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Guillot C, Aenishaenslin C, Acheson ES, Koffi J, Bouchard C, Leighton PA. Spatial multi-criteria decision analysis for the selection of sentinel regions in tick-borne disease surveillance. BMC Public Health 2024; 24:294. [PMID: 38267914 PMCID: PMC10809750 DOI: 10.1186/s12889-024-17684-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 01/05/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND The implementation of cost-effective surveillance systems is essential for tracking the emerging risk of tick-borne diseases. In Canada, where Lyme disease is a growing public health concern, a national sentinel surveillance network was designed to follow the epidemiological portrait of this tick-borne disease across the country. The surveillance network consists of sentinel regions, with active drag sampling carried out annually in all regions to assess the density of Ixodes spp. ticks and prevalence of various tick-borne pathogens in the tick population. The aim of the present study was to prioritize sentinel regions by integrating different spatial criteria relevant to the surveillance goals. METHODS We used spatially-explicit multi-criteria decision analyses (MCDA) to map priority areas for surveillance across Canada, and to evaluate different scenarios using sensitivity analyses. Results were shared with stakeholders to support their decision making for the selection of priority areas to survey during active surveillance activities. RESULTS Weights attributed to criteria by decision-makers were overall consistent. Sensitivity analyses showed that the population criterion had the most impact on rankings. Thirty-seven sentinel regions were identified across Canada using this systematic and transparent approach. CONCLUSION This novel application of spatial MCDA to surveillance network design favors inclusivity of nationwide partners. We propose that such an approach can support the standardized planning of spatial design of sentinel surveillance not only for vector-borne disease BDs, but more broadly for infectious disease surveillance where spatial design is an important component.
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Affiliation(s)
- C Guillot
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Department of Pathology and Microbiology, Faculty of Veterinary Medicine, University of Montreal, Montreal, Quebec, Canada.
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Quebec, Canada.
- Centre de recherche en santé publique (CRESP) de l'Université de Montréal et du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, University of Montreal, Montreal, Quebec, Canada.
| | - C Aenishaenslin
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Department of Pathology and Microbiology, Faculty of Veterinary Medicine, University of Montreal, Montreal, Quebec, Canada
- Centre de recherche en santé publique (CRESP) de l'Université de Montréal et du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, University of Montreal, Montreal, Quebec, Canada
| | - E S Acheson
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Department of Pathology and Microbiology, Faculty of Veterinary Medicine, University of Montreal, Montreal, Quebec, Canada
- Public Health Risk Sciences Divisions, National Microbiology Laboratory, Public Health Agency of Canada, Saint-Hyacinthe, Quebec, Canada
| | - J Koffi
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Department of Pathology and Microbiology, Faculty of Veterinary Medicine, University of Montreal, Montreal, Quebec, Canada
- Policy Integration and Zoonoses Division, Centre for Food-borne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada, Saint-Hyacinthe, Quebec, Canada
| | - C Bouchard
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Department of Pathology and Microbiology, Faculty of Veterinary Medicine, University of Montreal, Montreal, Quebec, Canada
- Public Health Risk Sciences Divisions, National Microbiology Laboratory, Public Health Agency of Canada, Saint-Hyacinthe, Quebec, Canada
| | - P A Leighton
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Department of Pathology and Microbiology, Faculty of Veterinary Medicine, University of Montreal, Montreal, Quebec, Canada
- Centre de recherche en santé publique (CRESP) de l'Université de Montréal et du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, University of Montreal, Montreal, Quebec, Canada
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Urcuqui-Bustamante AM, Leahy JE, Sponarski C, Gardner AM. Collaborative Modeling of the Tick-Borne Disease Social-Ecological System: A Conceptual Framework. ECOHEALTH 2023; 20:453-467. [PMID: 38214874 DOI: 10.1007/s10393-023-01669-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 12/17/2023] [Indexed: 01/13/2024]
Abstract
Hard-bodied ticks have become a major concern in temperate regions because they transmit a variety of pathogens of medical significance. Ticks and pathogens interact with hosts in a complex social-ecological system (SES) that influences human exposure to tick-borne diseases (TBD). We argue that addressing the urgent public health threat posed by TBD requires an understanding of the integrated processes in the forest ecosystem that influence tick density and infection prevalence, transmission among ticks, animal hosts, and ultimately disease prevalence in humans. We argue that collaborative modeling of the human-tick SES is required to understand the system dynamics as well as move science toward policy action. Recent studies in human health have shown the importance of stakeholder participation in understanding the factors that contribute to human exposure to zoonotic diseases. We discuss how collaborative modeling can be applied to understand the impacts of forest management practices on ticks and TBD. We discuss the potential of collaborative modeling for encouraging participation of diverse stakeholders in discussing the implications of managing forest ticks in the absence of large-scale control policy.
