Household Wastes as Larval Habitats of Dengue Vectors: Comparison between Urban and Rural Areas of Kolkata, India

Facing the escalating burden of dengue: Challenges and perspectives

Dengue is the most rapidly emerging mosquito-borne infection and, due to climate change and unplanned urbanization, it is predicted that the global burden of dengue will rise further as the infection spreads to new geographical locations. Dengue-endemic countries are often unable to cope with such increases, with health care facilities becoming overwhelmed during each dengue season. Furthermore, although dengue has been predominantly a childhood illness in the past, it currently mostly affects adults in many countries, with higher incidence of severe disease and mortality rates in pregnant women and in those with comorbidities. As there is currently no specific treatment for dengue and no early biomarker to identify those who will progress to develop vascular leakage, all individuals with dengue are closely monitored in case they need fluid management. Furthermore, diagnosing patients with acute dengue is challenging due to the similarity of clinical symptoms during early illness and poor sensitivity and specificity of point-of-care diagnostic tests. Novel vector control methods, such as the release of Wolbachia-infected mosquitoes, have shown promising results by reducing vector density and dengue incidence in clinical trial settings. A new dengue vaccine, TAK-003, had an efficacy of 61.2% against virologically confirmed dengue, 84.1% efficacy against hospitalizations and a 70% efficacy against development of dengue haemorrhagic fever (DHF) at 54 months. While vaccines and mosquito control methods are welcome, they alone are unlikely to fully reduce the burden of dengue, and a treatment for dengue is therefore essential. Several novel antiviral drugs are currently being evaluated along with drugs that inhibit host mediators, such as mast cell products. Although viral proteins such as NS1 contribute to the vascular leak observed in severe dengue, the host immune response to the viral infection also plays a significant role in progression to severe disease. There is an urgent need to discover safe and effective treatments for dengue to prevent disease progression.

Prevalence and Associated Factors of Dengue Virus Circulation in the Rural Community, Handeni District in Tanga, Tanzania

Dengue virus is among the most important re-emerging arbovirus that causes global public health attention. Dengue has historically been thought of as an urban disease that frequently occurs in rapidly urbanized settings. However, dengue has become more widespread in rural regions in recent years. Understanding the changing dengue epidemiology in different geographical settings is important for targeted intervention. In Tanzania, dengue fever is not frequently reported because of the poor surveillance infrastructure, underestimation, and a lack of consideration of dengue as a priority. Therefore, the true burden as well as the risk factors for increased transmission has not been fully ascertained, particularly in rural areas. A cross-sectional community-based study was conducted in June 2021, involving a total of 362 participants of all age groups. We investigated the prevalence of acute dengue infection, seroprevalence, and associated factors among the community in three villages of the rural Handeni district. The prevalence of acute dengue infection (based on PCR) was 2.2% (8/362). Dengue-specific IgM and IgG antibodies were detected in 3.3% (12/362) and 5.2% (19/362) of the participants, respectively. Adult participants who were having vegetation around their houses were more likely to be DENV seropositive (AOR = 2.4, CI = 1.88-4.18, p value = 0.05). Children living in houses with garbage pit around their households were less likely to be DENV seropositive (AOR = 0.13, CI = 0.03-0.56, p value <0.01). DENV continues to circulate in rural Tanzania, causes an alarming situation, and necessitates prompt public health action to enhance vector surveillance and control in rural communities.

D. R, Lakshmi M. I, Isvaran K, Ghosh SK, Ishtiaq F. Determinants of Aedes mosquito larval ecology in a heterogeneous urban environment- a longitudinal study in Bengaluru, India

BACKGROUND

Aedes-borne disease risk is associated with contemporary urbanization practices where city developing structures function as a catalyst for creating mosquito breeding habitats. We lack better understanding on how the links between landscape ecology and urban geography contribute to the prevalence and abundance of mosquito and pathogen spread.

METHODS

An outdoor longitudinal study in Bengaluru (Karnataka, India) was conducted between February 2021 and June 2022 to examine the effects of macrohabitat types on the diversity and distribution of larval habitats, mosquito species composition, and body size to quantify the risk of dengue outbreak in the landscape context.

FINDINGS

A total of 8,717 container breeding sites were inspected, of these 1,316 were wet breeding habitats. A total of 1,619 mosquito larvae representing 16 species from six macrohabitats and nine microhabitats were collected. Aedes aegypti and Aedes albopictus were the dominant species and significantly higher in artificial habitats than in natural habitats. Breeding preference ratio for Aedes species was high in grinding stones and storage containers. The Aedes infestation indices were higher than the WHO threshold and showed significant linear increase from Barren habitat to High density areas. We found Ae. albopictus breeding in sympatry with Ae. aegypti had shorter wing length.

