Adapting vector surveillance using Bayesian experimental design: An application to an ongoing tick monitoring program in the southeastern United States

Maps of the distribution of medically-important ticks throughout the US remain lacking in spatial and temporal resolution in many areas, leading to holes in our understanding of where and when people are at risk of tick encounters, an important baseline for informing public health response. In this work, we demonstrate the use of Bayesian Experimental Design (BED) in planning spatiotemporal surveillance of disease vectors. We frame survey planning as an optimization problem with the objective of identifying a calendar of sampling locations that maximizes the expected information regarding some goal. Here we consider the goals of understanding associations between environmental factors and tick presence and minimizing uncertainty in high risk areas. We illustrate our proposed BED workflow using an ongoing tick surveillance study in South Carolina parks. Following a model comparison study based on two years of initial data, several techniques for finding optimal surveys were compared to random sampling. Two optimization algorithms found surveys better than all replications of random sampling, while a space-filling heuristic performed favorably as well. Further, optimal surveys of just 20 visits were more effective than repeating the schedule of 111 visits used in 2021. We conclude that BED shows promise as a flexible and rigorous means of survey design for vector control, and could help alleviate pressure on local agencies by limiting the resources necessary for accurate information on arthropod distributions. We have made the code for our BED workflow publicly available on Zenodo to help promote the application of these methods to future surveillance efforts.

Accurately summarizing an outbreak using epidemiological models takes time

Recent outbreaks of Mpox and Ebola, and worrying waves of COVID-19, influenza and respiratory syncytial virus, have all led to a sharp increase in the use of epidemiological models to estimate key epidemiological parameters. The feasibility of this estimation task is known as the practical identifiability (PI) problem. Here, we investigate the PI of eight commonly reported statistics of the classic susceptible-infectious-recovered model using a new measure that shows how much a researcher can expect to learn in a model-based Bayesian analysis of prevalence data. Our findings show that the basic reproductive number and final outbreak size are often poorly identified, with learning exceeding that of individual model parameters only in the early stages of an outbreak. The peak intensity, peak timing and initial growth rate are better identified, being in expectation over 20 times more probable having seen the data by the time the underlying outbreak peaks. We then test PI for a variety of true parameter combinations and find that PI is especially problematic in slow-growing or less-severe outbreaks. These results add to the growing body of literature questioning the reliability of inferences from epidemiological models when limited data are available.

Spatial epidemiology and adaptive targeted sampling to manage the Chagas disease vector Triatoma dimidiata

Widespread application of insecticide remains the primary form of control for Chagas disease in Central America, despite only temporarily reducing domestic levels of the endemic vector Triatoma dimidiata and having little long-term impact. Recently, an approach emphasizing community feedback and housing improvements has been shown to yield lasting results. However, the additional resources and personnel required by such an intervention likely hinders its widespread adoption. One solution to this problem would be to target only a subset of houses in a community while still eliminating enough infestations to interrupt disease transfer. Here we develop a sequential sampling framework that adapts to information specific to a community as more houses are visited, thereby allowing us to efficiently find homes with domiciliary vectors while minimizing sampling bias. The method fits Bayesian geostatistical models to make spatially informed predictions, while gradually transitioning from prioritizing houses based on prediction uncertainty to targeting houses with a high risk of infestation. A key feature of the method is the use of a single exploration parameter, α, to control the rate of transition between these two design targets. In a simulation study using empirical data from five villages in southeastern Guatemala, we test our method using a range of values for α, and find it can consistently select fewer homes than random sampling, while still bringing the village infestation rate below a given threshold. We further find that when additional socioeconomic information is available, much larger savings are possible, but that meeting the target infestation rate is less consistent, particularly among the less exploratory strategies. Our results suggest new options for implementing long-term T. dimidiata control.

Effective public health interventions for the control and elimination of neglected tropical diseases require an efficient use of resources while still causing long-term disease reduction at the community level. To use resources to best effect, areas most in need of control efforts must be identified. However, strategies for correctly identifying these areas are rarely known due to the complex environmental, biological, and cultural factors shaping disease spread. In turn, incorrect prioritization of control targets can cause the intervention to have no lasting effect. We address this tradeoff between efficiency and efficacy by adapting control priorities throughout an intervention, targeting areas of high uncertainty during the initial stages while shifting to areas of greatest risk at later stages. In the context of controlling Triatoma dimidiata, the primary vector of Chagas disease in several countries in Latin America, our methods provide a means of targeting only a subset of homes for insecticide and housing improvements, while still reducing a village’s overall infestation rate below the critical threshold.