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Affiliation(s)
| | - Jessica E Leahy
- School of Forest Resources, University of Maine, 105 Nutting Hall, Orono, ME, USA
| | - Carly Sponarski
- Northern Forestry Centre, Canadian Forest Service, Edmonton, AB, Canada
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Lebert I, Bord S, Saint-Andrieux C, Cassar E, Gasqui P, Beugnet F, Chalvet-Monfray K, Vanwambeke SO, Vourc'h G, René-Martellet M. Habitat suitability map of <em>Ixodes ricinus</em> tick in France using multi-criteria analysis. GEOSPATIAL HEALTH 2022; 17. [PMID: 35579242 DOI: 10.4081/gh.2022.1058] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 04/14/2022] [Indexed: 06/15/2023]
Abstract
The tick Ixodes ricinus is widely distributed across Europe and is responsible for the transmission of several pathogens to humans and animals. In this study, we used a knowledge-based method to map variations in habitat suitability for I. ricinus ticks throughout continental France and Corsica. The multi-criteria decision analysis (MCDA) integrated four major biotic and abiotic factors known to influence tick populations: climate, land cover, altitude and the density of wild ungulates. For each factor, habitat suitability index (HSI) values were attributed to different locations based on knowledge regarding its impact on tick populations. For the MCDA, two methods of factor combination were tested, additive and multiplicative, both which were evaluated at the spatial scales of departments and local municipalities. The resulting habitat suitability maps (resolution=100x100 m) revealed that conditions are suitable for I. ricinus over most of France and Corsica. Particularly suitable habitats were located in central, north-eastern and south-western France, while less-suitable habitats were found in the Mediterranean and mountainous regions. To validate the approach, the HSI scores were compared to field data of I. ricinus nymph abundance. Regardless of scale, the correlation between abundance indicator and HSI score was stronger for the additive than for the multiplicative approach. Overall, this study demonstrates the value of MCDA for estimating habitat suitability maps for I. ricinus abundance, which could be especially useful in highlighting areas of the tick's distribution where preventive measures should be prioritised.
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Affiliation(s)
- Isabelle Lebert
- University of Clermont Auvergne, INRAE, VetAgro Sup, Saint-Genès Champanelle, France; University of Lyon, INRAE, VetAgro Sup, Marcy l'Etoile, France.
| | - Séverine Bord
- University of Clermont Auvergne, INRAE, VetAgro Sup, Saint-Genès Champanelle, France; University of Paris-Saclay, INRAE, AgroParisTech, Paris, France.
| | | | - Eva Cassar
- University of Clermont Auvergne, INRAE, VetAgro Sup, Saint-Genès Champanelle, France; University of Lyon, INRAE, VetAgro Sup, Marcy l'Etoile, France.
| | - Patrick Gasqui
- University of Clermont Auvergne, INRAE, VetAgro Sup, Saint-Genès Champanelle, France; University of Lyon, INRAE, VetAgro Sup, Marcy l'Etoile, France.
| | | | - Karine Chalvet-Monfray
- University of Clermont Auvergne, INRAE, VetAgro Sup, Saint-Genès Champanelle, France; University of Lyon, INRAE, VetAgro Sup, Marcy l'Etoile, France.
| | - Sophie O Vanwambeke
- Georges Lemaître Centre for Earth and Climate research, Earth and Life Institute, UCLouvain, Louvain-la-Neuve, Belgium.
| | - Gwenaël Vourc'h
- University of Clermont Auvergne, INRAE, VetAgro Sup, Saint-Genès Champanelle, France; University of Lyon, INRAE, VetAgro Sup, Marcy l'Etoile, France.
| | - Magalie René-Martellet
- University of Clermont Auvergne, INRAE, VetAgro Sup, Saint-Genès Champanelle, France; University of Lyon, INRAE, VetAgro Sup, Marcy l'Etoile, France.