CONCLUSIONS

A large proportion of larval habitats were man-made artificial containers. Landscape ecology drives mosquito diversity and abundance even at a small spatial scale which could be affecting the localized outbreaks. Our findings showed that sampling strategies for mosquito surveillance must include urban environments with non-residential locations and dengue transmission reduction programmes should focus on 'neighbourhood surveillance' as well to prevent and control the rising threat of Aedes-borne diseases.

Insecticide Resistance and Metabolic Mechanisms in Aedes aegypti from Two Agrosystems (Vegetable and Cotton Crops) in Côte d'Ivoire

Background: The emergence of insecticide resistance in Aedes vectors mosquitoes poses a real challenge for arboviral-borne disease control. In Côte d'Ivoire, data are available on phenotypic resistance and the presence of kdr mutations in Aedes aegypti. Therefore, information on metabolic resistance in Aedes populations is very scarce. Here, we assessed the insecticide resistance status of Ae. aegypti in periurban and rural areas of Côte d'Ivoire, and we investigated the role of detoxification enzymes as possible resistance mechanisms. Materials and Methods: Aedes mosquito eggs were collected between June 2019 to April 2021 in two agricultural sites. Adults of Ae. aegypti were tested using World Health Organization tube assays, with seven insecticides belonging to pyrethroids, organochlorines, carbamates, and organophosphates classes. We determined the knockdown times (KdT50, KdT95) and resistance ratios of pyrethroids in natural populations. The synergist piperonyl butoxide (PBO) was used to investigate the role of enzymes in resistance. Biochemical assays were performed to detect potential increased activities in mixed-function oxidase levels, nonspecific esterases (NSEs), and glutathione S-transferases. Results: The results showed that Ae. aegypti populations were resistant to five insecticides with mortality of 46% and 89% for 0.75% permethrin, 68% and 92% for 0.05% deltamethrin, 57% and 89% for lambda-cyhalothrin, 41% and 47% for dichlorodiphenyltrichloroethane (DDT), 82% and 91% for chlorpyrifos-methyl in Songon-Agban and Kaforo, respectively. Susceptibility to carbamates was observed in our study sites. After exposure to PBO, the susceptibility of Ae. aegypti to pyrethroids and DDT was partially restored in Songon-Agban. Whereas in Kaforo, none increase of the mortality rates of Ae. aegypti for these four insecticides was observed after exposure to PBO. Increased activity of NSE (α-esterases) was found in Songon-Agban compared with the reference susceptible strain. Conclusion: These findings provide valuable information to support decisions for vector control strategies in Cote d'Ivoire. Also, we highlight the need for the monitoring of insecticide resistance management in Aedes vectors.

Efficacy of household Aedes larval control practices in a peri-urban township, Yangon, Myanmar: Implication for entomological surveillance

Dengue is a major public health concern in Myanmar. We carried out a cross-sectional study to investigate the efficacy of larval control practices in household water containers, such as the use of the larvicide, temephos, covering the containers with lids and weekly cleaning. We surveyed 300 households in Kaw Hmu Township, a peri-urban community in the Yangon region. We inspected 1,892 water storage containers and 342 non-water storage/household waste containers during the rainy season and 1,866 water storage containers and 287 non-water storage/household waste containers during the dry season. The presence of Aedes larvae and larval control measures were recorded for each container. Results revealed that larval indices were higher than World Health Organization standard indices, and infestations in water storage containers were more common in the rainy season (6.6%) than in the dry season (5.7%). Infestations were also more likely in containers of non-potable water (9.1%-9.9%) than in containers of potable water (0.1%-0.7%). Two thirds of water storage containers were treated with temephos. Containers most likely to contain Aedes larvae were cement basins and barrels. Temephos was effective in controlling infestations in cement basins, while weekly cleaning was effective in controlling infestations in barrels. Combinations of control methods were more effective at larval control than the use of a single method. Larval infestations were high (18.4% in the rainy season) in unused containers and in containers which were household waste. Overall, we found a complex interaction between household water use, container characteristics, and larval control practices. Larval control strategies in Myanmar will require ongoing entomological surveillance and the identification of key breeding sources and optimal control methods.

Region-specific improvisation on WHO case definition and environmental risk factors associated with dengue: a case-control analysis from Kerala, India

BACKGROUND

Region-specific variations may occur in symptomatic manifestations that need to be addressed by dynamic case definitions. Environmental risk factors for dengue also vary widely across geographic settings. Our aim was to study the test positivity rate of the World Health Organization (WHO) 2009 probable dengue case definition and to suggest region-specific improvisations to it. The study also analyses the sociodemographic and environmental risk factors of dengue fever in South Kerala, India.

METHODS

A case-control study was conducted in South Kerala from 2017 to 2019. Dengue reverse transcription polymerase chain reaction (RT-PCR)-positive and RT-PCR-negative 'probable dengue' patients were compared to identify significant symptoms for a modified definition of dengue. A group of afebrile community controls was compared with RT-PCR-positive dengue cases to study the environmental and behavioural risk factors.

