Assessment of risk of dengue and yellow fever virus transmission in three major Kenyan cities based on Stegomyia indices

Analyses of Mosquito Species Composition, Blood-Feeding Habits and Infection with Insect-Specific Flaviviruses in Two Arid, Pastoralist-Dominated Counties in Kenya

Insect-specific flaviviruses (ISFs), although not known to be pathogenic to humans and animals, can modulate the transmission of arboviruses by mosquitoes. In this study, we screened 6665 host-seeking, gravid and blood-fed mosquitoes for infection with flaviviruses and assessed the vertebrate hosts of the blood-fed mosquitoes sampled in Baringo and Kajiado counties; both dryland ecosystem counties in the Kenyan Rift Valley. Sequence fragments of two ISFs were detected. Cuacua virus (CuCuV) was found in three blood-fed Mansonia (Ma.) africana. The genome was sequenced by next-generation sequencing (NGS), confirming 95.8% nucleotide sequence identity to CuCuV detected in Mansonia sp. in Mozambique. Sequence fragments of a potential novel ISF showing nucleotide identity of 72% to Aedes flavivirus virus were detected in individual blood-fed Aedes aegypti, Anopheles gambiae s.l., Ma. africana and Culex (Cx.) univittatus, all having fed on human blood. Blood-meal analysis revealed that the collected mosquitoes fed on diverse hosts, primarily humans and livestock, with a minor representation of wild mammals, amphibians and birds. The potential impact of the detected ISFs on arbovirus transmission requires further research.

A systematic review of published literature on mosquito control action thresholds across the world

BACKGROUND

Despite the use of numerous methods of control measures, mosquito populations and mosquito-borne diseases are still increasing globally. Evidence-based action thresholds to initiate or intensify control activities have been identified as essential in reducing mosquito populations to required levels at the correct/optimal time. This systematic review was conducted to identify different mosquito control action thresholds existing across the world and associated surveillance and implementation characteristics.

METHODOLOGY/PRINCIPAL FINDINGS

Searches for literature published from 2010 up to 2021 were performed using two search engines, Google Scholar and PubMed Central, according to PRISMA guidelines. A set of inclusion/exclusion criteria were identified and of the 1,485 initial selections, only 87 were included in the final review. Thirty inclusions reported originally generated thresholds. Thirteen inclusions were with statistical models that seemed intended to be continuously utilized to test the exceedance of thresholds in a specific region. There was another set of 44 inclusions that solely mentioned previously generated thresholds. The inclusions with "epidemiological thresholds" outnumbered those with "entomological thresholds". Most of the inclusions came from Asia and those thresholds were targeted toward Aedes and dengue control. Overall, mosquito counts (adult and larval) and climatic variables (temperature and rainfall) were the most used parameters in thresholds. The associated surveillance and implementation characteristics of the identified thresholds are discussed here.

CONCLUSIONS/SIGNIFICANCE

The review identified 87 publications with different mosquito control thresholds developed across the world and published during the last decade. Associated surveillance and implementation characteristics will help organize surveillance systems targeting the development and implementation of action thresholds, as well as direct awareness towards already existing thresholds for those with programs lacking available resources for comprehensive surveillance systems. The findings of the review highlight data gaps and areas of focus to fill in the action threshold compartment of the IVM toolbox.

Increasing global temperatures threaten gains in maternal and newborn health in Africa: A review of impacts and an adaptation framework

Anatomical, physiologic, and socio-cultural changes during pregnancy and childbirth increase vulnerability of women and newborns to high ambient temperatures. Extreme heat can overwhelm thermoregulatory mechanisms in pregnant women, especially during labor, cause dehydration and endocrine dysfunction, and compromise placental function. Clinical sequelae include hypertensive disorders, gestational diabetes, preterm birth, and stillbirth. High ambient temperatures increase rates of infections, and affect health worker performance and healthcare seeking. Rising temperatures with climate change and limited resources heighten concerns. We propose an adaptation framework containing four prongs. First, behavioral changes such as reducing workloads during pregnancy and using low-cost water sprays. Second, health system interventions encompassing Early Warning Systems centered around existing community-based outreach; heat-health indicator tracking; water supplementation and monitoring for heat-related conditions during labor. Building modifications, passive and active cooling systems, and nature-based solutions can reduce temperatures in facilities. Lastly, structural interventions and climate financing are critical. The overall package of interventions, ideally selected following cost-effectiveness and thermal modeling trade-offs, needs to be co-designed and co-delivered with affected communities, and take advantage of existing maternal and child health platforms. Robust-applied research will set the stage for programs across Africa that target pregnant women. Adequate research and climate financing are now urgent.

Risk assessment of urban yellow fever virus transmission in Kenya: is Aedes aegypti an efficient vector?

The absence of urban yellow fever epidemics in East Africa remains a mystery amidst the proliferation of Aedes aegypti in this region. To understand the transmission dynamics of the disease, we tested urban (Mombasa, Kisumu, and Nairobi) Aedes mosquito populations in Kenya for their susceptibility to an East African yellow fever virus (YFV) genotype. Overall, 22% (n = 805) of the Ae. aegypti that were orally challenged with an infectious dose of YFV had a midgut infection, with comparable rates for Mombasa and Kisumu (χ²= 0.35, df = 1, P = 0.55), but significantly lower rates for Nairobi (χ² ≥ 11.08, df = 1, P ≤ 0.0009). Variations in YFV susceptibility (midgut infection) among Ae. aegypti subspecies were not associated with discernable cytochrome c oxidase subunit 1 gene haplotypes. Remarkably, no YFV dissemination or transmission was observed among the orally challenged Ae. aegypti populations. Moreover, Ae. aegypti mosquitoes that were intrathoracically inoculated with YFV failed to transmit the virus via capillary feeding. In contrast, dissemination (oral exposure) and transmission (intrathoracic inoculation) of YFV was observed among a few peri-domestic Ae. bromeliae mosquitoes (n = 129) that were assessed from these urban areas. Our study highlights an inefficient urban Ae. aegypti population, and the potential for Ae. bromeliae in sustaining an urban YFV transmission in Kenya. An assessment of urban Ae. aegypti susceptibility to other YFV genotypes, and vector potential of urban Ae. bromeliae populations in Kenya is recommended to guide cost-effective vaccination.

