A climate-driven and field data-assimilated population dynamics model of sand flies

Modelling spatiotemporal patterns of visceral leishmaniasis incidence in two endemic states in India using environment, bioclimatic and demographic data, 2013-2022

BACKGROUND

As of 2021, the National Kala-azar Elimination Programme (NKAEP) in India has achieved visceral leishmaniasis (VL) elimination (<1 case / 10,000 population/year per block) in 625 of the 633 endemic blocks (subdistricts) in four states. The programme needs to sustain this achievement and target interventions in the remaining blocks to achieve the WHO 2030 target of VL elimination as a public health problem. An effective tool to analyse programme data and predict/ forecast the spatial and temporal trends of VL incidence, elimination threshold, and risk of resurgence will be of use to the programme management at this juncture.

METHODOLOGY/PRINCIPAL FINDINGS

We employed spatiotemporal models incorporating environment, climatic and demographic factors as covariates to describe monthly VL cases for 8-years (2013-2020) in 491 and 27 endemic and non-endemic blocks of Bihar and Jharkhand states. We fitted 37 models of spatial, temporal, and spatiotemporal interaction random effects with covariates to monthly VL cases for 6-years (2013-2018, training data) using Bayesian inference via Integrated Nested Laplace Approximation (INLA) approach. The best-fitting model was selected based on deviance information criterion (DIC) and Watanabe-Akaike Information Criterion (WAIC) and was validated with monthly cases for 2019-2020 (test data). The model could describe observed spatial and temporal patterns of VL incidence in the two states having widely differing incidence trajectories, with >93% and 99% coverage probability (proportion of observations falling inside 95% Bayesian credible interval for the predicted number of VL cases per month) during the training and testing periods. PIT (probability integral transform) histograms confirmed consistency between prediction and observation for the test period. Forecasting for 2021-2023 showed that the annual VL incidence is likely to exceed elimination threshold in 16-18 blocks in 4 districts of Jharkhand and 33-38 blocks in 10 districts of Bihar. The risk of VL in non-endemic neighbouring blocks of both Bihar and Jharkhand are less than 0.5 during the training and test periods, and for 2021-2023, the probability that the risk greater than 1 is negligible (P<0.1). Fitted model showed that VL occurrence was positively associated with mean temperature, minimum temperature, enhanced vegetation index, precipitation, and isothermality, and negatively with maximum temperature, land surface temperature, soil moisture and population density.

CONCLUSIONS/SIGNIFICANCE

The spatiotemporal model incorporating environmental, bioclimatic, and demographic factors demonstrated that the KAMIS database of the national programmme can be used for block level predictions of long-term spatial and temporal trends in VL incidence and risk of outbreak / resurgence in endemic and non-endemic settings. The database integrated with the modelling framework and a dashboard facility can facilitate such analysis and predictions. This could aid the programme to monitor progress of VL elimination at least one-year ahead, assess risk of resurgence or outbreak in post-elimination settings, and implement timely and targeted interventions or preventive measures so that the NKAEP meet the target of achieving elimination by 2030.

Entomological surveillance and spatiotemporal risk assessment of sand fly-borne diseases in Cyprus

Visceral and cutaneous leishmaniases are important public health concerns in Cyprus. Although the diseases, historically prevalent on the island, were nearly eradicated by 1996, an increase in frequency and geographical spread has recently been recorded. Upward trends in leishmaniasis prevalence have largely been attributed to environmental changes that amplify the abundance and activity of its vector, the phlebotomine sand flies. Here, we performed an extensive field study across the island to map the sand fly fauna and compared the presence and distribution of the species found with historical records. We mapped the habitat preferences of Phlebotomus papatasi and P. tobbi, two medically important species, and predicted the seasonal abundance of P. papatasi at unprecedented spatiotemporal resolution using a climate-sensitive population dynamics model driven by high-resolution meteorological forecasting. Our compendium holds a record of 18 species and the locations of a subset, including those of potential public and veterinary health concern. We confirmed that P. papatasi is widespread, especially in densely urbanized areas, and predicted that its abundance uniformly peaks across the island at the end of summer. We identified potential hotspots of P. papatasi activity even after this peak. Our results form a foundation to inform public health planning and contribute to the development of effective, efficient, and environmentally sensitive strategies to control sand fly populations and prevent sand fly-borne diseases.

