimed to evaluate the spatial distribution of Aedes aegypti in vulnerable areas for the transmission of arboviruses and assess the influence of climatic conditions on the infestation of these culicids.

METHODS

Ovitraps were installed in Agrestina, Pernambuco, Northeastern Brazil.

RESULTS

Overall, 44,936 eggs were collected, and the indexes of infestation varied. Relative humidity was significantly associated with the infestations.

CONCLUSIONS

Using ovitraps, entomologic indexes and analysis of climatic factors might be good strategies for monitoring vulnerable areas for the transmission of arboviruses.

Improved spatial ecological sampling using open data and standardization: an example from malaria mosquito surveillance

Vector-borne disease control relies on efficient vector surveillance, mostly carried out using traps whose number and locations are often determined by expert opinion rather than a rigorous quantitative sampling design. In this work we propose a framework for ecological sampling design which in its preliminary stages can take into account environmental conditions obtained from open data (i.e. remote sensing and meteorological stations) not necessarily designed for ecological analysis. These environmental data are used to delimit the area into ecologically homogeneous strata. By employing Bayesian statistics within a model-based sampling design, the traps are deployed among the strata using a mixture of random and grid locations which allows balancing predictions and model-fitting accuracies. Sample sizes and the effect of ecological strata on sample sizes are estimated from previous mosquito sampling campaigns open data. Notably, we found that a configuration of 30 locations with four households each (120 samples) will have a similar accuracy in the predictions of mosquito abundance as 200 random samples. In addition, we show that random sampling independently from ecological strata, produces biased estimates of the mosquito abundance. Finally, we propose standardizing reporting of sampling designs to allow transparency and repetition/re-use in subsequent sampling campaigns.

Interventions for the control of Aedes aegypti in Latin America and the Caribbean: systematic review and meta-analysis

OBJECTIVE

To determine the effectiveness and degree of implementation of interventions for the control of Aedes aegypti in Latin America and the Caribbean (LAC) as reported in scientific literature.

METHODS

We searched MEDLINE, EMBASE, CENTRAL, SOCINDEX, and LILACS, for experimental and observational studies, economic assessments and qualitative experiences carried out in LAC from 2000 to 2016. We assessed incidence and morbimortality of Aedes aegypti-related diseases and entomological indices: Breteau (containers), House, and Pupae per Person. We used GRADE methodology for assessing quality of evidence.

RESULTS

Of 1826 records retrieved, 75 were included and 9 cluster randomised clinical trials could be meta-analysed. We did not identify any intervention supported by a high certainty of evidence. In consistency with qualitative evidence, health education and community engagement probably reduces the entomological indices, as do the use of insecticide-treated materials, indoor residual spraying and the management of containers. There is low certainty of evidence supporting the use of ovitraps or larvitraps, and the integrated epidemiological surveillance strategy to improve indices and reduce the incidence of dengue. The reported degree of implementation of these vector control interventions was variable and most did not extend to whole cities and were not sustained beyond 2 years.

CONCLUSIONS

We found a general lack of evidence on effectiveness of vector control in the region, despite a few interventions that showed moderate to low certainty of evidence. It is important to engage and educate the community, apart from achieving the implementation of integrated actions between the health and other sectors at national and regional level.

Long-term exposure of Aedes aegypti to Bacillus thuringiensis svar. israelensis did not involve altered susceptibility to this microbial larvicide or to other control agents

Background

Bacillus thuringiensis svar. israelensis (Bti) is an effective and safe biolarvicide to control Aedes aegypti. Its mode of action based on four protoxins disfavors resistance; however, control in endemic areas that display high mosquito infestation throughout the year requires continuous larvicide applications, which imposes a strong selection pressure. Therefore, this study aimed to investigate the effects of an intensive Bti exposure on an Ae. aegypti strain (RecBti), regarding its susceptibility to Bti and two of its protoxins tested individually, to other control agents temephos and diflubenzuron, and its profile of detoxifying enzymes.

Methods

The RecBti strain was established using a large egg sample (10,000) from Recife city (Brazil) and more than 290,000 larvae were subjected to Bti throughout 30 generations. Larvae susceptibility to larvicides and the activity of detoxifying enzymes were determined by bioassays and catalytic assays, respectively. The Rockefeller strain was the reference used for these evaluations.