RESULTS

Arthralgia, palmar erythema and rashes have high discriminatory power (odds ratio [OR] >3) for identifying dengue. Redness of eyes, altered consciousness, abdominal distension and chills were found to moderately discriminate (OR 2-3) dengue. The adjusted analysis showed the presence of mosquito breeding sites (indoor p=0.02, outdoor p=0.03), solid waste dumping (p<0.001) and open water drainage in the compound (p=0.007) as significant predictors.

CONCLUSIONS

Regional modifications should be considered when using the WHO definition in endemic settings. Control of mosquito breeding at the household level is the key towards dengue prevention.

Association Between Hydrological Conditions and Dengue Fever Incidence in Coastal Southeastern China From 2013 to 2019

IMPORTANCE

Dengue fever is a climate-sensitive infectious disease. However, its association with local hydrological conditions and the role of city development remain unclear.

OBJECTIVE

To quantify the association between hydrological conditions and dengue fever incidence in China and to explore the modification role of city development in this association.

DESIGN, SETTING, AND PARTICIPANTS

This cross-sectional study collected data between January 1, 2013, and December 31, 2019, from 54 cities in 4 coastal provinces in southeast China. The Standardized Precipitation Evapotranspiration Index (SPEI) was calculated from ambient temperature and precipitation, with SPEI thresholds of 2 for extreme wet conditions and -2 for extreme dry conditions. The SPEI-dengue fever incidence association was examined over a 6-month lag, and the modification roles of 5 city development dimensions were assessed. Data were analyzed in May 2022.

EXPOSURES

City-level monthly temperature, precipitation, SPEI, and annual city development indicators from 2013 to 2019.

MAIN OUTCOMES AND MEASURES

The primary outcome was city-level monthly dengue fever incidence. Spatiotemporal bayesian hierarchal models were used to examine the SPEI-dengue fever incidence association over a 6-month lag period. An interaction term between SPEI and each city development indicator was added into the model to assess the modification role of city development.

RESULTS

Included in the analysis were 70 006 dengue fever cases reported in 54 cities in 4 provinces in China from 2013 to 2019. Overall, a U-shaped cumulative curve was observed, with wet and dry conditions both associated with increased dengue fever risk. The relative risk [RR] peaked at a 1-month lag for extreme wet conditions (1.27; 95% credible interval [CrI], 1.05-1.53) and at a 6-month lag for extreme dry conditions (1.63; 95% CrI, 1.29-2.05). The RRs of extreme wet and dry conditions were greater in areas with limited economic development, health care resources, and income per capita. Extreme dry conditions were higher and prolonged in areas with more green space per capita (RR, 1.84; 95% CrI, 1.37-2.46). Highly urbanized areas had a higher risk of dengue fever after extreme wet conditions (RR, 1.80; 95% CrI, 1.26-2.56), while less urbanized areas had the highest risk of dengue fever in extreme dry conditions (RR, 1.70; 95% CrI, 1.11-2.60).

CONCLUSIONS AND RELEVANCE

Results of this study showed that extreme hydrological conditions were associated with increased dengue fever incidence within a 6-month lag period, with different dimensions of city development playing various modification roles in this association. These findings may help in developing climate change adaptation strategies and public health interventions against dengue fever.

Worldwide impacts of landscape anthropization on mosquito abundance and diversity: A meta-analysis

In recent decades, the emergence and resurgence of vector-borne diseases have been well documented worldwide, especially in tropical regions where protection and defense tools for human populations are still very limited. In this context, the dynamics of pathogens are influenced by landscape anthropization (i.e., urbanization, deforestation, and agricultural development), and one of the mechanisms through which this occurs is a change in the abundance and/or diversity of the vectors. An increasing number of empirical studies have described heterogeneous effects of landscape anthropization on vector communities; therefore, it is difficult to have an overall picture of these effects on a global scale. Here, we performed a meta-analysis to quantify the impacts of landscape anthropization on a global scale on the presence/abundance and diversity of mosquitoes, the most important arthropods affecting human health. We obtained 338 effect sizes on 132 mosquito species, compiled from 107 studies in 52 countries that covered almost every part of the world. The results of the meta-analysis showed an overall decline of mosquito presence/abundance and diversity in response to urbanization, deforestation, and agricultural development, except for a few mosquito species that have been able to exploit landscape anthropization well. Our results highlighted that these few favored mosquito species are those of global concern. They, thus, provide a better understanding of the overall effect of landscape anthropization on vector communities and, more importantly, suggest a greater risk of emergence and transmission of vector-borne diseases in human-modified landscapes.

Primary health care situations in remote rural villages of the Savannakhet province, Lao People's Democratic Republic

BACKGROUND

To improve the health of the rural population in the Lao People's Democratic Republic (Lao PDR), the government has emphasized a primary health care approach in the Health Sector Reform Strategy by 2025. The objective of the present study was to describe the health-related situations of remote rural villages of the Lao PDR to inform strategies for promoting primary health care in such villages.