The distinctive bionomics of Aedes aegypti populations in Africa

Aedes aegypti is the primary vector of dengue, chikungunya, and Zika viruses of medical importance. Behavioral and biological attributes contribute to its vectorial capacity. The mosquito domestic form, which resides outside Africa (Ae. aegypti aegypti (Aaa)), is considered to breed in artificial containers in and around homes and preferentially feeds on human blood but commonly indulges in a plant diet. Potential divergence in these attributes, in sub-Saharan Africa (SSA) where Aaa coexists with the forest ecotype (Ae. aegypti formosus), should impact the vectoring ability and hence disease epidemiology. A summary of current knowledge on Ae. aegypti blood feeding, oviposition, and plant-feeding habits among SSA populations is provided in comparison with those in different geographies, globally. Emphasis is placed on improved understanding of the connection between changing subspecies adaptation in these traits and arbovirus disease risk in SSA in response to climate change and increasing urbanization, with the ultimate use of this information for effective disease control.

Urbanization of Aedes mosquito populations and evolution of arboviral disease risk in Africa

The arboviral diseases dengue, chikungunya, and yellow fever are re-merging and gaining a foothold in Africa, with a significant threat of large outbreaks in urban areas. Although their emergence is intimately linked to the primary vector Aedes aegypti, which thrives in urban environments, the risk of these diseases remains substantially heterogeneous in different geographic areas. Range expansion of invasive mosquito species Aedes albopictus, and colonization of urban habitats by sylvatic and peridomestic Aedes vectors, are likely to alter the diseases' epidemiology. We discuss how a network of different vector species and perhaps vector subpopulations could interact with associated serotypes/genotypes/lineages of the causative viruses of these diseases potentially impacting transmission risk in urban landscapes with implications for disease surveillance and control.

Sandfly Blood-Feeding Habits and Competence in Transmitting Ntepes Virus, a Recently Discovered Member of the Genus Phlebovirus

Phleboviruses transmitted by sandflies are among emerging public health threats. A novel Phlebovirus named Ntepes virus (NTPV) was recently described and found to infect humans from a wide geographic area in Kenya. However, the entomologic risk factors of this virus such as the potential vectors and the transmission cycles remain poorly defined. This study assessed the ability of the colonized sandfly Phlebotomus duboscqi to transmit NTPV and determined the bloodmeal host sources of field-collected sandflies from the area where NTPV was found in Baringo County, Kenya. Five-day old laboratory-reared P. duboscqi were orally challenged with an infectious dose of NTPV (≈106.0 pfu/ml) and incubated for up to 15 days postinfection. Individual sandflies were dissected into abdomens, legs, and salivary glands and screened for the virus infection by cell culture. Of the 205 virus-exposed sandflies, 19.5% developed non-disseminated infections in the midgut, with no evidence of virus dissemination or transmission in legs and salivary glands, respectively. The midgut infection rates decreased with increasing extrinsic incubation period (Spearman's correlation, ρ = -0.71). Blood-fed specimens analyzed by polymerase chain reaction (PCR) and sequencing of a region of the mitochondrial 12S rRNA, revealed almost exclusive feeding on humans (98%) represented by the sandflies Sergentomyia schwetzi, S. clydei, S. antennata, S. squamipleuris, S. africana, and Phlebotomus martini. One specimen of S. clydei had fed on cattle (2%). These findings suggest P. duboscqi is an incompetent laboratory vector of NTPV. The high human-feeding rate by diverse sandfly species increases the likelihood of human exposure to pathogens associated with these sandflies. Assessment of the susceptibility of Sergentomyia species to NTPV is recommended given their high human-feeding tendency.

Spatiotemporal distribution and insecticide resistance status of Aedes aegypti in Ghana

Background

Vector control is the main intervention used to control arboviral diseases transmitted by Aedes mosquitoes because there are no effective vaccines or treatments for most of them. Control of Aedes mosquitoes relies heavily on the use of insecticides, the effectiveness of which may be impacted by resistance. In addition, rational insecticide application requires detailed knowledge of vector distribution, dynamics, resting, and feeding behaviours, which are poorly understood for Aedes mosquitoes in Africa. This study investigated the spatiotemporal distribution and insecticide resistance status of Aedes aegypti across ecological extremes of Ghana.

Methods

Immature mosquitoes were sampled from containers in and around human dwellings at seven study sites in urban, suburban, and rural areas of Ghana. Adult Aedes mosquitoes were sampled indoors and outdoors using Biogents BG-Sentinel 2 mosquito traps, human landing catches, and Prokopack aspiration. Distributions of immature and adult Aedes mosquitoes were determined indoors and outdoors during dry and rainy seasons at all sites. The phenotypic resistance status of Aedes mosquitoes to insecticides was determined using World Health Organization susceptibility bioassays. The host blood meal source was determined by polymerase chain reaction.

Results

A total of 16,711 immature Aedes were sampled, with over 70% found in car tyres. Significantly more breeding containers had Aedes immatures during the rainy season (11,856; 70.95%) compared to the dry season (4855; 29.05%). A total of 1895 adult Aedes mosquitos were collected, including Aedes aegypti (97.8%), Aedes africanus (2.1%) and Aedesluteocephalus (0.1%). Indoor sampling of adult Aedes yielded a total of 381 (20.1%) and outdoor sampling a total of 1514 (79.9%) mosquitoes (z = − 5.427, P = 0.0000) over the entire sampling period. Aedes aegypti populations were resistant to dichlorodiphenyltrichloroethane at all study sites. Vectors showed suspected resistance to bendiocarb (96–97%), permethrin (90–96%) and deltamethrin (91–96%), and were susceptible to the organophosphate for all study sites. Blood meal analysis showed that the Aedes mosquitoes were mostly anthropophilic, with a human blood index of 0.9 (i.e. humans, 90%; human and dog, 5%; dog and cow, 5%).