Results

Bti exposure yielded an average of 74% mortality at each generation. Larvae assessed in seven time points throughout the 30 generations were susceptible to Bti crystal (resistance ratio RR ≤ 2.8) and to its individual toxins Cry11Aa and Cry4Ba (RR ≤ 4.1). Early signs of altered susceptibility to Cry11Aa were detected in the last evaluations, suggesting that this toxin was a marker of the selection pressure imposed. RecBti larvae were also susceptible (RR ≤ 1.6) to the other control agents, temephos and diflubenzuron. The activity of the detoxifying enzymes α- and β-esterases, glutathione-S-transferases and mixed-function oxidases was classified as unaltered in larvae from two generations (F₁₉ and F₂₅), except for a β-esterases increase in F₂₅.

Conclusions

Prolonged exposure of Ae. aegypti larvae to Bti did not evolve into resistance to the crystal, and no cross-resistance with temephos and diflubenzuron were recorded, which supports their sustainable use with Bti for integrated control practices. The unaltered activity of most detoxifying enzymes suggests that they might not play a major role in the metabolism of Bti toxins, therefore resistance by this mechanism is unlikely to occur. This study also highlights the need to establish suitable criteria to classify the status of larval susceptibility/resistance.

Electronic supplementary material

The online version of this article (10.1186/s13071-018-3246-1) contains supplementary material, which is available to authorized users.

Effective surveillance systems for vector-borne diseases in urban settings and translation of the data into action: a scoping review

Background

Vector-borne diseases (VBDs) continue to represent a global threat, with “old” diseases like malaria, and “emergent” or “re-emergent” ones like Zika, because of an increase in international trade, demographic growth, and rapid urbanization. In this era of globalization, surveillance is a key element in controlling VBDs in urban settings, but surveillance alone cannot solve the problem. A review of experiences is of interest to examine other solution elements. The objectives were to assess the different means of VBD surveillance in urban environments, to evaluate their potential for supporting public health actions, and to describe the tools used for public health actions, the constraints they face, and the research and health action gaps to be filled.

Main body

For this scoping review we searched peer-reviewed articles and grey literature published between 2000 and 2016. Various tools were used for data coding and extraction. A quality assessment was done for each study reviewed, and descriptive characteristics and data on implementation process and transferability were analyzed in all studies.

After screening 414 full-text articles, we retained a total of 79 articles for review. The main targets of the articles were arboviral diseases (65.8%) and malaria (16.5%). The positive aspects of many studies fit within the framework of integrated vector management. Public awareness is considered a key to successful vector control programs. Advocacy and legislation can reinforce both empowerment and capacity building. These can be achieved by collaboration within the health sector and with other sectors. Research is needed to develop well designed studies and new tools for surveillance and control.

Conclusions

The need for surveillance systems in urban settings in both developing and developed countries was highlighted. Countries face the same challenges relating to human, financial, and structural resources. These findings also constitute a wake-up call for governments, academia, funders, and World Health Organization to strengthen control programs and enhance VBD research in urban environments.

Electronic supplementary material

The online version of this article (10.1186/s40249-018-0473-9) contains supplementary material, which is available to authorized users.

Field evaluation of sticky BR-OVT traps to collect culicids eggs and adult mosquitoes inside houses

INTRODUCTION

Culex quinquefasciatus is a mosquito of importance to public health, as it represents a real and/or potential risk for the transmission of pathogens to humans, such as some arthropod-borne viruses and nematodes that cause filariasis. In Brazil, three municipalities in the Metropolitan Region of Recife (RMR) that are endemic for lymphatic filariasis conducted control actions targeting this vector. With the goal of contributing novel C. quinquefasciatus collection strategies, a sticky trap capable of collecting eggs and imprisoning mosquitoes was investigated.

METHODS

To evaluate the performance of the sticky BR-OVT trap, tests were carried out in the neighborhoods of Caixa d'Água and Passarinho (Olinda-PE-Brasil) between August 2011 and June 2012. Sixty traps were installed in the indoor areas of residences in the two districts.