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Zhao J, Smith T, Lavigne M, Aenishaenslin C, Cox R, Fazil A, Johnson A, Sanchez J, Hermant B. A Rapid Literature Review of Multi-Criteria Decision Support Methods in the Context of One Health for All-Hazards Threat Prioritization. Front Public Health 2022; 10:861594. [PMID: 35493347 PMCID: PMC9051240 DOI: 10.3389/fpubh.2022.861594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/11/2022] [Indexed: 11/24/2022] Open
Abstract
Background Multi-Criteria Decision Analysis (MCDA) is a decision support tool that can be used in public health emergency management. The use of a One Health lens in MCDA can support the prioritization of threats and interventions which cut across the human, animal, and environmental domains. Previous literature reviews have focused on creating a snapshot of MCDA methodological trends. Our study provides an update to the MCDA methods literature with key considerations from a One Health perspective and addresses the application of MCDA in an all-hazards decision-making context. Methods We conducted a literature search on MEDLINE, EMBASE, SCOPUS, the CAB database, and a limited online gray literature search in partnership with a librarian from Health Canada. Articles were limited to those published in the year 2010 or later in a high-income setting (OECD member countries). Results Sixty-two articles were included for synthesis. Of these articles, most were Canadian studies (20%); and prioritized health risks, threats, and interventions in the human domain (69%). Six commonly used prioritization criteria were identified: threat, health, intervention, strategic, social, and economic impact. Stakeholders were engaged in 85% of studies and commonly consisted of government groups, non-governmental groups, subject matter experts, and the public. While most articles (65%) included elements of One Health based on our definition, only 5 studies (9%) explicitly acknowledged One Health as a guiding principle for the study. Forty seven percentage of studies noted that MCDA was beneficial in supporting the decision-making process. Conclusion Current literature on health prioritization presents some variability in the depth of integration of the One Health framework and on the use of various MCDA methodologies given prioritization objectives. Studies which applied a comprehensive One Health approach, prioritized disparate threats, or conducted cyclical prioritizations for governing bodies were broad in scope, but sparse. The results of our review indicate the need for better guidance on the integration of a One Health approach and the use of various MCDA methods given the main prioritization objectives.
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Affiliation(s)
- Jiawei Zhao
- Risk and Capability Assessment Unit, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Tiffany Smith
- Risk and Capability Assessment Unit, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Melissa Lavigne
- Risk and Capability Assessment Unit, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Cécile Aenishaenslin
- Department of Pathology and Microbiology, University of Montreal, Montreal, QC, Canada
- Centre de recherche en santé publique de L'Université de Montréal et du CIUSSS du Centre-Sud-de-L'Île-de-Montréal, Montréal, QC, Canada
| | - Ruth Cox
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
- National Wildlife Management Centre, Animal and Plant Health Agency, Woodchester Park, United Kingdom
| | - Aamir Fazil
- National Microbiology Laboratory, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Ana Johnson
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada
| | - Javier Sanchez
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Benoit Hermant
- Risk and Capability Assessment Unit, Public Health Agency of Canada, Ottawa, ON, Canada
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Talantsev A, Fasth T, Wenner C, Wolff E, Larsson A. Evaluation of pharmaceutical intervention strategies against pandemics in Sweden: A scenario‐driven multiple criteria decision analysis study. JOURNAL OF MULTI-CRITERIA DECISION ANALYSIS 2022. [DOI: 10.1002/mcda.1779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Anton Talantsev
- Department of Computer and Systems Sciences Stockholm University Stockholm Sweden
| | - Tobias Fasth
- Department of Computer and Systems Sciences Stockholm University Stockholm Sweden
- Public Health Analysis and Data Management Public Health Agency of Sweden Solna Sweden
| | - Cenny Wenner
- Public Health Analysis and Data Management Public Health Agency of Sweden Solna Sweden
| | - Ellen Wolff
- Public Health Analysis and Data Management Public Health Agency of Sweden Solna Sweden
| | - Aron Larsson
- Department of Computer and Systems Sciences Stockholm University Stockholm Sweden
- Risk and Crisis Research Centre Mid Sweden University Sundsvall Sweden
