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Phillips MT, Sánchez-González L, Shragai T, Rodriguez DM, Major CG, Johansson MA, Rivera-Amill V, Paz-Bailey G, Adams LE. Quantifying the relationship between arboviral infection prevalence and human mobility patterns among participants of the Communities Organized to Prevent Arboviruses cohort (COPA) in southern Puerto Rico. PLoS Negl Trop Dis 2023; 17:e0011840. [PMID: 38100525 PMCID: PMC10756524 DOI: 10.1371/journal.pntd.0011840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 12/29/2023] [Accepted: 12/04/2023] [Indexed: 12/17/2023] Open
Abstract
Human movement is increasingly being recognized as a major driver of arbovirus risk and dissemination. The Communities Organized to Prevent Arboviruses (COPA) study is a cohort in southern Puerto Rico to measure arboviral prevalence, evaluate interventions, and collect mobility data. To quantify the relationship between arboviral prevalence and human mobility patterns, we fit multilevel logistic regression models to estimate odds ratios for mobility-related predictors of positive chikungunya IgG or Zika IgM test results collected from COPA, assuming mobility data does not change substantially from year to year. From May 8, 2018-June 8, 2019, 39% of the 1,845 active participants during the study period had a positive arboviral seroprevalence result. Most (74%) participants reported spending five or more weekly hours outside of their home. A 1% increase in weekly hours spent outside the home was associated with a 4% (95% confidence interval (CI): 2-7%) decrease in the odds of testing positive for arbovirus. After adjusting for age and whether a person had air conditioning (AC) at home, any time spent in a work location was protective against arbovirus infection (32% decrease, CI: 9-49%). In fact, there was a general decreased prevalence for individuals who visited locations that were inside and had AC or screens, regardless of the type of location (32% decrease, CI: 12-47%). In this population, the protective characteristics of locations visited appear to be the most important driver of the relationship between mobility and arboviral prevalence. This relationship indicates that not all mobility is the same, with elements like screens and AC providing protection in some locations. These findings highlight the general importance of AC and screens, which are known to be protective against mosquitoes and mosquito-transmitted diseases.
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Affiliation(s)
- Maile T. Phillips
- Dengue Branch, Division of Vector-borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Liliana Sánchez-González
- Dengue Branch, Division of Vector-borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Talya Shragai
- Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Dania M. Rodriguez
- Dengue Branch, Division of Vector-borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Chelsea G. Major
- Dengue Branch, Division of Vector-borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Michael A. Johansson
- Dengue Branch, Division of Vector-borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | | | - Gabriela Paz-Bailey
- Dengue Branch, Division of Vector-borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
| | - Laura E. Adams
- Dengue Branch, Division of Vector-borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico
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Custer B, Grebe E, Buccheri R, Bakkour S, Stone M, Capuani L, Alencar C, Amorim L, Loureiro P, Carneiro-Proietti AB, Mendrone-Junior A, Gonçalez T, Gao K, Livezey KW, Linnen JM, Brambilla D, McClure C, Busch MP, Sabino EC. Surveillance for Zika, Chikungunya, and Dengue Virus Incidence and RNAemia in Blood Donors at 4 Brazilian Blood Centers During 2016-2019. J Infect Dis 2023; 227:696-707. [PMID: 35687888 PMCID: PMC10152499 DOI: 10.1093/infdis/jiac173] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/12/2022] [Accepted: 05/03/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Except for public health case reports, the incidence of Zika virus (ZIKV), chikungunya virus (CHIKV), and dengue virus (DENV) infection are not available to assess the potential blood transfusion safety threat in Brazil. METHODS Pools of 6 donation samples (MP6) left over from human immunodeficiency virus, hepatitis B virus, and hepatitis C virus nucleic acid testing were combined to create MP18 pools (3 MP6 pools). Samples were tested using the Grifols triplex ZIKV, CHIKV, and DENV real-time transcription mediated amplification assay to estimate prevalence of RNAemia and incidence, and to compare these results to case reports in São Paulo, Belo Horizonte, Recife, and Rio de Janeiro, from April 2016 through June 2019. RESULTS ZIKV, CHIKV, and DENV RNAemia were found from donors who donated without overt symptoms of infection that would have led to deferral. The highest RNAemic donation prevalence was 1.2% (95% CI, .8%-1.9%) for DENV in Belo Horizonte in May 2019. Arbovirus infections varied by location and time of year, and were not always aligned with annual arbovirus outbreak seasons in different regions of the country. CONCLUSIONS Testing donations for arboviruses in Brazil can contribute to public health. Transfusion recipients were likely exposed to ZIKV, CHIKV, and DENV viremic blood components during the study period.