RESULTS

During the 11-month study, 0.52 [standard deviation (SD) = 1.52] Culex egg rafts, 2.16 (SD = 4.78) C. quinquefasciatus/trap/month, and 0.55 (SD = 1.28) Aedes/trap/month were caught. Female specimens predominated the traps (59% of C. quinquefasciatus and 96% of Aedes spp.).

CONCLUSIONS

The results demonstrated that the sticky BR-OVT trap is a useful tool for the collection of adult culicids of medical importance and offers an innovative way to collect C. quinquefasciatus eggs and adults in a single trap.

The Zika Virus Epidemic in Brazil: From Discovery to Future Implications

The first confirmed case of Zika virus infection in the Americas was reported in Northeast Brazil in May 2015, although phylogenetic studies indicate virus introduction as early as 2013. Zika rapidly spread across Brazil and to more than 50 other countries and territories on the American continent. The Aedesaegypti mosquito is thought to be the principal vector responsible for the widespread transmission of the virus. However, sexual transmission has also been reported. The explosively emerging epidemic has had diverse impacts on population health, coinciding with cases of Guillain-Barré Syndrome and an unexpected epidemic of newborns with microcephaly and other neurological impairments. This led to Brazil declaring a national public health emergency in November 2015, followed by a similar decision by the World Health Organization three months later. While dengue virus serotypes took several decades to spread across Brazil, the Zika virus epidemic diffused within months, extending beyond the area of permanent dengue transmission, which is bound by a climatic barrier in the south and low population density areas in the north. This rapid spread was probably due to a combination of factors, including a massive susceptible population, climatic conditions conducive for the mosquito vector, alternative non-vector transmission, and a highly mobile population. The epidemic has since subsided, but many unanswered questions remain. In this article, we provide an overview of the discovery of Zika virus in Brazil, including its emergence and spread, epidemiological surveillance, vector and non-vector transmission routes, clinical complications, and socio-economic impacts. We discuss gaps in the knowledge and the challenges ahead to anticipate, prevent, and control emerging and re-emerging epidemics of arboviruses in Brazil and worldwide.

A Possible Link Between Pyriproxyfen and Microcephaly

The Zika virus has been the primary suspect in the large increase in incidence of microcephaly in 2015-6 in Brazil. While evidence for Zika being the cause of some of the cases is strong, its role as the primary cause of the large number of cases in Brazil has not been confirmed. Recently, the disparity between the incidences in different geographic locations has led to questions about the virus's role. Here we consider the alternative possibility that the use of the insecticide pyriproxyfen for control of mosquito populations in Brazilian drinking water is the primary cause. Pyriproxifen is a juvenile hormone analog which has been shown to correspond in mammals to a number of fat soluble regulatory molecules including retinoic acid, a metabolite of vitamin A, with which it has cross-reactivity and whose application during development has been shown to cause microcephaly. Methoprene, another juvenile hormone analog that was approved as an insecticide based upon tests performed in the 1970s, has metabolites that bind to the mammalian retinoid X receptor, and has been shown to cause developmental disorders in mammals. Isotretinoin is another example of a retinoid causing microcephaly in human babies via maternal exposure and activation of the retinoid X receptor in developing fetuses. Moreover, tests of pyriproxyfen by the manufacturer, Sumitomo, widely quoted as giving no evidence for developmental toxicity, actually found some evidence for such an effect, including low brain mass and arhinencephaly-incomplete formation of the anterior cerebral hemispheres-in exposed rat pups. Finally, the pyriproxyfen use in Brazil is unprecedented-it has never before been applied to a water supply on such a scale. Claims that it is not being used in Recife, the epicenter of microcephaly cases, do not distinguish the metropolitan area of Recife, where it is widely used, and the municipality, and have not been adequately confirmed. Given this combination of information about molecular mechanisms and toxicological evidence, we strongly recommend that the use of pyriproxyfen in Brazil be suspended until the potential causal link to microcephaly is investigated further.