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Lima Y, Pinheiro W, Barbosa CE, Magalhães M, Chaves M, de Souza JM, Rodrigues S, Xexéo G. Development of an Index for the Inspection of Aedes aegypti Breeding Sites in Brazil: Multi-criteria Analysis. JMIR Public Health Surveill 2021; 7:e19502. [PMID: 33970118 PMCID: PMC8145087 DOI: 10.2196/19502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 02/20/2021] [Accepted: 03/19/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Aedes aegypti is a vector for the transmission of diseases such as dengue fever, chikungunya, Zika fever, and yellow fever. In 2016, over 1 million cases of these diseases were reported in Brazil, which is an alarming public health issue. One of the ways of controlling this disease is by inspecting and neutralizing the places where A. aegypti lays its eggs. The Ministry of Planning, Development, and Administration of Brazil maintains the inspection statistics. OBJECTIVE We propose a multi-criteria analysis to create an index for A. aegypti inspections reported through the Ministry of Planning, Development, and Administration system of Brazil. METHODS Based on the repository from urban cleaning services combined with data on inspections conducted by government agencies in several Brazilian cities and municipalities, we selected and combined metrics, which we further ranked using the analytic hierarchy process methodology. We also developed risk maps based on the analytic hierarchy process ranking of the A. aegypti breeding sites. RESULTS Based on our analysis and the available data, the priority for inspections should consider the number of sick people (weight 0.350), medical evaluations (weight 0.239), inspections (weight 0.201), mosquito breeding sites (weight 0.126), and days of absence from work (weight 0.096). CONCLUSIONS The proposed index could aid public health practitioners in preventing the appearance of new A. aegypti breeding sites. This information technology application can help solve such public health challenges.
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Affiliation(s)
- Yuri Lima
- Graduate School of Engineering (COPPE), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Wallace Pinheiro
- Graduate School of Engineering (COPPE), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.,Military School of Engineering (IME), Rio de Janeiro, Brazil
| | - Carlos Eduardo Barbosa
- Graduate School of Engineering (COPPE), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.,Center of Analysis of Naval Systems (CASNAV), Brazilian Navy, Rio de Janeiro, Brazil
| | - Matheus Magalhães
- Graduate School of Engineering (COPPE), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.,Center of Analysis of Naval Systems (CASNAV), Brazilian Navy, Rio de Janeiro, Brazil
| | - Miriam Chaves
- National Laboratory of Scientific Computation, Brazilian Ministry of Science, Technology, Innovation, and Communications, Petrópolis, Brazil
| | - Jano Moreira de Souza
- Graduate School of Engineering (COPPE), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | | | - Geraldo Xexéo
- Graduate School of Engineering (COPPE), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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Bouchard C, Aenishaenslin C, Rees EE, Koffi JK, Pelcat Y, Ripoche M, Milord F, Lindsay LR, Ogden NH, Leighton PA. Integrated Social-Behavioral and Ecological Risk Maps to Prioritize Local Public Health Responses to Lyme Disease. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:047008. [PMID: 29671475 PMCID: PMC6071748 DOI: 10.1289/ehp1943] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 03/15/2018] [Accepted: 03/19/2018] [Indexed: 05/31/2023]
Abstract
BACKGROUND The risk of contracting Lyme disease (LD) can vary spatially because of spatial heterogeneity in risk factors such as social-behavior and exposure to ecological risk factors. Integrating these risk factors to inform decision-making should therefore increase the effectiveness of mitigation interventions. OBJECTIVES The objective of this study was to develop an integrated social-behavioral and ecological risk-mapping approach to identify priority areas for LD interventions. METHODS The study was conducted in the Montérégie region of Southern Quebec, Canada, where LD is a newly endemic disease. Spatial variation in LD knowledge, risk perceptions, and behaviors in the population were measured using web survey data collected in 2012. These data were used as a proxy for the social-behavioral component of risk. Tick vector population densities were measured in the environment during field surveillance from 2007 to 2012 to provide an index of the ecological component of risk. Social-behavioral and ecological components of risk were combined with human population density to create integrated risk maps. Map predictions were validated by testing the association between high-risk areas and the current spatial distribution of human LD cases. RESULTS Social-behavioral and ecological components of LD risk had markedly different distributions within the study region, suggesting that both factors should be considered for locally adapted interventions. The occurrence of human LD cases in a municipality was positively associated with tick density (p<0.01) but was not significantly associated with social-behavioral risk. CONCLUSION This study is an applied demonstration of how integrated social-behavioral and ecological risk maps can be created to assist decision-making. Social survey data are a valuable but underutilized source of information for understanding regional variation in LD exposure, and integrating this information into risk maps provides a novel approach for prioritizing and adapting interventions to the local characteristics of target populations. https://doi.org/10.1289/EHP1943.