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Affiliation(s)
- Brian Custer
- Vitalant Research Institute, San Francisco, California, USA.,Department of Laboratory Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Eduard Grebe
- Vitalant Research Institute, San Francisco, California, USA.,Department of Laboratory Medicine, University of California, San Francisco, San Francisco, California, USA.,Department of Science and Innovation, National Research Foundation Centre of Excellence in Epidemiological Modelling and Analysis, Stellenbosch University, Stellenbosch, South Africa
| | | | - Sonia Bakkour
- Vitalant Research Institute, San Francisco, California, USA.,Department of Laboratory Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Mars Stone
- Vitalant Research Institute, San Francisco, California, USA.,Department of Laboratory Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Ligia Capuani
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Cecilia Alencar
- Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Paula Loureiro
- Fundação Hemope, Recife, Brazil.,Faculdade de Medicina da Universidade de Pernambuco, Recife, Brazil
| | | | | | | | - Kui Gao
- Grifols Diagnostics Solutions, San Diego, California, USA
| | | | | | - Don Brambilla
- Research Triangle Institute International, Rockville, Maryland, USA
| | - Chris McClure
- Research Triangle Institute International, Rockville, Maryland, USA
| | - Michael P Busch
- Vitalant Research Institute, San Francisco, California, USA.,Department of Laboratory Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Ester C Sabino
- Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Sánchez-González L, Adams LE, Saavedra R, Little EM, Medina NA, Major CG, Bruck M, Miranda J, Rosado-Santiago C, Ryff K, Ortiz M, Brown G, Barrera R, Pérez-Guerra CL, Rivera-Amill V, Paz-Bailey G. Assessment of community support for Wolbachia-mediated population suppression as a control method for Aedes aegypti mosquitoes in a community cohort in Puerto Rico. PLoS Negl Trop Dis 2021; 15:e0009966. [PMID: 34871301 PMCID: PMC8675917 DOI: 10.1371/journal.pntd.0009966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 12/16/2021] [Accepted: 11/03/2021] [Indexed: 11/21/2022] Open
Abstract
Arboviral diseases transmitted by Aedes species mosquitoes pose an increasing public health challenge in tropical regions. Wolbachia-mediated population suppression (Wolbachia suppression) is a vector control method used to reduce Aedes mosquito populations by introducing male mosquitoes infected with Wolbachia, a naturally occurring endosymbiotic bacterium. When Wolbachia-infected male mosquitoes mate with female wild mosquitoes, the resulting eggs will not hatch. Public support is vital to the successful implementation and sustainability of vector control interventions. Communities Organized to Prevent Arboviruses (COPA) is a cohort study to determine the incidence of arboviral disease in Ponce, Puerto Rico and evaluate vector control methods. Focus groups were conducted with residents of COPA communities to gather their opinion on vector control methods; during 2018–2019, adult COPA participants were interviewed regarding their views on Wolbachia suppression; and a follow-up questionnaire was conducted among a subset of participants and non-participants residing in COPA communities. We analyzed factors associated with support for this method. Among 1,528 participants in the baseline survey, median age was 37 years and 63% were female. A total of 1,032 (68%) respondents supported Wolbachia suppression. Respondents with an income of $40,000 or more were 1.34 times as likely [95% CI: 1.03, 1.37] to support Wolbachia suppression than those who earned less than $40,000 annually. Respondents who reported repellant use were 1.19 times as likely to support Wolbachia suppression [95% CI: 1.03, 1.37]. A follow-up survey in 2020 showed that most COPA participants (86%) and non-participants living in COPA communities (84%) supported Wolbachia suppression during and after an educational campaign. The most frequent questions regarding this method were related to its impact on human and animal health, and the environment. Continuous community engagement and education efforts before and during the implementation of novel vector control interventions are necessary to increase and maintain community support. Vector control is key to decrease the incidence of viral infections transmitted by Aedes mosquitoes, like dengue, but traditional control methods like insecticides and breeding sites reduction can be time-consuming, ineffective, and challenged by insecticide resistance. In the method known as Wolbachia suppression, male mosquitoes infected with the bacterium Wolbachia are released to mate with wild female mosquitoes. As the resulting eggs do not hatch, the mosquito population decreases over time. As public support is key to implement and maintain any vector control method, we assessed community support for Wolbachia suppression through focus groups and interviews with residents of Ponce, Puerto Rico, where a community cohort has been implemented. Support for this method in this population was high and increased after an educational campaign. Respondents with higher income and those who used repellent in the last 30 days were more likely to support Wolbachia suppression. Questions regarding the impact of this method on human and animal health, and the environment, were the most reported. Community engagement activities to increase the understanding of the method, including clear and specific information on health risk assessments, should be conducted before and during the implementation of Wolbachia suppression.
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Affiliation(s)
| | - Laura E. Adams
- CDC Division of Vector Borne Diseases, Dengue Branch, San Juan, Puerto Rico
| | | | - Emma M. Little
- CDC Division of Vector Borne Diseases, Dengue Branch, San Juan, Puerto Rico
| | - Nicole A. Medina
- CDC Division of Vector Borne Diseases, Dengue Branch, San Juan, Puerto Rico
| | - Chelsea G. Major
- CDC Division of Vector Borne Diseases, Dengue Branch, San Juan, Puerto Rico
| | - Marina Bruck
- Emory University, Atlanta, Georgia, United States of America
| | | | | | - Kyle Ryff
- CDC Division of Vector Borne Diseases, Dengue Branch, San Juan, Puerto Rico
| | | | - Grayson Brown
- Puerto Rico Vector Control Unit, San Juan, Puerto Rico
| | - Roberto Barrera
- CDC Division of Vector Borne Diseases, Dengue Branch, San Juan, Puerto Rico
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