Aedes ægypti control in urban areas: A systemic approach to a complex dynamic

The available strategy for controlling the diseases transmitted by Aedes ægypti (dengue fever, Zika, and chikungunya) relies on continued community participation. Despite slogans emphasizing how easy it should be, no country has achieved it since the seventies. To better investigate potentially sustainable interventions, we developed a systemic model based on a multidisciplinary approach, integrating as deeply as possible specialized knowledge and field experience. The resulting model is composed of 4 external and 8 internal subsystems and 31 relationships, consistent with the literature and checked over multiple iterations with specialists of the many areas. We analyzed the model and the main feedback loops responsible for the system’s stability, searching for possible interventions that could shift the existing balance. We suggest the introduction of 1 more player, the local primary health care structure, with the potential to change the undesired equilibrium. The health agents in the areas are the first to detect disease cases, and they could stimulate individuals to inform about potential mosquitoes’ breeding sites and bring timely information to the vector-control program. Triggering such an action could introduce changes in people's attitude through a positive feedback loop in the desired direction.

Impact of Autocidal Gravid Ovitraps on Chikungunya Virus Incidence in Aedes aegypti (Diptera: Culicidae) in Areas With and Without Traps

Puerto Rico detected the first confirmed case of chikungunya virus (CHIKV) in May 2014 and the virus rapidly spread throughout the island. The invasion of CHIKV allowed us to observe Aedes aegypti (L.) densities, infection rates, and impact of vector control in urban areas using CDC autocidal gravid ovitraps (AGO traps) for mosquito control over several years. Because local mosquitoes can only get the virus from infectious residents, detecting the presence of virus in mosquitoes functions as a proxy for the presence of virus in people. We monitored the incidence of CHIKV in gravid females of Ae. aegypti in four neighborhoods-two with three AGO traps per home in most homes and two nearby neighborhoods without AGO mosquito control traps. Monitoring of mosquito density took place weekly using sentinel AGO traps from June to December 2014. In all, 1,334 pools of female Ae. aegypti (23,329 individuals) were processed by real-time reverse transcription PCR to identify CHIKV and DENV RNA. Density of Ae. aegypti females was 10.5 times lower (91%) in the two areas with AGO control traps during the study. Ten times (90.9%) more CHIKV-positive pools were identified in the nonintervention areas (50/55 pools) than in intervention areas (5/55). We found a significant linear relationship between the number of positive pools and both density of Ae. aegypti and vector index (average number of expected infected mosquitoes per trap per week). Temporal and spatial patterns of positive CHIKV pools suggested limited virus circulation in areas with AGO traps.

The State of the Art of Lethal Oviposition Trap-Based Mass Interventions for Arboviral Control

The intensifying expansion of arboviruses highlights the need for effective invasive Aedes control. While mass-trapping interventions have long been discredited as inefficient compared to insecticide applications, increasing levels of insecticide resistance, and the development of simple affordable traps that target and kill gravid female mosquitoes, show great promise. We summarize the methodologies and outcomes of recent lethal oviposition trap-based mass interventions for suppression of urban Aedes and their associated diseases. The evidence supports the recommendation of mass deployments of oviposition traps to suppress populations of invasive Aedes, although better measures of the effects on disease control are needed. Strategies associated with successful mass-trap deployments include: (1) high coverage (>80%) of the residential areas; (2) pre-intervention and/or parallel source reduction campaigns; (3) direct involvement of community members for economic long-term sustainability; and (4) use of new-generation larger traps (Autocidal Gravid Ovitrap, AGO; Gravid Aedes Trap, GAT) to outcompete remaining water-holding containers. While to the best of our knowledge all published studies so far have been on Ae. aegypti in resource-poor or tropical settings, we propose that mass deployment of lethal oviposition traps can be used for focused cost-effective control of temperate Ae. albopictus pre-empting arboviral epidemics and increasing participation of residents in urban mosquito control.

DengueME: A Tool for the Modeling and Simulation of Dengue Spatiotemporal Dynamics

The prevention and control of dengue are great public health challenges for many countries, particularly since 2015, as other arboviruses have been observed to interact significantly with dengue virus. Different approaches and methodologies have been proposed and discussed by the research community. An important tool widely used is modeling and simulation, which help us to understand epidemic dynamics and create scenarios to support planning and decision making processes. With this aim, we proposed and developed DengueME, a collaborative open source platform to simulate dengue disease and its vector's dynamics. It supports compartmental and individual-based models, implemented over a GIS database, that represent Aedes aegypti population dynamics, human demography, human mobility, urban landscape and dengue transmission mediated by human and mosquito encounters. A user-friendly graphical interface was developed to facilitate model configuration and data input, and a library of models was developed to support teaching-learning activities. DengueME was applied in study cases and evaluated by specialists. Other improvements will be made in future work, to enhance its extensibility and usability.