Conclusions

Aedes mosquitoes were found at high densities in all ecological zones of Ghana. Resistance of Aedes spp. to pyrethroids and carbamates may limit the efficacy of vector control programmes and thus requires careful monitoring.

Graphical abstract

Survival rate, blood feeding habits and sibling species composition of Aedes simpsoni complex: Implications for arbovirus transmission risk in East Africa

Aedes simpsoni complex has a wide distribution in Africa and comprises at least three described sub-species including the yellow fever virus (YFV) vector Ae. bromeliae. To date, the distribution and relative contributions of the sub-species and/or subpopulations including bionomic characteristics in relation to YF transmission dynamics remain poorly studied. In this study conducted in two areas with divergent ecosystems: peri-urban (coastal Rabai) and rural (Rift Valley Kerio Valley) in Kenya, survival rate was estimated by parity in Ae. simpsoni s.l. mosquitoes sampled using CO₂-baited BG Sentinel traps. We then applied PCR targeting the nuclear internal transcribed spacer 2 (ITS2), region followed by sequencing and phylogenetic analytics to identify the sibling species in the Ae. simpsoni complex among parous and blood fed cohorts. Our results show that Ae. bromeliae was the most dominant sub-species in both areas, exhibiting high survival rates, human blood-feeding, and potentially, high vectorial capacity for pathogen transmission. We document for the first time the presence of Ae. lilii in Kenya and potentially yet-to-be described species in the complex displaying human feeding tendencies. We also infer a wide host feeding range on rodents, reptile, and domestic livestock besides humans especially for Ae. bromeliae. This feeding trend could likely expose humans to various zoonotic pathogens. Taken together, we highlight the utility of genotype-based analyses to generate precision surveillance data of vector populations for enhanced disease risk prediction and to guide cost-effective interventions (e.g. YF vaccinations).

Yellow fever (YF) remains a significant public health risk in East Africa, however, with gaps in the transmission ecology. Important YF virus vectors include Aedes simpsoni mosquitoes that comprise subspecies with varying vectoring abilities and, poorly described ecology and biologic traits relevant to disease transmission. Through active surveillance, we analyzed the survival, human blood feeding habits and genetics of wild populations of Aedes simpsoni s.l. in two contrasting ecosystems in Kenya: peri-urban, coastal Rabai, and rural, Rift Valley Kerio Valley. Our findings reveal i) Aedes bromeliae as the most abundant subspecies in both areas exhibiting high survival rates, human blood-feeding, and potentially, high vectoring ability, ii) occurrence of Ae. lilii contrary to previous reports albeit in low numbers, iii) potential undescribed species in the group displaying human feeding tendencies. Knowledge of the locally adapted subspecies and associated traits that underlie vectorial capacity, impinges on YF distribution risk useful for guiding vector control or cost-effective vaccination.

Assessment of Mosquito Collection Methods for Dengue Surveillance

Several methods exist to collect and assess the abundance of dengue vector mosquitoes, i.e., morning adult collection, pupal collection, ovitraps, human landing, and larval collection. Several of these methods are officially implemented to monitor mosquito density and make decisions on treatments for dengue control. This monitoring is also constrained by the need to conduct this assessment on a “one point/one day” process, meaning that once the threshold of 100 households is reached, the assessment is made, and the collectors teams move to another place, thus preventing the use of long-term sampling methods. This diversity of methods might be a source of variability and lack of statistical significance. There is also a lack of published data regarding the efficacy of these methods. Furthermore, the Stegomyia indices are shown to be not reliable for assessing the risk of dengue outbreaks. A mosquito survey was, thus, conducted in 39 locations corresponding to 15 dengue endemic provinces in Indonesia by using the different adult and larval collection methods recommended nationwide. A total of 44,675 mosquitoes were collected. The single larva method was the most efficient. Out of a total of 89 dengue-positive pools, the most frequently encountered virus was DENV2, which made up half of the positive samples, followed by DENV3 and DENV1, respectively. Factor analysis of mixed data showed that no correlation could be found between any methods and the presence of dengue virus in mosquitoes. Moreover, no correlation could be found between any methods and the incidence of dengue. There was no consistency in the efficacy of a given method from one site to another. There was no correlation between any of the parameters considered, i.e., method, incidence of dengue, location, and the presence of dengue virus in mosquitoes.

Biological traits of wild-caught populations of Aedes aegypti in dengue endemic and non-endemic regions of Kenya

Variation in vector traits can modulate local scale differences in pathogen transmission. Here, we compared seasonal variation in the wing length (proxy for body size) and energy reserves of adult wild-caught Aedes aegypti populations from a dengue endemic (Kilifi) and non-endemic (Isiolo) area of Kenya. Vector sampling in the dengue endemic site was conducted during the dry and wet seasons. In the non-endemic area, it was limited to the dry season which characterizes this ecology where sporadic or no rainfall is commonplace during the year. We found variation by site in the body size of both sexes, with an overall smaller size of Ae. aegypti populations collected from Isiolo than those from Kilifi. Our results show that although total carbohydrates and lipids levels were highest in both sexes during the dry season, they were two-fold higher in males than females. However, we found weak correlations between body size and energy reserves for both sexes, with body size being more sensitive in identifying differences at a population level. These results provide insights into the determinants of the vectoring potential of Ae. aegypti populations in dengue endemic and non-endemic ecologies in Kenya.