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Affiliation(s)
- Catherine Bouchard
- Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, Saint-Hyacinthe, Québec, Canada
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire (FMV), Université de Montréal, Saint-Hyacinthe, Québec, Canada
| | - Cécile Aenishaenslin
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire (FMV), Université de Montréal, Saint-Hyacinthe, Québec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Erin E Rees
- Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, Saint-Hyacinthe, Québec, Canada
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire (FMV), Université de Montréal, Saint-Hyacinthe, Québec, Canada
| | - Jules K Koffi
- Policy Integration and Zoonoses Division, Centre for Foodborne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada, Saint-Hyacinthe, Québec, Canada
| | - Yann Pelcat
- Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, Saint-Hyacinthe, Québec, Canada
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire (FMV), Université de Montréal, Saint-Hyacinthe, Québec, Canada
| | - Marion Ripoche
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire (FMV), Université de Montréal, Saint-Hyacinthe, Québec, Canada
| | - François Milord
- Direction de santé publique de la Montérégie, Centre intégré de santé et de services sociaux Montérégie-Centre, Québec, Canada
| | - L Robbin Lindsay
- Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Nicholas H Ogden
- Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, Saint-Hyacinthe, Québec, Canada
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire (FMV), Université de Montréal, Saint-Hyacinthe, Québec, Canada
| | - Patrick A Leighton
- Groupe de recherche en épidémiologie des zoonoses et santé publique (GREZOSP), Faculté de médecine vétérinaire (FMV), Université de Montréal, Saint-Hyacinthe, Québec, Canada
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Hoshikawa K, Ono S. Discrepancies between multicriteria decision analysis-based ranking and intuitive ranking for pharmaceutical benefit-risk profiles in a hypothetical setting. J Clin Pharm Ther 2016; 42:80-86. [PMID: 27914099 DOI: 10.1111/jcpt.12486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 11/04/2016] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Multicriteria decision analysis (MCDA) has been generally considered a promising decision-making methodology for the assessment of drug benefit-risk profiles. There have been many discussions in both public and private sectors on its feasibility and applicability, but it has not been employed in official decision-makings. For the purpose of examining to what extent MCDA would reflect the first-hand, intuitive preference of evaluators in practical pharmaceutical assessments, we conducted a questionnaire survey involving the participation of employees of pharmaceutical companies. METHODS Showing profiles of the efficacy and safety of four hypothetical drugs, each respondent was asked to rank them following the standard MCDA process and then to rank them intuitively (i.e. without applying any analytical framework). RESULTS AND DISCUSSION These two approaches resulted in substantially different ranking patterns from the same individuals, and the concordance rate was surprisingly low (17%). Although many respondents intuitively showed a preference for mild, balanced risk-benefit profiles over profiles with a conspicuous advantage in either risk or benefit, the ranking orders based on MCDA scores did not reflect the intuitive preference. WHAT IS NEW AND CONCLUSION Observed discrepancies between the rankings seemed to be primarily attributed to the structural characteristics of MCDA, which assumes that evaluation on each benefit and risk component should have monotonic impact on final scores. It would be difficult for MCDA to reflect commonly observed non-monotonic preferences for risk and benefit profiles. Possible drawbacks of MCDA should be further investigated prior to the real-world application of its benefit-risk assessment.