Epidemiological Scenario of Dengue in Brazil

Dengue is the most important reemerging mosquito-borne viral disease worldwide. It is caused by any of four Dengue virus types or serotypes (DENV-1 to DENV-4) and is transmitted by mosquitoes from the genus Aedes. Ecological changes have favored the geographic expansion of the vector and, since the dengue pandemic in the Asian and Pacific regions, the infection became widely distributed worldwide, reaching Brazil in 1845. The incidence of dengue in Brazil has been frequently high, and the number of cases in the country has at some point in time represented up to 60% of the dengue reported cases worldwide. This review addresses vector distribution, dengue outbreaks, circulating serotypes and genotypes, and prevention approaches being utilized in Brazil.

Aedes aegypti Control Strategies in Brazil: Incorporation of New Technologies to Overcome the Persistence of Dengue Epidemics

Dengue is considered to be the most important mosquito-borne viral disease in the world. The Aedes aegypti mosquito, its vector, is highly anthropophilic and is very well adapted to urban environments. Although several vaccine candidates are in advanced stages of development no licensed dengue vaccine is yet available. As a result, controlling the spread of dengue still requires that mosquitoes be targeted directly. We review the current methods of dengue vector control focusing on recent technical advances. We first examine the history of Brazil’s National Dengue Control Plan in effect since 2002, and we describe its establishment and operation. With the persistent recurrence of dengue epidemics, current strategies should be reassessed to bring to the forefront a discussion of the possible implementation of new technologies in Brazil’s mosquito control program.

Dengue virus detection in Aedes aegypti larvae from southeastern Brazil

The transmission of dengue, the most important arthropod-borne viral disease in Brazil, has been intensified over the past decades, along with the accompanying expansion and adaptation of its Aedes vectors. In the present study, we mapped dengue vectors in Ouro Preto and Ouro Branco, Minas Gerais, by installing ovitraps in 32 public schools. The traps were examined monthly between September, 2011 through July, 2012 and November, 2012 to April, 2013. The larvae were reared until the fourth stadium and identified according to species. The presence of dengue virus was detected by real time PCR and agarose gel electrophoresis. A total of 1,945 eggs was collected during the 17 months of the study. The Ovitrap Positivity Index (OPI) ranged from 0 to 28.13% and the Eggs Density Index (EDI) ranged from 0 to 59.9. The predominant species was Aedes aegypti, with 84.9% of the hatched larvae. Although the collection was low when compared to other ovitraps studies, vertical transmission could be detected. Of the 54 pools, dengue virus was detected in four Ae. aegypti pools.

Mosquito-disseminated pyriproxyfen yields high breeding-site coverage and boosts juvenile mosquito mortality at the neighborhood scale

Background

Mosquito-borne pathogens pose major public health challenges worldwide. With vaccines or effective drugs still unavailable for most such pathogens, disease prevention heavily relies on vector control. To date, however, mosquito control has proven difficult, with low breeding-site coverage during control campaigns identified as a major drawback. A novel tactic exploits the egg-laying behavior of mosquitoes to have them disseminate tiny particles of a potent larvicide, pyriproxyfen (PPF), from resting to breeding sites, thus improving coverage. This approach has yielded promising results at small spatial scales, but its wider applicability remains unclear.

Methodology/Principal Findings

We conducted a four-month trial within a 20-month study to investigate mosquito-driven dissemination of PPF dust-particles from 100 ‘dissemination stations’ (DSs) deployed in a 7-ha sub-area to surveillance dwellings and sentinel breeding sites (SBSs) distributed over an urban neighborhood of about 50 ha. We assessed the impact of the trial by measuring juvenile mosquito mortality and adult mosquito emergence in each SBS-month. Using data from 1,075 dwelling-months, 2,988 SBS-months, and 29,922 individual mosquitoes, we show that mosquito-disseminated PPF yielded high coverage of dwellings (up to 100%) and SBSs (up to 94.3%). Juvenile mosquito mortality in SBSs (about 4% at baseline) increased by over one order of magnitude during PPF dissemination (about 75%). This led to a >10-fold decrease of adult mosquito emergence from SBSs, from approximately 1,000–3,000 adults/month before to about 100 adults/month during PPF dissemination.