Invasive Alien Plants in Africa and the Potential Emergence of Mosquito-Borne Arboviral Diseases-A Review and Research Outlook

The emergence of arthropod-borne viruses (arboviruses) as linked to land-use changes, especially the growing agricultural intensification and expansion efforts in rural parts of Africa, is of growing health concern. This places an additional burden on health systems as drugs, vaccines, and effective vector-control measures against arboviruses and their vectors remain lacking. An integrated One Health approach holds potential in the control and prevention of arboviruses. Land-use changes favour invasion by invasive alien plants (IAPs) and investigating their impact on mosquito populations may offer a new dimension to our understanding of arbovirus emergence. Of prime importance to understand is how IAPs influence mosquito life-history traits and how this may affect transmission of arboviruses to mammalian hosts, questions that we are exploring in this review. Potential effects of IAPs may be significant, including supporting the proliferation of immature and adult stages of mosquito vectors, providing additional nutrition and suitable microhabitats, and a possible interaction between ingested secondary plant metabolites and arboviruses. We conclude that aspects of vector biology are differentially affected by individual IAPs and that while some plants may have the potential to indirectly increase the risk of transmission of certain arboviruses by their direct interaction with the vectors, the reverse holds for other IAPs. In addition, we highlight priority research areas to improve our understanding of the potential health impacts of IAPs.

Epidemic risk of arboviral diseases: Determining the habitats, spatial-temporal distribution, and abundance of immature Aedes aegypti in the Urban and Rural areas of Zanzibar, Tanzania

Background

In Zanzibar, little is known about the arboviral disease vector Aedes aegypti in terms of abundance, spatio-temporal distribution of its larval habitats or factors associated with its proliferation. Effective control of the vector requires knowledge on ecology and habitat characteristics and is currently the only available option for reducing the risk of arboviral epidemics in the island nation of Zanzibar.

Methodology

We conducted entomological surveys in households and surrounding compounds from February to May 2018 in the urban (Mwembemakumbi and Chumbuni) and rural (Chuini and Kama) Shehias (lowest government administrative unit) situated in the Urban-West region of Unguja island, Zanzibar. Larvae and pupae were collected, transported to the insectary, reared to adult, and identified to species level. Characteristics and types of water containers were also recorded on site. Generalized linear mixed models with binomial and negative binomial distributions were applied to determine factors associated with presence of Ae. aegypti immatures (i.e. both larvae and pupae) or pupae, alone and significant predictors of the abundance of immature Ae. aegypti or pupae, respectively.

Results

The survey provided evidence of widespread presence and abundance of Ae. aegypti mosquitoes in both urban and rural settings of Unguja Island. Interestingly, rural setting had higher numbers of infested containers, all immatures, and pupae than urban setting. Likewise, higher House and Breteau indices were recorded in rural compared to the urban setting. There was no statistically significant difference in Stegomyia indices between seasons across settings. Plastics, metal containers and car tires were identified as the most productive habitats which collectively produced over 90% of all Ae. aegypti pupae. Water storage, sun exposure, vegetation, and organic matter were significant predictors of the abundance of immature Ae. aegypti.

Conclusions

Widespread presence and abundance of Ae. aegypti were found in rural and urban areas of Unguja, the main island of Zanzibar. Information on productive habitats and predictors of colonization of water containers are important for the development of a routine Aedes surveillance system and targeted control interventions in Zanzibar and similar settings.

Dengue is considered the most important mosquito-borne viral disease and a global public health threat. In recent decades, large scale epidemics of dengue have occurred across sub-Saharan Africa including mainland Tanzania. Aedes aegypti is identified as the principal vector for dengue transmission in most affected countries. In the absence of antiviral treatment and as a dengue vaccine is not readily available; dengue prevention depends largely on vector control. As mosquitoes develop resistance towards commonly applied chemical insecticides, environmental management targeting the destruction of larval habitats is recommended. In Zanzibar, little is known about Ae. aegypti in terms of type, magnitude, or distribution of its larval habitats. In this study, we identified the main larval habitats of Ae. aegypti, their seasonal variations and factors contributing to Ae. aegypti abundance across urban and rural settings of Unguja Island in Zanzibar. We found widespread presence and abundance of the vector with plastic and metal containers as well as car tires identified as the most important larval habitats. Season, location of water container, water storage, sun exposure, presence of vegetation and organic matter were among the factors associated with high Ae. aegypti abundance. This study is the first to document widespread occurrence and distribution of Ae. aegypti in Zanzibar and highlights the need for the establishment of a nation-wide Aedes surveillance program to guide the development and monitoring of targeted, context specific vector control interventions for prevention of dengue and other arboviral epidemics. Aedes surveillance involves periodic inspection of households and surrounding environments for presence of larvae/pupae in water-holding containers which are then targeted for larval source reduction, as well as monitoring of adult mosquito populations.

The evolution of dengue-2 viruses in Malindi, Kenya and greater East Africa: Epidemiological and immunological implications

Kenya experiences a substantial burden of dengue, yet there are very few DENV-2 sequence data available from this country and indeed the entire continent of Africa. We therefore undertook whole genome sequencing and evolutionary analysis of fourteen dengue virus (DENV)-2 strains sampled from Malindi sub-County Hospital during the 2017 DENV-2 outbreak in the Kenyan coast. We further performed an extended East African phylogenetic analysis, which leveraged 26 complete African env genes. Maximum likelihood analysis showed that the 2017 outbreak was due to the Cosmopolitan genotype, indicating that this has been the only confirmed human DENV-2 genotype circulating in Africa to date. Phylogeographic analyses indicated transmission of DENV-2 viruses between East Africa and South/South-West Asia. Time-scaled genealogies show that DENV-2 viruses shows spatial structure at the country level in Kenya, with a time-to-most-common-recent ancestor analysis indicating that these DENV-2 strains were circulating for up to 5.38 years in Kenya before detection in the 2017 Malindi outbreak. Selection pressure analyses indicated sampled Kenyan DENV strains uniquely being under positive selection at 6 sites, predominantly across the non-structural genes, and epitope prediction analyses showed that one of these sites corresponds to a putative predicted MHC-I CD8+ DENV-2 Cosmopolitan virus epitope only evident in a sampled Kenyan virus. Taken together, our findings indicate that the 2017 Malindi DENV-2 outbreak arose from a strain which had circulated for several years in Kenya before recent detection, has experienced diversifying selection pressure, and may contain new putative immunogens relevant to vaccine design. These findings prompt further genomic epidemiology studies in this and other Kenyan locations to further elucidate the transmission dynamics of DENV in this region.

