Clustering of vector control interventions has important consequences for their effectiveness: a modelling study

Managing disease outbreaks: The importance of vector mobility and spatially heterogeneous control

Management strategies for control of vector-borne diseases, for example Zika or dengue, include using larvicide and/or adulticide, either through large-scale application by truck or plane or through door-to-door efforts that require obtaining permission to access private property and spray yards. The efficacy of the latter strategy is highly dependent on the compliance of local residents. Here we develop a model for vector-borne disease transmission between mosquitoes and humans in a neighborhood setting, considering a network of houses connected via nearest-neighbor mosquito movement. We incorporate large-scale application of adulticide via aerial spraying through a uniform increase in vector death rates in all sites, and door-to-door application of larval source reduction and adulticide through a decrease in vector emergence rates and an increase in vector death rates in compliant sites only, where control efficacies are directly connected to real-world experimentally measurable control parameters, application frequencies, and control costs. To develop mechanistic insight into the influence of vector motion and compliance clustering on disease controllability, we determine the basic reproduction number R0 for the system, provide analytic results for the extreme cases of no mosquito movement, infinite hopping rates, and utilize degenerate perturbation theory for the case of slow but non-zero hopping rates. We then determine the application frequencies required for each strategy (alone and combined) in order to reduce R0 to unity, along with the associated costs. Cost-optimal strategies are found to depend strongly on mosquito hopping rates, levels of door-to-door compliance, and spatial clustering of compliant houses, and can include aerial spray alone, door-to-door treatment alone, or a combination of both. The optimization scheme developed here provides a flexible tool for disease management planners which translates modeling results into actionable control advice adaptable to system-specific details.

Spatial distribution of Anopheles gambiae sensu lato larvae in the urban environment of Yaoundé, Cameroon

Background

The rapid and unplanned urbanization of African cities is considered to increase the risk of urban malaria transmission. The present study objective was to assess factors influencing the spatio-temporal distribution of Anopheles gambiae s.l. larvae in the city of Yaoundé, Cameroon.

Methods

All water bodies were checked once every 2 months for the presence of mosquito larvae from March 2017 to May 2018 in 32 districts of Yaoundé. Physico-chemical characteristics including the size, depth, turbidity, pH, temperature, conductivity, sulfates, organophosphates, hydrogen peroxide (H₂O₂), conductivity, iron and calcium were recorded and analyzed according to anopheline larvae presence or absence. High resolution satellite images from landsat sentinel Enhanced Thematic Mapper were used for spatial mapping of both field and environmental variables. Bivariate and multivariate logistic regression models were used to identify variables closely associated with anopheline larvae distribution.

Results

A total of 18 696 aquatic habitats were checked and only 2942 sites (15.7%) contained anopheline larvae. A high number of sites with anopheline larvae (≥ 69%) presented late instar larvae (L3, L4 and pupae). Anopheline mosquito larvae were sampled from a variety of breeding sites including puddles (51.6%), tire prints (12.9%), wells (11.7%) and drains (11.3%). Bivariate logistic regression analyses associated anopheline larvae presence with the absence of predators, absence of algae, absence of vegetation and depth of less than 1 m. Conductivity, turbidity, organophosphates, H₂O₂ and temperature were significantly high in breeding sites with anopheline larvae than in breeding sites without these larvae (P <  0.1). Anopheline species collected included An. coluzzii (91.1%) and An. gambiae s.s. (8.9%). GIS mapping indicated a heterogeneous distribution of anopheline breeding habitats in the city of Yaoundé. Land cover analysis indicated high variability of the city of Yaoundé’s landscape.

Conclusions

The data confirms adaptation of An. gambiae s.l. to the urban domain in the city of Yaoundé and calls for urgent actions to improve malaria vector control.

(Meta)population dynamics determine effective spatial distributions of mosquito-borne disease control

Recent epidemics of mosquito-borne dengue and Zika viruses demonstrate the urgent need for effective measures to control these diseases. The best method currently available to prevent or reduce the size of outbreaks is to reduce the abundance of their mosquito vectors, but there is little consensus on which mechanisms of control are most effective, or when and where they should be implemented. Although the optimal methods are likely context dependent, broadly applicable strategies for mosquito control, such as how to distribute limited resources across a landscape in times of high epidemic risk, can mitigate (re)emerging outbreaks. We used mathematical simulations to examine how the spatial distribution of larval mosquito control affects the size of disease outbreaks, and how mosquito metapopulation dynamics and demography might impact the efficacy of different spatial distributions of control. We found that the birth rate and mechanism of density-dependent regulation of mosquito populations affected the average outbreak size across all control distributions. These factors also determined whether control distributions favoring the interior or the edges of the landscape most effectively reduced human infections. Thus, understanding local mosquito population regulation and dispersion can lead to more effective control strategies.