Conclusions/Significance

By expanding breeding-site coverage and boosting juvenile mosquito mortality, a strategy based on mosquito-disseminated PPF has potential to substantially enhance mosquito control. Sharp declines in adult mosquito emergence can lower vector/host ratios, reducing the risk of disease outbreaks. This approach is a very promising complement to current and novel mosquito control strategies; it will probably be especially relevant for the control of urban disease vectors, such as Aedes and Culex species, that often cause large epidemics.

Mosquito-transmitted diseases are among the most challenging infectious threats worldwide. Mosquito control is crucial for preventing infection and disease, particularly when effective vaccines or drugs are unavailable. A major drawback of current mosquito control strategies is that mosquito breeding sites are often overlooked, and therefore left untreated, during control campaigns. One appealing alternative proposes exploiting the innate breeding-site–finding ability of female mosquitoes to have them disseminate tiny insecticide particles that poison their offspring. Thus far, however, this idea has only been tested in small-scale trials. Here we show that mosquitoes effectively transferred insecticide particles from dissemination stations to sentinel breeding sites over distances between 3 and 400 m in a tropical urban neighborhood. This yielded high breeding-site coverage, with up to 94.3% of sentinel breeding sites presenting evidence of contamination with mosquito-disseminated insecticide. We recorded a 10-fold increase of juvenile mosquito mortality and a 10-fold decrease of adult mosquito emergence during the four-month dissemination trial. In combination with other tactics, this approach has the potential to considerably enhance mosquito-borne disease prevention, particularly in urban settings.

Dengue virus infections among Haitian and expatriate non-governmental organization workers--Léogane and Port-au-Prince, Haiti, 2012

In October 2012, the Haitian Ministry of Health and the US CDC were notified of 25 recent dengue cases, confirmed by rapid diagnostic tests (RDTs), among non-governmental organization (NGO) workers. We conducted a serosurvey among NGO workers in Léogane and Port-au-Prince to determine the extent of and risk factors for dengue virus infection. Of the total 776 staff from targeted NGOs in Léogane and Port-au-Prince, 173 (22%; 52 expatriates and 121 Haitians) participated. Anti-dengue virus (DENV) IgM antibody was detected in 8 (15%) expatriates and 9 (7%) Haitians, and DENV non-structural protein 1 in one expatriate. Anti-DENV IgG antibody was detected in 162 (94%) participants (79% of expatriates; 100% of Haitians), and confirmed by microneutralization testing as DENV-specific in 17/34 (50%) expatriates and 42/42 (100%) Haitians. Of 254 pupae collected from 68 containers, 65% were Aedes aegypti; 27% were Ae. albopictus. Few NGO workers reported undertaking mosquito-avoidance action. Our findings underscore the risk of dengue in expatriate workers in Haiti and Haitians themselves.

Dengue is the most common mosquito-borne viral disease in the world, and caused an estimated 390 million infections and 96 million cases in the tropics and subtropics in 2010. Over the last decade, the number of cases of dengue and the severity of dengue virus infections have increased in the Americas, including the Caribbean, yet little is still known about dengue in Haiti. Following an outbreak of dengue in mostly expatriate NGO workers, the investigators of this study took blood samples from expatriate and Haitian NGO workers living in two cities in Haiti and tested them for evidence of current, recent, and past dengue virus infection. They also investigated the amount and kinds of mosquitoes at homes and work sites. The study found recent infections among some Haitians and expatriates and widespread past infections among all Haitians and most expatriates. It also found that many people were not doing basic things to avoid mosquito bites, like applying mosquito repellent multiple times a day and wearing long sleeves or pants. These findings highlight the likely endemicity of dengue virus in Haiti, and the need to improve knowledge and awareness of dengue prevention among expatriates visiting Haiti and local Haitians.