Seroprevalence of Zika virus in selected regions in Kenya

BACKGROUND

The Zika virus pandemic in South America in 2015-2016 and the association of Zika virus infection with neurological complications such as microcephaly in newborns distressed the global community. There is limited data on the prevalence of Zika virus in Kenya despite evidence of its circulation in East Africa. This study aimed at assessing the seroprevalence of Zika virus in selected areas in Kenya.

METHODS

Healthy adult human sera originally collected from Nairobi, Eldoret and Kisumu from 2009 to 2014 and archived at the University of Nairobi laboratories were examined for Zika virus antibodies. An IgG-based ELISA was used to screen 577 sera. Any serum tested positive by ELISA was confirmed for Zika virus infection by plaque reduction neutralization test (PRNT).

RESULTS

The seroprevalence of Zika virus in the study population was about 0.2 % (1/577) as confirmed by PRNT. Additionally, three sera that were false positive by ELISA for Zika virus were confirmed as positive for dengue virus by PRNT.

CONCLUSION

There was evidence of low previous exposure to Zika virus in the study population. Of the three regions in Kenya where sera for this study were obtained, only Kisumu County had one case of previous exposure to Zika virus.

Aedes-borne disease outbreaks in West Africa: A call for enhanced surveillance

Arboviruses transmitted by Aedes mosquitoes are a growing global concern; however, there remain large gaps in surveillance of both arboviruses and their vectors in West Africa. We reviewed over 50 years of data including outbreak reports, peer-reviewed literature, and prior data compilations describing Zika, dengue, and chikungunya, and their vectors in West Africa. Large outbreaks of dengue, Zika, and chikungunya have recently occurred in the region with over 27,000 cases of Aedes-borne disease documented since 2007. Recent arboviral outbreaks have become more concentrated in urban areas, and Aedes albopictus, recently documented in the region, has emerged as an important vector in several areas. Seroprevalence surveys suggest reported cases are a gross underestimate of the underlying arboviral disease burden. These findings indicate a shifting epidemiology of arboviral disease in West Africa and highlight a need for increased research and implementation of vector and disease control. Rapid urbanization and climate change may further alter disease patterns, underscoring the need for improved diagnostic capacity, and vector and disease surveillance to address this evolving health challenge.

Stegomyia Indices and Risk of Dengue Transmission: A Lack of Correlation

Dengue is present in 128 countries worldwide and is still expanding. There is currently no treatment or universally approved vaccine available. Therefore, prevention and control of mosquito vectors remain the most efficient ways of managing the risk of dengue outbreaks. The Stegomyia indices have been developed as quantitative indicators of the risk of dengue outbreaks. However, conflictual data are circulating about their reliability. We report in this article the first extensive study on Stegomyia indices, covering 78 locations of differing environmental and socio-economic conditions, climate, and population density across Indonesia, from West Sumatra to Papua. A total of 65,876 mosquito larvae and pupae were collected for the study. A correlation was found between incidence and human population density. No correlation was found between the incidence of dengue and the Stegomyia indices.

Geographical Distribution of Aedes aegypti aegypti and Aedes aegypti formosus (Diptera: Culicidae) in Kenya and Environmental Factors Related to Their Relative Abundance

The mosquito Aedes aegypti (L.) is the primary vector of various infectious viruses and is typified by a polymorphic color and abundance of white scales on the body. It has been conventionally separated into two subspecies, Ae. aeg. formosus (Walker) (Aaf) and Ae. aeg. aegypti (L.) (Aaa), with Aaf considered a 'sylvan' form and Aaa a 'domestic' form. Because the two subspecies show different susceptibilities to dengue viruses it is important to understand their distribution. In this study, we collected larvae from artificial and natural habitats in southern Kenya and reared them to adults to morphologically identify subspecies. We describe the geographical distribution and relative abundance of Aaa and Aaf in Kenya, and estimate the environmental factors associated with their distributions by GIS using climate and environment data. A total of 5,243 Ae. aegypti adults were collected from 249 sites, with Aaa accounting for 22% of the specimens. The relative abundance of Aaa was higher in coastal areas versus sites in western Kenya. Aaa abundance was also higher in urbanized than forested areas, which is consistent with known ecology. In contrast and inconsistent with previous studies, both Aaa and Aaf were sympatric in artificial and natural habitats. The high relative abundance of Aaa in coastal areas might derive from old populated cities, climate, and/or introduction from abroad.

Spatial modelling of the infestation indices of Aedes aegypti: an innovative strategy for vector control actions in developing countries

BACKGROUND

Larval indices such as the house index (HI), Breteau index (BI) and container index (CI) are widely used to interpret arbovirus vector density in surveillance programmes. However, the use of such data as an alarm signal is rarely considered consciously when planning programmes. The present study aims to investigate the spatial distribution pattern of the infestation of Aedes aegypti, considering the data available in the Ae. aegypti Infestation Index Rapid Survey (LIRAa) for the city of Campina Grande, Paraíba State in Brazil.

METHODS

The global and local Moran's indices were used in spatial analysis to measure the effects of spatial dependencies between neighbourhoods, using secondary data related to HI and BI gathered from surveillance service.