Current Status of Omics Studies Elucidating the Features of Reproductive Biology in Blood-Feeding Insects

Female insects belonging to the genera Anopheles, Aedes, Glossina, and Rhodnius account for the majority of global vector-borne disease mortality. In response to mating, these female insects undergo several molecular, physiological, and behavioral changes. Studying the dynamic post-mating molecular responses in these insects that transmit human diseases can lead to the identification of potential targets for the development of novel vector control methods. With the continued advancements in bioinformatics tools, we now have the capability to delve into various physiological processes in these insects. Here, we discuss the availability of multiple datasets describing the reproductive physiology of the common blood-feeding insects at the molecular level. Additionally, we compare the male-derived triggers transferred during mating to females, examining both shared and species-specific factors. These triggers initiate post-mating genetic responses in female vectors, affecting not only their reproductive success but also disease transmission.

A dynamically structured matrix population model for insect life histories observed under variable environmental conditions

Various environmental drivers influence life processes of insect vectors that transmit human disease. Life histories observed under experimental conditions can reveal such complex links; however, designing informative experiments for insects is challenging. Furthermore, inferences obtained under controlled conditions often extrapolate poorly to field conditions. Here, we introduce a pseudo-stage-structured population dynamics model to describe insect development as a renewal process with variable rates. The model permits representing realistic life stage durations under constant and variable environmental conditions. Using the model, we demonstrate how random environmental variations result in fluctuating development rates and affect stage duration. We apply the model to infer environmental dependencies from the life history observations of two common disease vectors, the southern (Culex quinquefasciatus) and northern (Culex pipiens) house mosquito. We identify photoperiod, in addition to temperature, as pivotal in regulating larva stage duration, and find that carefully timed life history observations under semi-field conditions accurately predict insect development throughout the year. The approach we describe augments existing methods of life table design and analysis, and contributes to the development of large-scale climate- and environment-driven population dynamics models for important disease vectors.

Sand flies: Basic information on the vectors of leishmaniasis and their interactions with Leishmania parasites

Blood-sucking arthropods transmit a variety of human pathogens acting as disseminators of the so-called vector-borne diseases. Leishmaniasis is a spectrum of diseases caused by different Leishmania species, transmitted quasi worldwide by sand flies. However, whereas many laboratories focus on the disease(s) and etiological agents, considerably less study the respective vectors. In fact, information on sand flies is neither abundant nor easy to find; aspects including basic biology, ecology, and sand-fly-Leishmania interactions are usually reported separately. Here, we compile elemental information on sand flies, in the context of leishmaniasis. We discuss the biology, distribution, and life cycle, the blood-feeding process, and the Leishmania-sand fly interactions that govern parasite transmission. Additionally, we highlight some outstanding questions that need to be answered for the complete understanding of parasite–vector–host interactions in leishmaniasis.

In this review, numerous aspects of sand flies as vectors of Leishmania parasites—from biology to the vector parasite interactions—are discussed.

Climate change impacts on infectious diseases in the Eastern Mediterranean and the Middle East (EMME)-risks and recommendations

The Eastern Mediterranean and Middle East (EMME) region has rapid population growth, large differences in socio-economic levels between developed and developing countries, migration, increased water demand, and ecosystems degradation. The region is experiencing a significant warming trend with longer and warmer summers, increased frequency and severity of heat waves, and a drier climate. While climate change plays an important role in contributing to political instability in the region through displacement of people, food insecurity, and increased violence, it also increases the risks of vector-, water-, and food-borne diseases. Poorer and less educated people, young children and the elderly, migrants, and those with long-term health problems are at highest risk. A result of the inequalities among EMME countries is an inconsistency in the availability of reliable evidence about the impacts on infectious diseases. To help address this gap, a search of the literature was conducted as a basis for related recommended responses and suggested actions for preparedness and prevention. Since climate change already impacts the health of vulnerable populations in the EMME and will have a greater impact in future years, risk assessment and timely design and implementation of health preparedness and adaptation strategies are essential. Joint national and cross-border infectious diseases management systems for more effective preparedness and prevention are needed, supported by interventions that improve the environment. Without such cooperation and effective interventions, climate change will lead to an increasing morbidity and mortality in the EMME from infectious diseases, with a higher risk for the most vulnerable populations.