Mesocosm experiments reveal the impact of mosquito control measures on malaria vector life history and population dynamics

The impact of control measures on mosquito vector fitness and demography is usually estimated from bioassays or indirect variables in the field. Whilst indicative, neither approach is sufficient to quantify the potentially complex response of mosquito populations to combined interventions. Here, large replicated mesocosms were used to measure the population-level response of the malaria vector Anopheles arabiensis to long-lasting insecticidal nets (LLINs) when used in isolation, or combined with insecticidal eave louvers (EL), or treatment of cattle with the endectocide Ivermectin (IM). State-space models (SSM) were fit to these experimental data, revealing that LLIN introduction reduced adult mosquito survival by 91% but allowed population persistence. ELs provided no additional benefit, but IM reduced mosquito fecundity by 59% and nearly eliminated all populations when combined with LLINs. This highlights the value of IM for integrated vector control, and mesocosm population experiments combined with SSM for identifying optimal combinations for vector population elimination.

Individual and contextual risk factors for chikungunya virus infection: the SEROCHIK cross-sectional population-based study

The purpose of the study was to weigh the community burden of chikungunya determinants on Reunion island. Risk factors were investigated within a subset of 2101 adult persons from a population-based cross-sectional serosurvey, using Poisson regression models for dichotomous outcomes. Design-based risk ratios and population attributable fractions (PAF) were generated distinguishing individual and contextual (i.e. that affect individuals collectively) determinants. The disease burden attributable to contextual determinants was twice that of individual determinants (overall PAF value 89.5% vs. 44.1%). In a model regrouping both categories of determinants, the independent risk factors were by decreasing PAF values: an interaction term between the reporting of a chikungunya history in the neighbourhood and individual house (PAF 45.9%), a maximal temperature of the month preceding the infection higher than 28.5 °C (PAF 25.7%), a socio-economically disadvantaged neighbourhood (PAF 19.0%), altitude of dwelling (PAF 13.1%), cumulated rainfalls of the month preceding the infection higher than 65 mm (PAF 12.6%), occupational inactivity (PAF 11.6%), poor knowledge on chikungunya transmission (PAF 7.3%) and obesity/overweight (PAF 5.2%). Taken together, these covariates and their underlying causative factors uncovered 80.8% of chikungunya at population level. Our findings lend support to a major role of contextual risk factors in chikungunya virus outbreaks.

Human movement, cooperation and the effectiveness of coordinated vector control strategies

Vector-borne disease transmission is often typified by highly focal transmission and influenced by movement of hosts and vectors across different scales. The ecological and environmental conditions (including those created by humans through vector control programmes) that result in metapopulation dynamics remain poorly understood. The development of control strategies that would most effectively limit outbreaks given such dynamics is particularly urgent given the recent epidemics of dengue, chikungunya and Zika viruses. We developed a stochastic, spatial model of vector-borne disease transmission, allowing for movement of hosts between patches. Our model is applicable to arbovirus transmission by Aedes aegypti in urban settings and was parametrized to capture Zika virus transmission in particular. Using simulations, we investigated the extent to which two aspects of vector control strategies are affected by human commuting patterns: the extent of coordination and cooperation between neighbouring communities. We find that transmission intensity is highest at intermediate levels of host movement. The extent to which coordination of control activities among neighbouring patches decreases the prevalence of infection is affected by both how frequently humans commute and the proportion of neighbouring patches that commits to vector surveillance and control activities. At high levels of host movement, patches that do not contribute to vector control may act as sources of infection in the landscape, yet have comparable levels of prevalence as patches that do cooperate. This result suggests that real cooperation among neighbours will be critical to the development of effective pro-active strategies for vector-borne disease control in today's commuter-linked communities.

malERA: An updated research agenda for combination interventions and modelling in malaria elimination and eradication

This paper summarises key advances and priorities since the 2011 presentation of the Malaria Eradication Research Agenda (malERA), with a focus on the combinations of intervention tools and strategies for elimination and their evaluation using modelling approaches. With an increasing number of countries embarking on malaria elimination programmes, national and local decisions to select combinations of tools and deployment strategies directed at malaria elimination must address rapidly changing transmission patterns across diverse geographic areas. However, not all of these approaches can be systematically evaluated in the field. Thus, there is potential for modelling to investigate appropriate 'packages' of combined interventions that include various forms of vector control, case management, surveillance, and population-based approaches for different settings, particularly at lower transmission levels. Modelling can help prioritise which intervention packages should be tested in field studies, suggest which intervention package should be used at a particular level or stratum of transmission intensity, estimate the risk of resurgence when scaling down specific interventions after local transmission is interrupted, and evaluate the risk and impact of parasite drug resistance and vector insecticide resistance. However, modelling intervention package deployment against a heterogeneous transmission background is a challenge. Further validation of malaria models should be pursued through an iterative process, whereby field data collected with the deployment of intervention packages is used to refine models and make them progressively more relevant for assessing and predicting elimination outcomes.