METHODS

Ten remote rural villages were purposively selected from the catchment areas of two health centers in the Xepon district, Savannakhet province. The surveyors collected data by conducting a questionnaire-based interview with village health volunteers and by observing the village environment in 2018. The survey focused on village situations on the eight elements of primary health care (health education; food supply and nutrition; safe water and basic sanitation; maternal and child health care; immunization; prevention and control of locally endemic diseases; treatment of common diseases and injuries; and provision of essential drug).

RESULTS

The common health problems were diarrhea, followed by malaria, and cough. The identified possible risk factors for the health problems were not washing hands with soap, open defecation, not boiling drinking water, not exclusively breastfeeding, presence of animal feces on the village ground, absence of garbage management system, not using a bed net when sleeping in the forest, and exposure to indoor cooking and tobacco smoke. In many villages, villagers were not able to eat enough food and did not eat protein-rich food and vegetables daily.

CONCLUSIONS

Potential risk factors for the reported common health problems were often prevalent in the study villages. Villagers can address most of these risk factors, as interventions to address such risk factors do not require a large financial input. There is a need for intersectoral actions between the health and other sectors to address food shortages and indoor air pollution due to indoor cooking using biomass fuel.

Effects of the Developing and Using a Model to Predict Dengue Risk Villages Based on Subdistrict Administrative Organization in Southern Thailand

The purpose of this study was to evaluate the effects of developing and using a model to predict dengue risk in villages and of a larval indices surveillance system for 2372 households in 10 Thai villages. A community participatory action research method was used in five steps: (1) community preparation covering all stakeholders, (2) assessment of the understanding of a dengue solution and a larval indices surveillance system, (3) development of a prediction and intervention model for dengue risk villages, (4) implementation of the model that responds to all stakeholders, and (5) evaluation of the effects of using the model. The questionnaires to assess and evaluate were validated and reliability tested. The chi-square test and Fisher's exact test were used to analyze the quantitative data collected by means of questionnaires. Thematic analysis was applied to the qualitative data collected through interviews. The results found that the model consisted of six main activities, including (1) setting team leader responsibility, (2) situation assessment, (3) prediction of the dengue risk in villages, (4) the six steps of the larval indices surveillance system, (5) the understanding of the dengue solution and the understanding of the larval indices surveillance system training program, and (6) local wisdom innovation. The effects of using the model showed a statistically significant increase in correct understanding among 932 family leaders, 109 village health volunteers, and 59 student leaders regarding dengue prevention and control (p < 0.05). The larval indices and dengue morbidity were diminished and related to the nine themes present in the community leaders' reflections and to the satisfaction of the community members. Hence, local administrative organizations should use community-based approaches as the subdistrict dengue solution innovation to reduce the dengue problem.

Coagulopathy of Dengue and COVID-19: Clinical Considerations

Thrombocytopenia and platelet dysfunction commonly occur in both dengue and COVID-19 and are related to clinical outcomes. Coagulation and fibrinolytic pathways are activated during an acute dengue infection, and endothelial dysfunction is observed in severe dengue. On the other hand, COVID-19 is characterised by a high prevalence of thrombotic complications, where bleeding is rare and occurs only in advanced stages of critical illness; here thrombin is the central mediator that activates endothelial cells, and elicits a pro-inflammatory reaction followed by platelet aggregation. Serological cross-reactivity may occur between COVID-19 and dengue infection. An important management aspect of COVID-19-induced immunothrombosis associated with thrombocytopenia is anticoagulation with or without aspirin. In contrast, the use of aspirin, nonsteroidal anti-inflammatory drugs and anticoagulants is contraindicated in dengue. Mild to moderate dengue infections are treated with supportive therapy and paracetamol for fever. Severe infection such as dengue haemorrhagic fever and dengue shock syndrome often require escalation to higher levels of support in a critical care facility. The role of therapeutic platelet transfusion is equivocal and should not be routinely used in patients with dengue with thrombocytopaenia and mild bleeding. The use of prophylactic platelet transfusion in dengue fever has strained financial and healthcare systems in endemic areas, together with risks of transfusion-transmitted infections in low- and middle-income countries. There is a clear research gap in the management of dengue with significant bleeding.

Constructing and validating a transferable epidemic risk index in data scarce environments using open data: A case study for dengue in the Philippines

Epidemics are among the most costly and destructive natural hazards globally. To reduce the impacts of infectious disease outbreaks, the development of a risk index for infectious diseases can be effective, by shifting infectious disease control from emergency response to early detection and prevention.