RESULTS

Our analysis shows that there is a predominance of high rates of mosquito infestation, placing Campina Grande at a near-constant risk of arbovirus outbreaks and epidemics. A highly significant Moran's index value (P < 0.001) was observed, indicating a positive spatial dependency between the neighbourhoods in Campina Grande. Using the Moran mapping and LISA mapping, the autocorrelation patterns of Ae. aegypti infestation rates among neighbourhoods have revealed hotpots that should be considered a priority to preventive actions of the entomological surveillance services. Predominance of high infestation rates and clearer relationships of these between neighbourhoods were observed between the months of May and July, the period with the highest rainfall in the city.

CONCLUSIONS

This analysis is an innovative strategy capable of providing detailed information on infestation locations to the relevant public health authorities, which will enable a more efficient allocation of resources, particularly for arbovirus prevention.

Spatial Dynamics of Chikungunya Virus, Venezuela, 2014

Since chikungunya virus emerged in the Caribbean region in late 2013, ≈45 countries have experienced chikungunya outbreaks. We described and quantified the spatial and temporal events after the introduction and propagation of chikungunya into an immunologically naive population from the urban north-central region of Venezuela during 2014. The epidemic curve (n = 810 cases) unraveled within 5 months with a basic reproductive number of 3.7 and a radial spread traveled distance of 9.4 km at a mean velocity of 82.9 m/day. The highest disease diffusion speed occurred during the first 90 days, and space and space-time modeling suggest the epidemic followed a particular geographic pathway with spatiotemporal aggregation. The directionality and heterogeneity of transmission during the first introduction of chikungunya indicated existence of areas of diffusion and elevated risk for disease and highlight the importance of epidemic preparedness. This information will help in managing future threats of new or reemerging arboviruses.

Seroprevalence of yellow fever, dengue, West Nile and chikungunya viruses in children in Teso South Sub-County, Western Kenya

BACKGROUND

Arboviruses often cause widespread morbidity in children in endemic regions. Data on the burden of arboviruses in Kenyan children are limited.

OBJECTIVES

This study was performed to determine the seroprevalence of yellow fever (YFV), dengue (DENV), West Nile (WNV), and chikungunya (CHIKV) viruses among children 1-12 years of age at two health facilities in Teso South Sub-County in Western Kenya.

METHODS

In a hospital-based cross-sectional survey, a questionnaire was used to collect socio-demographic information. Serum drawn from the children was tested for IgA/IgM/IgG serocomplex antibodies to selected arboviruses using indirect ELISA and plaque reduction neutralization tests.

RESULTS

A total of 182 (27.7%) of the 656 participants tested were positive for any arbovirus antibody. Of these, 4.4% (29/656) tested positive for YFV, 9.6% (62/649) for WNV, 5.6% (36/649) for CHIKV, 1.4% (5/368) for DENV1, 9% (59/656) for DENV2, and 19.7% (40/203) for DENV3. Neutralizing antibodies to CHIKV were found in 77.8% (42/54) of participants, to YFV in 15.8% (3/19), to DENV2 in 58% (29/50), and to WNV in 8% (1/55). Sex, age, urban residence, schooling, and lack of vaccination were associated with arbovirus exposure.

CONCLUSIONS

This study confirmed that children under 12 years of age in Teso South Sub-County are exposed to ongoing arbovirus infections early in life.

Aedes vector-host olfactory interactions in sylvatic and domestic dengue transmission environments

Interactions between Aedes (Stegomyia) species and non-human primate (NHP) and human hosts govern the transmission of the pathogens, dengue, zika, yellow fever and chikungunya viruses. Little is known about Aedes mosquito olfactory interactions with these hosts in the domestic and sylvatic cycles where these viruses circulate. Here, we explore how the different host-derived skin odours influence Aedes mosquito responses in these two environments. In field assays, we show that the cyclic ketone cyclohexanone is a signature cue for Aedes mosquitoes to detect the NHP baboon, sykes and vervet, whereas for humans, it is the unsaturated aliphatic keto-analogue 6-methyl-5-hepten-2-one (sulcatone). We find that in the sylvatic environment, CO₂-baited traps combined with either cyclohexanone or sulcatone increased trap catches of Aedes mosquitoes compared to traps either baited with CO₂ alone or CO₂ combined with NHP- or human-derived crude skin odours. In the domestic environment, each of these odourants and crude human skin odours increased Aedes aegypti catches in CO₂-baited traps. These results expand our knowledge on the role of host odours in the ecologies of Aedes mosquitoes, and the likelihood of associated spread of pathogens between primates and humans. Both cyclohexanone and sulcatone have potential practical applications as lures for monitoring Aedes disease vectors.

Entomological assessment of dengue virus transmission risk in three urban areas of Kenya

Urbanization is one of the major drivers of dengue epidemics globally. In Kenya, an intriguing pattern of urban dengue virus epidemics has been documented in which recurrent epidemics are reported from the coastal city of Mombasa, whereas no outbreaks occur in the two major inland cities of Kisumu and Nairobi. In an attempt to understand the entomological risk factors underlying the observed urban dengue epidemic pattern in Kenya, we evaluated vector density, human feeding patterns, vector genetics, and prevailing environmental temperature to establish how these may interact with one another to shape the disease transmission pattern. We determined that (i) Nairobi and Kisumu had lower vector density and human blood indices, respectively, than Mombasa, (ii) vector competence for dengue-2 virus was comparable among Ae. aegypti populations from the three cities, with no discernible association between susceptibility and vector cytochrome c oxidase subunit 1 gene variation, and (iii) vector competence was temperature-dependent. Our study suggests that lower temperature and Ae. aegypti vector density in Nairobi may be responsible for the absence of dengue outbreaks in the capital city, whereas differences in feeding behavior, but not vector competence, temperature, or vector density, contribute in part to the observed recurrent dengue epidemics in coastal Mombasa compared to Kisumu.