Climate change and infectious disease in Europe: Impact, projection and adaptation

Europeans are not only exposed to direct effects from climate change, but also vulnerable to indirect effects from infectious disease, many of which are climate sensitive, which is of concern because of their epidemic potential. Climatic conditions have facilitated vector-borne disease outbreaks like chikungunya, dengue, and West Nile fever and have contributed to a geographic range expansion of tick vectors that transmit Lyme disease and tick-borne encephalitis. Extreme precipitation events have caused waterborne outbreaks and longer summer seasons have contributed to increases in foodborne diseases. Under the Green Deal, The European Union aims to support climate change health policy, in order to be better prepared for the next health security threat, particularly in the aftermath of the traumatic COVID-19 experience. To bolster this policy process we discuss climate change-related hazards, exposures and vulnerabilities to infectious disease and describe observed impacts, projected risks, with policy entry points for adaptation to reduce these risks or avoid them altogether.

Influence of Temperature on the Life-Cycle Dynamics of Aedes albopictus Population Established at Temperate Latitudes: A Laboratory Experiment

Simple Summary

Mosquitoes represent a potential major public health concern, as they are capable of transmitting several pathogens when biting humans. It is well known that temperature is a crucial factor affecting mosquito biology: for instance, warmer conditions can increase survival and fecundity. Here, we quantify the influence of different temperatures on the bionomics of Aedes albopictus, which is a mosquito species native to Southeast Asia that has been able to spread worldwide during the last forty years. We used specimens collected from northern Italy to assess if temperate individuals are characterized, possibly thanks to an adaptation process, by a different thermal response with respect to subtropical individuals. We found that immature stages are well adapted to colder temperatures, which nonetheless seem to prevent any blood-feeding activity. Adult longevity and fecundity were substantially greater at mild conditions. This thermal adaptation might increase the length of the breeding season and could allow the colonization of areas at higher altitude, resulting in an overall increased risk for potential transmission of Ae. albopictus-borne pathogens.

Abstract

The mosquito species Aedes albopictus has successfully colonized many areas at temperate latitudes, representing a major public health concern. As mosquito bionomics is critically affected by temperature, we experimentally investigated the influence of different constant rearing temperatures (10, 15, 25, and 30 °C) on the survival rates, fecundity, and developmental times of different life stages of Ae. albopictus using a laboratory colony established from specimens collected in northern Italy. We compared our results with previously published data obtained with subtropical populations. We found that temperate Ae. albopictus immature stages are better adapted to colder temperatures: temperate larvae were able to develop even at 10 °C and at 15 °C, larval survivorship was comparable to the one observed at warmer conditions. Nonetheless, at these lower temperatures, we did not observe any blood-feeding activity. Adult longevity and fecundity were substantially greater at 25 °C with respect to the other tested temperatures. Our findings highlight the ability of Ae. albopictus to quickly adapt to colder environments and provide new important insights on the bionomics of this species at temperate latitudes.