In this study, we introduce a methodology to construct and validate an epidemic risk index using only open data, with a specific focus on scalability. The external validation of our risk index makes use of distance sampling to correct for underreporting of infections, which is often a major source of biases, based on geographical accessibility to health facilities. We apply this methodology to assess the risk of dengue in the Philippines.

The results show that the computed dengue risk correlates well with standard epidemiological metrics, i.e. dengue incidence (p = 0.002). Here, dengue risk constitutes of the two dimensions susceptibility and exposure. Susceptibility was particularly associated with dengue incidence (p = 0.048) and dengue case fatality rate (CFR) (p = 0.029). Exposure had lower correlations to dengue incidence (p = 0.193) and CFR (p = 0.162). Highest risk indices were seen in the south of the country, mainly among regions with relatively high susceptibility to dengue outbreaks.

Our findings reflect that the modelled epidemic risk index is a strong indication of sub-national dengue disease patterns and has therefore proven suitability for disease risk assessments in the absence of timely epidemiological data. The presented methodology enables the construction of a practical, evidence-based tool to support public health and humanitarian decision-making processes with simple, understandable metrics. The index overcomes the main limitations of existing indices in terms of construction and actionability.

Epidemics are among the most costly and destructive natural hazards occurring globally; currently, the response to epidemics is still focused on reaction rather than prevention or preparedness. The development of an epidemic risk index can support identifying high-risk areas and can guide prioritization of preventive action and humanitarian response. While several frameworks for epidemic risk assessment exist, they suffer from several limitations, which resulted in limited uptake by local health actors—such as governments and humanitarian relief workers—in their decision-making processes. In this study, we present a methodology to develop epidemic risk indices, which overcomes the major limitations of previous work: strict data requirements, insufficient geographical granularity, validation against epidemiological data. We take as a case study dengue in the Philippines and develop an epidemic risk index; we correct dengue incidence for underreporting based on accessibility to healthcare and show that it correlates well with the risk index (Pearson correlation coefficient 0.69, p-value 0.002). Our methodology enables the development of disease-specific epidemic risk indices at a sub-national level, even in countries with limited data availability; these indices can guide local actors in programming prevention and response activities. Our findings on the case study show that the epidemic risk index is a strong indicator of sub-national dengue disease patterns and is therefore suitable for disease risk assessments in the absence of timely and complete epidemiological data.

Synthesis and characterization of bio catalyst prepared from dairy waste for lactic acid esterification

Dairy byproduct is known for its valuable chemical and nutritional content possessing high market potential. Notwithstanding, it is tractable to exploit its utilization. The waste generated is organic and having huge energy potential. The objective of current research is to synthesize novel catalyst from a dairy based solid waste called Ghee Residue by chemical activation process and deploy it for the production of iso-butyl lactate. Surface identity of catalyst was furnished using Brunauer-Emmet Teller (BET) method and Fourier Transform Infrared Spectroscopy (FTIR). Effect of variables like reaction time, temperature of reaction and loading of catalyst on lactic acid conversion were studied. In addition to this, reaction kinetics modelling was performed using 2nd order pseudo-homogeneous approach. It was inferred that, both internal as well as external resistance of mass transfer could not offer any influence on overall rate of reaction in this esterification. Optimum condition for esterification reaction was at 368 K with 3% catalyst loading giving the highest conversion around 74%. The energy of activation for the present system using synthesized catalyst was 41.5 kJ/mol and found to be lower in comparison with the other catalysts. Although, the activity of GRC declined gradually less than 10% from the activity of the several reaction cycle.

Developing Risk Assessment Criteria and Predicting High- and Low-Dengue Risk Villages for Strengthening Dengue Prevention Activities: Community Participatory Action Research, Thailand

Background:

Risk assessment criteria for predicting dengue outbreak must be appropriated at village levels. We aimed to develop risk dengue village prediction criteria, predict village dengue risk, and strengthen dengue prevention based on community participation.

Methods:

This participatory research conducted in Southern Thailand included the following 5 phases: (i) preparing communities in 3 districts; (ii) developing risk dengue village prediction criteria; (iii) applying computer program; (iv) predicting village dengue risk with 75 public health providers in 39 PCUs; and (v) utilizing findings to strengthen dengue prevention activities in 220 villages. Data collecting for prediction used secondary data from primary care units in the past 5 year and current year. Descriptive statistics used calculating criteria and comparing with standard level to adjust score of risk.

Results:

Risk dengue village assessment criteria had 2 aspects: dengue severity (3 factors) and dengue outbreak opportunity (3 factors). Total scores were 33 points and cut-off of 17 points for high and low dengue risks villages. All criteria were applied using computer program (http://surat.denguelim.com). Risk prediction involved stakeholder participation in 220 villages, and used for strengthening dengue prevention activities. The concept of integrated vector management included larval indices surveillance system, garbage management, larval indices level lower than the standard, community capacity activities for dengue prevention, and school-based dengue prevention. The risk prediction criteria and process mobilized villages for dengue prevention activities to decrease morbidity rate.