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Affiliation(s)
- K Hoshikawa
- Laboratory of Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan
| | - S Ono
- Laboratory of Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan
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Aenishaenslin C, Michel P, Ravel A, Gern L, Waaub JP, Milord F, Bélanger D. Acceptability of tick control interventions to prevent Lyme disease in Switzerland and Canada: a mixed-method study. BMC Public Health 2016; 16:12. [PMID: 26733007 PMCID: PMC4700560 DOI: 10.1186/s12889-015-2629-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 12/16/2015] [Indexed: 11/10/2022] Open
Abstract
Background Lyme disease control strategies may include tick control interventions in high risk areas. Public authorities may be interested to assess how these types of interventions are perceived by the public which may then impact their acceptability. The aims of this paper are to compare socio-cognitive factors associated with high acceptability of tick control interventions and to describe perceived issues that may explain their low acceptability in populations living in two different regions, one being an endemic region for LD since the last 30 years, the Neuchâtel canton, in Switzerland, and another where the disease is emerging, the Montérégie region, in Canada. Methods A mixed methods’ design was chosen. Quantitative data were collected using web-surveys conducted in both regions (n = 814). Multivariable logistic regressions were used to compare socio-cognitive factors associated with high acceptability of selected interventions. Qualitative data were collected using focus group’s discussions to describe perceived issues relative to these interventions. Results Levels of acceptability in the studied populations were the lowest for the use of acaricides and landscaping and were under 50 % in both regions for six out of eight interventions, but were higher overall in Montérégie. High perceived efficacy of the intervention was strongly associated with high acceptability of tick control interventions. A high perceived risk about LD was also associated with a high acceptability of intervention under some models. High level of knowledge about LD was negatively associated with high acceptability of the use of acaricides in Neuchâtel. Perceived issues explaining low acceptability included environmental impacts, high costs to the public system, danger of individual disempowerment and perceptions that tick control interventions were disproportionate options for the level of LD risk. Conclusion This study suggests that the perceived efficacy and LD risk perception may be key factors to target to increase the acceptability of tick control interventions. Community-level issues seem to be important considerations driving low acceptability of public health interventions. Results of this study highlight the importance for decision-makers to account for socio-cognitive factors and perceived issues that may affect the acceptability of public health interventions in order to maximize the efficacy of actions to prevent and control LD.
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Affiliation(s)
- Cécile Aenishaenslin
- Research Group on Epidemiology of Zoonoses and Public Health, Pavillon de la santé publique, Faculté de médecine vétérinaire, Université de Montréal, CP 5000, Saint-Hyacinthe, J2S 7C6, Québec, Canada. .,Département de pathologie et microbiologie, Faculté de médecine vétérinaire, Université de Montréal, CP 5000, Saint-Hyacinthe, J2S 7C6, Québec, Canada.
| | - Pascal Michel
- Research Group on Epidemiology of Zoonoses and Public Health, Pavillon de la santé publique, Faculté de médecine vétérinaire, Université de Montréal, CP 5000, Saint-Hyacinthe, J2S 7C6, Québec, Canada. .,Laboratory for Foodborne Zoonoses, Public Health Agency of Canada, CP 5000, Saint-Hyacinthe, H2S 7C6, Québec, Canada.
| | - André Ravel
- Département de pathologie et microbiologie, Faculté de médecine vétérinaire, Université de Montréal, CP 5000, Saint-Hyacinthe, J2S 7C6, Québec, Canada.
| | - Lise Gern
- Laboratoire d'Eco-Épidémiologie, Institut de Biologie, Université de Neuchâtel, 11 Émile-Argand, CP 158, 2009, Neuchâtel, Switzerland.
| | - Jean-Philippe Waaub
- Group for Research in Decision Analysis (GERAD), 3000 Côte-Sainte-Catherine, Montréal, H3T 2A7, Québec, Canada.
| | - François Milord
- Institut national de santé publique du Québec, 1255 Beauregard, Longueuil, J4K 2M3, Québec, Canada.
| | - Denise Bélanger
- Research Group on Epidemiology of Zoonoses and Public Health, Pavillon de la santé publique, Faculté de médecine vétérinaire, Université de Montréal, CP 5000, Saint-Hyacinthe, J2S 7C6, Québec, Canada. .,Département de pathologie et microbiologie, Faculté de médecine vétérinaire, Université de Montréal, CP 5000, Saint-Hyacinthe, J2S 7C6, Québec, Canada.
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