Species diversity and molecular insights into phlebotomine sand flies in Sardinia (Italy)-an endemic region for leishmaniasis

This study provides updated information on the distribution of the phlebotomine sand fly species and their genetic characterization in Sardinia, a Mediterranean island where leishmaniasis is endemic. From April to November 2017, sand flies were trapped in five different capture sites using sticky traps and light traps as collection methods, operated nearby sheep, poultry, cat, and dog shelters. Phlebotomine specimens (n = 513) collected were morphologically and molecularly identified as Phlebotomus perniciosus (249/513, 48.5%), Phlebotomus perfiliewi (236/513; 46%), and Sergentomyia minuta (28/513, 5.5%). Sand flies were collected from the second half of May to October confirming the well-defined seasonal activity, which peaks in August in Sardinia. Overall, correlation analyses indicated a significant positive association between the monthly number of sand flies collected and the mean temperature (r = 0.88, rho = 0.87, and tau = 0.69, P < 0.05), while there was non-significant, moderately negative correlation between the monthly number of sand flies collected and the monthly mean relative humidity and wind (r = - 0.22, rho = 0.02, and tau = 0.04, P > 0.05). This study provides the first data on the molecular characterization of phlebotomine sand flies in this region and confirms the presence of three sand fly species. Molecular results suggest that the morphological features used for analysis represent synapomorphic-derived characters which are shared among descendant taxa and the common ancestor.

Effects of time-lagged meteorological variables on attributable risk of leishmaniasis in central region of Afghanistan

BACKGROUND

Leishmaniasis remains one of the world's most neglected vector-borne diseases, affecting predominantly poor communities mainly in developing countries. Previous studies have shown that the distribution and dynamics of leishmaniasis infections are sensitive to environmental factors, however, there are no studies on the burden of leishmaniasis attributable to time-varying meteorological variables.

METHODS

This study used data from 3 major leishmaniosis afflicted provinces of Afghanistan, between 2003 and 2009, to provide empirical analysis of change in heat/cold-leishmaniosis association. Non-linear and delayed exposure-lag-response relationship between meteorological variables and leishmaniasis were fitted with a distributed lag non-linear model applying a spline function which describes the dependency along the range of values with a lag of up to 12 months. We estimated the risk of leishmaniasis attributable to high and low temperature.

RESULTS

The median monthly mean temperature and rainfall were 16.1 °C and 0.6 in., respectively. Seasonal variations of leishmaniasis were consistent between males and females, however significant differences were observed among different age groups. Temperature effects were immediate and persistent (lag 0-12 months). The cumulative risks were highest at cold temperatures. The cumulative relative risks (logRR) for leishmaniasis were 6.16 (95% CI: 5.74-6.58) and 1.15 (95% CI: 1.32-1.31) associated with the 10th percentile temperature (2.16 °C) and the 90th percentile temperature (28.46 °C). The subgroup analysis showed increased risk for males as well as young and middle aged people at cold temperatures, however, higher risk was observed for the elderly in heat. The overall leishmaniasis-temperature attributable fractions was estimated to be 7.6% (95% CI: 7.5%-7.7%) and mostly due to cold.

CONCLUSION

Findings in this study highlight the non-linearity, delay of effects and magnitude of leishmaniasis risk associated with temperature. The disparity of risk between different subgroups can hopefully advise policy makers and assist in leishmaniasis control program.

The changing distribution of Leishmania infantum Nicolle, 1908 and its Mediterranean sandfly vectors in the last 140 kys

The understanding of the effects of past climatic changes on the distribution of vector arthropods can strongly support the understanding of the future potential impact of anthropogenic climatic change on the geographical risk of vector-borne diseases. The zoogeographical patterns of the European sandfly vectors may suffer the continuously changing climate of the last 140 kys. The former range of L. infantum and six Phlebotomus species were modelled for the Last Interglacial, the Last Glacial Maximum and the Mid-Holocene Periods. It was found that the potential distribution of the parasite was much smaller in the Last Glacial Period L. infantum mainly could persist in the western shelves of the Mediterranean Sea. West and East Mediterranean sandfly species inhabited partly distinct refugia. The Apennine Peninsula, Sicily and the Iberian refugium formed a habitat chain along with the coastal areas of the West Mediterranean Basin. There was no direct connection between the Eastern and the Western sandfly refugia in the last 140 kys. The modelled distribution of sandfly taxa for the Middle Holocene Period can explain the relict populations of sandfly taxa in such Central European countries. The former genetic studies strongly confirm the existence of the modelled glacial refugees.