Conclusion:

Dengue risk assessment criteria were appropriated within the village, with its smallest unit, the household, included. The data can be utilized at village levels for evaluating dengue outbreak risks.

Forest Coverage and Socioeconomic Factors Associated with Dengue in El Salvador, 2011-2013

Dengue virus serotypes 1, 2, 3, and 4 are transmitted by Aedes aegypti and Aedes albopictus mosquitoes, which cause illness in an estimated 100 million annually. Although dengue viruses are endemic throughout El Salvador, very little is known about their ecology and epidemiology. The principal methods to prevent and reduce dengue cases are through vector control and by adoption of a vaccine. In addition, understanding the environmental and socioeconomic factors associated with dengue could contribute to case reduction by targeting prevention efforts in dengue hotspots. This study investigated environmental and socioeconomic factors associated with dengue cases in El Salvador. Dengue cases were obtained from 2011 to 2013 for 262 municipalities. The mean incidence was determined for each municipality for the 3 year period. Negative binomial regression models evaluated the relationship between dengue cases and the environmental factors elevation, forest coverage, mean annual temperature, and cumulative precipitation. Twelve socioeconomic and infrastructure variables and their relationship with dengue were also investigated by using negative binomial regression. A total of 29,764 confirmed dengue cases were reported. The mean dengue incidence for 2011-2013 was 135/100,000. The highest number of dengue cases occurred in San Salvador and surrounding municipalities, as well as in two additional cities, Santa Ana and San Miguel; the highest incidence of dengue cases (per 100,000) occurred in cities in the west and at the center of the country. Significant environmental variables associated with dengue included temperature, precipitation, and non-forested area. The socioeconomic variables poverty rate, illiteracy rate, and school attendance, and the infrastructure variables percent of homes with sanitary service, municipal trash service, electricity, and cement brick flooring, as well as population density, were also significant predictors of dengue. Understanding these environmental and socioeconomic factors and their relationship with dengue will help design and implement timely prevention strategies and vector control to reduce dengue in El Salvador.

Factors associated with dengue prevention behaviour in riverbank area: A cross-sectional study

Introduction

Dengue has been a burden, especially in tropical country. Indonesian Ministry of Health promote dengue prevention through environmental control with 3 M (covering water storage, cleaning water storage, and recycling unused items) practices. Here we analyzed factors associated with dengue prevention behavior in riverbank area of Yogyakarta Province.

Methods

The study employed cross-sectional survey covering riverbank area of Sendowo, Yogyakarta Province. This study systematically sampled 1 representative from every household to describe the condition of 1 house. We analyzed the associations between subjects' characteristics and dependent variables using Pearson's chi-square test.

Results

Overall, 89 subjects were enrolled in this study, of whom 11.2% males and 88.8% females. Age and occupation were associated with covering water storage variable with p-value of <0.001 and 0.007, respectively. Recycling unused items variable was associated with monthly income with p-values of 0.045. Furthermore, there were no significant associations between cleaning water storage variable with sex, age, marital status, education level, monthly income, and occupation.

Conclusion

Age and occupations were associated with covering water storage variable. Recycling unused items variable shows significant association with income. Further multiarea study is necessary to compare our findings with other areas.

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Dengue has been a burden in tropical country

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Several factors associated with dengue prevention behavior in riverbank area

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It is essential to promote dengue prevention through environmental control

Integrated disease management: arboviral infections and waterborne diarrhoea

Water-related diseases such as diarrhoeal diseases from viral, bacterial and parasitic organisms and Aedes-borne arboviral diseases are major global health problems. We believe that these two disease groups share common risk factors, namely inadequate household water management, poor sanitation and solid waste management. Where water provision is inadequate, water storage is essential. Aedes mosquitoes commonly breed in household water storage containers, which can hold water contaminated with enteric disease-causing organisms. Microbiological contamination of water between source and point-of-use is a major cause of reduced drinking-water quality. Inadequate sanitation and solid waste management increase not only risk of water contamination, but also the availability of mosquito larval habitats. In this article we discuss integrated interventions that interrupt mosquito breeding while also providing sanitary environments and clean water. Specific interventions include improving storage container design, placement and maintenance and scaling up access to piped water. Vector control can be integrated into sanitation projects that target sewers and drains to avoid accumulation of stagnant water. Better management of garbage and solid waste can reduce the availability of mosquito habitats while improving human living conditions. Our proposed integration of disease interventions is consistent with strategies promoted in several global health frameworks, such as the sustainable development goals, the global vector control response, behavioural change, and water, sanitation and hygiene initiatives. Future research should address how interventions targeting water, sanitation, hygiene and community waste disposal also benefit Aedes-borne disease control. The projected effects of climate change mean that integrated management and control strategies will become increasingly important.