Dengue is a viral disease of global public health significance owing to rapid spread and increasing disease burden. Urbanization is an important risk factor for dengue emergence. In Kenya, repeated outbreaks of the disease have occurred in the urban areas of Mombasa but not in Nairobi and Kisumu, despite the presence of susceptible human hosts and the primary vector, Aedes aegypti throughout these areas. We set out to determine whether this trend is related to variations in biological parameters of the vector, Ae. aegypti between these areas. Our findings show that (i) Ae. aegypti had lower density and human blood feeding ability in Nairobi and Kisumu, respectively, compared to Mombasa, (ii) the ability of Ae. aegypti populations from the three cities to transmit dengue-2 virus was comparable with no observed association between susceptibility and vector genetic variation, and (iii) vector competence was temperature-dependent. Based on this, it appears that higher temperature and Ae. aegypti vector density explains the higher risk of dengue virus transmission in Mombasa, compared to Nairobi, whereas differences in feeding behavior of Ae. aegypti may be responsible for the lower risk at Kisumu.

Risk of Dengue Transmission in Cocody (Abidjan, Ivory Coast)

In recent years, an upsurge of vector-borne diseases has been reported in several parts of the world. Among these is dengue fever, the first arbovirus transmitted by mosquitoes of the genus Aedes. After the detection of the dengue virus serological types (type 1, 2, and 3) in the health district of Cocody-Bingerville in Ivory Coast, entomological investigations were carried out in the city of Cocody (host of most cases) to evaluate the risk of transmission of the disease in view of an effective vector control. Larval prospection together with the pitching of emergence traps was carried out in Caféier 5, Sideci-Coteau, Danga, Ecole de police, Gobelet village, Laurier 9, Lemania, Perles, 7ème tranche, and 12ème arrondissement. Entomological prospections revealed the predominance of Aedes aegypti (97.38%) as the main vector species of dengue viruses in Cocody. The Kruskall-Wallis test showed no statistically significant difference (KW = 1.8, p = 0.407) in the proportions of the vector species collected from the sampled sites. The risk of an outbreak of dengue fever in Cocody and other municipalities in the city of Abidjan is very certain insofar as the larval epidemic risk indices (Habitat Index, HI = 70.9; Container Index, CI = 40.26; and Breteau Index, BI= 21.3) reflect a very high epidemic risk (4 to 9) on the WHO density scale. The occurrence of Aedes aegypti in Cocody indicates the risk of transmission of the Dengue fever virus.

Vector competence of Aedes bromeliae and Aedes vitattus mosquito populations from Kenya for chikungunya virus

Background

Kenya has experienced outbreaks of chikungunya in the past years with the most recent outbreak occurring in Mandera in the northern region in May 2016 and in Mombasa in the coastal region from November 2017 to February 2018. Despite the outbreaks in Kenya, studies on vector competence have only been conducted on Aedes aegypti. However, the role played by other mosquito species in transmission and maintenance of the virus in endemic areas remains unclear. This study sought to determine the possible role of rural Aedes bromeliae and Aedes vittatus in the transmission of chikungunya virus, focusing on Kilifi and West Pokot regions of Kenya.

Methods

Four day old female mosquitoes were orally fed on chikungunya virus-infected blood at a dilution of 1:1 of the viral isolate and blood (10^6.4 plaque-forming units [PFU]/ml) using artificial membrane feeder (Hemotek system) for 45 minutes. The engorged mosquitoes were picked and incubated at 29–30°C ambient temperature and 70–80% humidity in the insectary. At days 5, 7 and 10 post-infection, the mosquitoes were carefully dissected to separate the legs and wings from the body and their proboscis individually inserted in the capillary tube containing minimum essential media (MEM) to collect salivary expectorate. The resultant homogenates and the salivary expectorates were tested by plaque assay to determine virus infection, dissemination and transmission potential of the mosquitoes.

Results

A total of 515 female mosquitoes (311 Ae. bromeliae and 204 Ae. vittatus) were exposed to the East/Central/South Africa (ECSA) lineage of chikungunya virus. Aedes vittatus showed high susceptibility to the virus ranging between 75–90% and moderate dissemination and transmission rates ranging from 35–50%. Aedes bromeliae had moderate susceptibility ranging between 26–40% with moderate dissemination and transmission rates ranging from 27–55%.

Conclusion

This study demonstrates that both Ae. vittatus and Ae. bromeliae populations from West Pokot and Kilifi counties in Kenya are competent vectors of chikungunya virus. Based on these results, the two areas are at risk of virus transmission in the event of an outbreak. This study underscores the need to institute vector competence studies for populations of potential vector species as a means of evaluating risk of transmission of the emerging and re-emerging arboviruses in diverse regions of Kenya.

Kenya experienced its first chikungunya outbreak in 2004/2005 along the coastal area, followed by sporadic outbreaks in Mandera in 2016, and subsequently in Mombasa city in late 2017 and early 2018. Despite the rising risk of transmission of the virus in the country based on evidence of outbreaks in Kenya, vector competence studies have only been limited to Ae. aegypti, while the role played by other Aedes species largely remain unknown. This study demonstrated the ability of Ae. bromeliae and Ae. vittatus to transmit chikungunya virus under controlled laboratory conditions. Vector competence remains the most important approach in disease risk assessment that provides knowledge to the public health sector in developing vector control guideline.

The occurrence, diversity and blood feeding patterns of potential vectors of dengue and yellow fever in Kacheliba, West Pokot County, Kenya

INTRODUCTION

Yellow fever (YF) and dengue (DEN) viruses are important re-emerging mosquito-borne viruses sharing similar vectors and reservoirs. The last documented YF outbreak in Kenya occurred in 1992-95. However, YF virus is re-emerging in bordering countries including Uganda, Ethiopia and South Sudan with the potential for spread to the neighboring regions in Kenya. Dengue is endemic in Kenya with outbreaks being detected in various towns in the north and the coast. This study reports on the Aedes (Stegomyia) mosquito species occurrence, diversity, and blood feeding patterns, as means of measuring the risk of transmission of YF and DEN in Kacheliba sub-county, West Pokot County, which borders previous YF outbreak areas in eastern Uganda.