Sustained, area-wide control of Aedes aegypti using CDC autocidal gravid ovitraps

We have shown that the Centers for Disease Control and Prevention (CDC) autocidal gravid ovitraps (AGO trap) reduced the Aedes aegypti population and prevented mosquito outbreaks in southern Puerto Rico. After showing treatment efficacy for 1 year, we deployed three traps per home in an area that formerly did not have traps and in a site that served as the intervention area. Two new areas were selected as reference sites to compare the density of Ae. aegypti without traps. We monitored mosquitoes and weather every week in all four sites. The hypotheses were the density of Ae. aegypti in the former reference area converges to the low levels observed in the intervention area, and mosquito density in both areas having control traps is lower than in the new reference areas. Mosquito density in the former reference area decreased 79% and mosquito density in the new reference areas was 88% greater than in the intervention areas.

Characterization of the spatial and temporal dynamics of the dengue vector population established in urban areas of Fernando de Noronha, a Brazilian oceanic island

Aedes aegypti has played a major role in the dramatic expansion of dengue worldwide. The failure of control programs in reducing the rhythm of global dengue expansion through vector control suggests the need for studies to support more appropriated control strategies. We report here the results of a longitudinal study on Ae. aegypti population dynamics through continuous egg sampling aiming to characterize the infestation of urban areas of a Brazilian oceanic island, Fernando de Noronha. The spatial and temporal distribution of the dengue vector population in urban areas of the island was described using a monitoring system (SMCP-Aedes) based on a 103-trap network for Aedes egg sampling, using GIS and spatial statistics analysis tools. Mean egg densities were estimated over a 29-month period starting in 2011 and producing monthly maps of mosquito abundance. The system detected continuous Ae. aegypti oviposition in most traps. The high global positive ovitrap index (POI=83.7% of 2815 events) indicated the frequent presence of blood-fed-egg laying females at every sampling station. Egg density (eggs/ovitrap/month) reached peak values of 297.3 (0 - 2020) in May and 295 (0 - 2140) in August 2012. The presence of a stable Ae. aegypti population established throughout the inhabited areas of the island was demonstrated. A strong association between egg abundance and rainfall with a 2-month lag was observed, which combined with a first-order autocorrelation observed in the series of egg counts can provide an important forecasting tool. This first description of the characteristics of the island infestation by the dengue vector provides baseline information to analyze relationships between the spatial distribution of the vector and dengue cases, and to the development of integrated vector control strategies.

The susceptibility of Aedes aegypti populations displaying temephos resistance to Bacillus thuringiensis israelensis: a basis for management

Background

Aedes aegypti is the vector of dengue virus, and its control is essential to prevent disease transmission. Among the agents available to control this species, biolarvicides based on Bacillus thuringiensis serovar israelensis (Bti) are an effective alternative to replace the organophosphate temephos for controlling populations that display resistance to this insecticide. The major goal of this study was to determine the baseline susceptibility of Brazilian Ae. aegypti populations to Bti, taking into account their background in terms of larvicide exposure, status of temephos resistance and the level of activity of detoxifying enzymes involved in metabolic resistance to insecticides.

Methods

Population samples were established under insectarium conditions. Larval susceptibility to temephos and Bti was evaluated through bioassays and lethal concentrations of these compounds were determined. Biochemical assays were performed to determine the specific activity of five detoxifying enzymes in these samples.

Results

Fourteen populations were characterized and, except for one case, all displayed resistance to temephos. Most populations were classified as highly resistant. The populations also showed increased activity of one or more detoxifying enzymes (glutathione-S-transferases, esterases and mixed function oxidases), regardless of their temephos resistance status. All populations analyzed were susceptible to Bti, and the lethal concentrations were similar to those detected in two laboratory susceptible colonies. The response to Bti showed little variation. A maximum resistance ratio of 2.1 was observed in two untreated populations, while in two Bti-treated populations, the maximum resistance ratio was 1.9. No positive correlation was found between temephos resistance, increased activity of detoxifying enzymes, and susceptibility to Bti.

Conclusions

Data from this study show that all populations were susceptible to Bti, including twelve untreated and two treated populations that had been exposed to this agent for more than ten years. The temephos resistance and increased activity of detoxifying enzymes observed in thirteen populations was not correlated with changes in susceptibility to Bti. Our data show a lack of cross-resistance between these two compounds; thus, Bti can be used in an integrated control program to fight Ae. aegypti and counteract the temephos resistance that was found among all populations analyzed.