The Impact of Illegal Waste Sites on the Transmission of Zoonotic Cutaneous Leishmaniasis in Central Tunisia

Illegal waste disposal represents a risk health factor for vector-borne diseases by providing shelter for rodents and their ectoparasites. The presence of the Phlebotomus papatasi vector of Leishmania major, an etiologic agent of zoonotic cutaneous leishmaniasis (ZCL), was assessed at illegal waste sites located at the vicinity of villages in endemic areas of Central Tunisia. The study was performed over a two-year period over three nights from July to September 2017, and over three nights in September 2018. Household waste is deposited illegally forming dumpsites at the vicinity of each village and contains several rodent burrows of Psammomys obesus, the main reservoir host of L. major. Sandflies were collected from rodent burrows in the natural environment and in dumpsites using sticky traps and were identified at species level. Female sandflies were tested for the presence of L. major by PCR. Our entomological survey showed that Phlebotomus papatasi is the most abundant sandfly species associated with rodent burrows in these waste sites. The densities of P. papatasi in dumpsites are significantly higher compared to the natural environment. The minimum infection rate of P. papatasi with L. major in these illegal waste sites is not significantly different compared to the natural environment. Considering the short flight range of P. papatasi, increases in its densities, associated with burrows of P. obesus in illegal waste sites located at the edge of villages, expands the overlap of infected ZCL vectors with communities. Thus, illegal waste sites pose a high risk of spreading ZCL to neighboring home ranges. Waste management is an environmentally friendly method of controlling sandfly populations and should be included in an integrated management program for controlling ZCL in endemic countries.

Narrative Review on Health-EDRM Primary Prevention Measures for Vector-Borne Diseases

Climate change is expanding the global at-risk population for vector-borne diseases (VBDs). The World Health Organization (WHO) health emergency and disaster risk management (health-EDRM) framework emphasises the importance of primary prevention of biological hazards and its value in protecting against VBDs. The framework encourages stakeholder coordination and information sharing, though there is still a need to reinforce prevention and recovery within disaster management. This keyword-search based narrative literature review searched databases PubMed, Google Scholar, Embase and Medline between January 2000 and May 2020, and identified 134 publications. In total, 10 health-EDRM primary prevention measures are summarised at three levels (personal, environmental and household). Enabling factor, limiting factors, co-benefits and strength of evidence were identified. Current studies on primary prevention measures for VBDs focus on health risk-reduction, with minimal evaluation of actual disease reduction. Although prevention against mosquito-borne diseases, notably malaria, has been well-studied, research on other vectors and VBDs remains limited. Other gaps included the limited evidence pertaining to prevention in resource-poor settings and the efficacy of alternatives, discrepancies amongst agencies' recommendations, and limited studies on the impact of technological advancements and habitat change on VBD prevalence. Health-EDRM primary prevention measures for VBDs require high-priority research to facilitate multifaceted, multi-sectoral, coordinated responses that will enable effective risk mitigation.

Modeling and prediction of dengue occurrences in Kolkata, India, based on climate factors

Dengue is one of the most serious vector-borne infectious diseases in India, particularly in Kolkata and its neighbouring districts. Dengue viruses have infected several citizens of Kolkata since 2012 and it is amplifying every year. It has been derived from earlier studies that certain meteorological variables and climate change play a significant role in the spread and amplification of dengue infections in different parts of the globe. In this study, our primary objective is to identify the relative contribution of the putative drivers responsible for dengue occurrences in Kolkata and project dengue incidences with respect to the future climate change. The regression model was developed using maximum temperature, minimum temperature, relative humidity and rainfall as key meteorological factors on the basis of statistically significant cross-correlation coefficient values to predict dengue cases. Finally, climate variables from the Coordinated Regional Climate Downscaling Experiment (CORDEX) for South Asia region were input into the statistical model to project the occurrences of dengue infections under different climate scenarios such as Representative Concentration Pathways (RCP4.5 and RCP8.5). It has been estimated that from 2020 to 2100, dengue cases will be higher from September to November with more cases in RCP8.5 (872 cases per year) than RCP4.5 (531 cases per year). The present research further concludes that from December to February, RCP8.5 leads to suitable warmer weather conditions essential for the survival and multiplication of dengue pathogens resulting more than two times dengue cases in RCP8.5 than in RCP4.5. Furthermore, the results obtained will be useful in developing early warning systems and provide important evidence for dengue control policy-making and public health intervention.

Solid Wastes Provide Breeding Sites, Burrows, and Food for Biological Disease Vectors, and Urban Zoonotic Reservoirs: A Call to Action for Solutions-Based Research

Background: Infectious disease epidemiology and planetary health literature often cite solid waste and plastic pollution as risk factors for vector-borne diseases and urban zoonoses; however, no rigorous reviews of the risks to human health have been published since 1994. This paper aims to identify research gaps and outline potential solutions to interrupt the vicious cycle of solid wastes; disease vectors and reservoirs; infection and disease; and poverty.