METHODOLOGY

Adult mosquitoes were collected using CO₂-baited BG Sentinel traps at three time points during the rainy season. Mosquitoes were identified to the species level. Species abundance during the three sampling periods were compared, with emphasis on Aedes aegypti and other Stegomyia species, using generalized linear models that included mosquito diversity. Individually blood-fed mosquitoes were analyzed by DNA amplification of the 12S rRNA gene followed by sequencing to determine the source of blood meal.

RESULTS

Overall, 8605 mosquitoes comprising 22 species in 5 genera were collected. Sampled Stegomyia species included Ae. aegypti (77.3%), Ae. vittatus (11.4%), Ae. metallicus (10.2%) and Ae. unilineatus (1.1%). Ae. aegypti dominated the blood-fed specimens (77%, n = 68) and were found to have fed mostly on rock hyraxes (79%), followed by goats (9%), humans and cattle (each 4%), with a minor proportion on hippopotamus and rock monitor lizards (each comprising 1%).

CONCLUSION

Our findings reveal the presence of important Stegomyia species, which are known potential vectors of YF and DEN viruses. In addition, evidence of more host feeding on wild and domestic animals (hyrax and goat) than humans was observed. How the low feeding on humans translates to risk of transmission of these viruses, remains unclear, but calls for further research including vector competence studies of the mosquito populations for these viruses. This forms part of a comprehensive risk assessment package to guide decisions on implementation of affordable and sustainable vaccination (YF) and vector control plans in West Pokot County, Kenya.

Host plant forensics and olfactory-based detection in Afro-tropical mosquito disease vectors

The global spread of vector-borne diseases remains a worrying public health threat, raising the need for development of new combat strategies for vector control. Knowledge of vector ecology can be exploited in this regard, including plant feeding; a critical resource that mosquitoes of both sexes rely on for survival and other metabolic processes. However, the identity of plant species mosquitoes feed on in nature remains largely unknown. By testing the hypothesis about selectivity in plant feeding, we employed a DNA-based approach targeting trnH-psbA and matK genes and identified host plants of field-collected Afro-tropical mosquito vectors of dengue, Rift Valley fever and malaria being among the most important mosquito-borne diseases in East Africa. These included three plant species for Aedes aegypti (dengue), two for both Aedes mcintoshi and Aedes ochraceus (Rift Valley fever) and five for Anopheles gambiae (malaria). Since plant feeding is mediated by olfactory cues, we further sought to identify specific odor signatures that may modulate host plant location. Using coupled gas chromatography (GC)-electroantennographic detection, GC/mass spectrometry and electroantennogram analyses, we identified a total of 21 antennally-active components variably detected by Ae. aegypti, Ae. mcintoshi and An. gambiae from their respective host plants. Whereas Ae. aegypti predominantly detected benzenoids, Ae. mcintoshi detected mainly aldehydes while An. gambiae detected sesquiterpenes and alkenes. Interestingly, the monoterpenes β-myrcene and (E)-β-ocimene were consistently detected by all the mosquito species and present in all the identified host plants, suggesting that they may serve as signature cues in plant location. This study highlights the utility of molecular approaches in identifying specific vector-plant associations, which can be exploited in maximizing control strategies such as such as attractive toxic sugar bait and odor-bait technology.

Dengue and yellow fever virus vectors: seasonal abundance, diversity and resting preferences in three Kenyan cities

BACKGROUND

The transmission patterns of dengue (DENV) and yellow fever (YFV) viruses, especially in urban settings, are influenced by Aedes (Stegomyia) mosquito abundance and behavior. Despite recurrent dengue outbreaks on the Kenyan coast, these parameters remain poorly defined in this and other areas of contrasting dengue endemicity in Kenya. In assessing the transmission risk of DENV/YFV in three Kenyan cities, we determined adult abundance and resting habits of potential Aedes (Stegomyia) vectors in Kilifi (dengue-outbreak prone), and Nairobi and Kisumu (no dengue outbreaks reported). In addition, mosquito diversity, an important consideration for changing mosquito-borne disease dynamics, was compared.

METHODS

Between October 2014 and June 2016, host-seeking adult mosquitoes were sampled using CO₂-baited BG-Sentinel traps (12 traps daily) placed in vegetation around homesteads, across study sites in the three major cities. Also, indoor and outdoor resting mosquitoes were sampled using Prokopack aspirators. Three samplings, each of five consecutive days, were conducted during the long-rains, short-rains and dry season for each city. Inter-city and seasonal variation in mosquito abundance and diversity was evaluated using general linear models while mosquito-resting preference (indoors vs outdoors) was compared using Chi-square test.

RESULTS

Aedes aegypti, which comprised 60% (n = 7772) of the total 12,937 host-seeking mosquitoes collected, had comparable numbers in Kisumu (45.2%, n = 3513) and Kilifi (37.7%, n = 2932), both being significantly higher than Nairobi (17.1%, n = 1327). Aedes aegypti abundance was significantly lower in the short-rains and dry season relative to the long-rains (P < 0.0001). Aedes bromeliae, which occurred in low numbers, did not differ significantly between seasons or cities. Mosquito diversity was highest during the long-rains and in Nairobi. Only 10% (n = 43) of the 450 houses aspirated were found positive for resting Ae. aegypti, with overall low captures in all areas. Aedes aegypti densities were comparable indoors/outdoors in Kilifi; but with higher densities outdoors than indoors in Kisumu and Nairobi.

CONCLUSIONS

The presence and abundance of Ae. aegypti near human habitations and dwellings, especially in Kilifi/Kisumu, is suggestive of increased DENV transmission risk due to higher prospects of human vector contact. Despite low abundance of Ae. bromeliae suggestive of low YFV transmission risk, its proximity to human habitation as well as the observed diversity of potential YFV vectors should be of public health concern and monitored closely for targeted control. The largely outdoor resting behavior for Ae. aegypti provides insights for targeted adult vector control especially during emergency outbreak situations.