A spatial agent-based model of Anopheles vagus for malaria epidemiology: examining the impact of vector control interventions

BACKGROUND

Malaria, being a mosquito-borne infectious disease, is still one of the most devastating global health issues. The malaria vector Anopheles vagus is widely distributed in Asia and a dominant vector in Bandarban, Bangladesh. However, despite its wide distribution, no agent based model (ABM) of An. vagus has yet been developed. Additionally, its response to combined vector control interventions has not been examined.

METHODS

A spatial ABM, denoted as ABM[Formula: see text], was designed and implemented based on the biological attributes of An. vagus by modifying an established, existing ABM of Anopheles gambiae. Environmental factors such as temperature and rainfall were incorporated into ABM[Formula: see text] using daily weather profiles. Real-life field data of Bandarban were used to generate landscapes which were used in the simulations. ABM[Formula: see text] was verified and validated using several standard techniques and against real-life field data. Using artificial landscapes, the individual and combined efficacies of existing vector control interventions are modeled, applied, and examined.

RESULTS

Simulated female abundance curves generated by ABM[Formula: see text] closely follow the patterns observed in the field. Due to the use of daily temperature and rainfall data, ABM[Formula: see text] was able to generate seasonal patterns for a particular area. When two interventions were applied with parameters set to mid-ranges, ITNs/LLINs with IRS produced better results compared to the other cases. Moreover, any intervention combined with ITNs/LLINs yielded better results. Not surprisingly, three interventions applied in combination generate best results compared to any two interventions applied in combination.

CONCLUSIONS

Output of ABM[Formula: see text] showed high sensitivity to real-life field data of the environmental factors and the landscape of a particular area. Hence, it is recommended to use the model for a given area in connection to its local field data. For applying combined interventions, three interventions altogether are highly recommended whenever possible. It is also suggested that ITNs/LLINs with IRS can be applied when three interventions are not available.

Impact of Irrigation Extension on Malaria Transmission in Simret, Tigray, Ethiopia

Poor subsistence farmers who live in a semi-arid area of northern Ethiopia build irrigation systems to overcome water shortages. However, there is a high risk of malaria transmission when increased standing water provides more favorable habitats for mosquito breeding. This is a serious problem because there are many barriers to malaria control measures and health care systems in the area. Using a causal loop diagram and computer simulations, the author attempted to visually illustrate positive and negative feedbacks between mosquito and human populations in the context of Simret, which is a small village located in northern Ethiopia and is generally considered a malaria-free area. The simulation results show that the number of infectious mosquitos increases to 17,215 at its peak, accounting for 3.5% of potentially dangerous mosquitos. At the same time, the number of sick people increases to 574 at its peak, accounting for 15% of local population. The malaria outbreak is controlled largely because of a fixed number of vulnerable people or local population that acts as an intermediate host.

Control methods against invasive Aedes mosquitoes in Europe: a review

Five species of invasive Aedes mosquitoes have recently become established in Europe: Ae. albopictus, Ae. aegypti, Ae. japonicus japonicus, Ae. koreicus and Ae. atropalpus. These mosquitoes are a serious nuisance for people and are also competent vectors for several exotic pathogens such as dengue and chikungunya viruses. As they are a growing public health concern, methods to control these mosquitoes need to be implemented to reduce their biting and their potential for disease transmission. There is a crucial need to evaluate methods as part of an integrated invasive mosquito species control strategy in different European countries, taking into account local Aedes infestations and European regulations. This review presents the control methods available or in development against invasive Aedes mosquitoes, with a particular focus on those that can be implemented in Europe. These control methods are divided into five categories: environmental (source reduction), mechanical (trapping), biological (e.g. copepods, Bacillus thuringiensis var. israelensis, Wolbachia), chemical (insect growth regulators, pyrethroids) and genetic (sterile insect technique and genetically modified mosquitoes). We discuss the effectiveness, ecological impact, sustainability and stage of development of each control method.