Methods: We searched peer-reviewed publications from PubMed, Google Scholar, and Stanford Searchworks, and references from relevant articles using the search terms (“disease” OR “epidemiology”) AND (“plastic pollution,” “garbage,” and “trash,” “rubbish,” “refuse,” OR “solid waste”). Abstracts and reports from meetings were included only when they related directly to previously published work. Only articles published in English, Spanish, or Portuguese through 2018 were included, with a focus on post-1994, after the last comprehensive review was published. Cancer, diabetes, and food chain-specific articles were outside the scope and excluded. After completing the literature review, we further limited the literature to “urban zoonotic and biological vector-borne diseases” or to “zoonotic and biological vector-borne diseases of the urban environment.”

Results: Urban biological vector-borne diseases, especially Aedes-borne diseases, are associated with solid waste accumulation but vector preferences vary over season and region. Urban zoonosis, especially rodent and canine disease reservoirs, are associated with solid waste in urban settings, especially when garbage accumulates over time, creating burrowing sites and food for reservoirs. Although evidence suggests the link between plastic pollution/solid waste and human disease, measurements are not standardized, confounders are not rigorously controlled, and the quality of evidence varies. Here we propose a framework for solutions-based research in three areas: innovation, education, and policy.

Conclusions: Disease epidemics are increasing in scope and scale with urban populations growing, climate change providing newly suitable vector climates, and immunologically naïve populations becoming newly exposed. Sustainable solid waste management is crucial to prevention, specifically in urban environments that favor urban vectors such as Aedes species. We propose that next steps should include more robust epidemiological measurements and propose a framework for solutions-based research.

Dengue Virus

Dengue virus (DENV) belongs to the family Flaviviridae, genus Flavivirus. It is a single-stranded positive-sense ribonucleic acid virus with 10,700 bases. The genus Flavivirus includes other arthropod borne viruses such as yellow fever virus, West Nile virus, Zika virus, tick-borne encephalitis virus. It infects ~50–200 million people annually, putting over 3.6 billion people living in tropical regions at risk and causing ~20,000 deaths annually. The expansion of dengue is attributed to factors such as the modern dynamics of climate change, globalization, travel, trade, socioeconomics, settlement, and also viral evolution. There are four antigenically different serotypes of DENV based on the differences in their viral structural and nonstructural proteins. DENV infection causes a spectrum of illness ranging from asymptomatic to dengue fever to severe dengue shock syndrome. Infection with one serotype confers lifelong immunity against that serotype, but heterologus infection leads to severe dengue hemorrhagic fever due to antibody-dependent enhancement. Diagnosis of dengue infections is based mainly on serological detection of either antigen in acute cases or antibodies in both acute and chronic infection. Viral detection and real-time PCR detection though helpful is not feasible in resource poor setup. Treatment of dengue depends on symptomatic management along with fluid resuscitation and may require platelet transfusion. Although vaccine development is in late stages of development, developing a single vaccine against four serotypes often causes serious challenges to researchers; hence, the main stay of prevention is vector control and management.

The Anthropology of Plastics: An Agenda for Local Studies of a Global Matter of Concern

Anthropology has largely ignored plastics, even as they have emerged as the paradigmatic material-and problem-of our times. In this article, we make the case for an anthropology of plastics as a priority for environmental and medical anthropological research. Drawing from exploratory fieldwork in India, we briefly highlight the benefits and risks of different types of plastics, identify areas for anthropological investigations of human-plastic entanglements, and unpack major debates about plastic control. We recommend analyses that take into account the social life of plastics and the life cycle of plastic production, consumption, circulation, disposal, retrieval, and decomposition. We propose a facilitator role for anthropologists in bringing environmental NGOs and the plastic industry to the table to reduce the human and environmental health risks related to widespread reliance on plastics. Overall, we argue that anthropological analyses are urgently needed to address environmental and global health concerns related to plastics.

An analysis of community perceptions of mosquito-borne disease control and prevention in Sint Eustatius, Caribbean Netherlands

BACKGROUND

In the Caribbean, mosquito-borne diseases are a public health threat. In Sint Eustatius, dengue, Chikungunya and Zika are now endemic. To control and prevent mosquito-borne diseases, the Sint Eustatius Public Health Department relies on the community to assist with the control of Aedes aegypti mosquito. Unfortunately, community based interventions are not always simple, as community perceptions and responses shape actions and influence behavioural responses Objective: The aim of this study was to determine how the Sint Eustatius population perceives the Aedes aegypti mosquito, mosquito-borne diseases and prevention and control measures and hypothesized that increased knowledge of the virus, vector, control and prevention should result in a lower AQ1 prevalence and incidence of mosquito-borne diseases.

METHODS

This study was conducted in Sint Eustatius island in the Eastern Caribbean. We combined qualitative and quantitative designs. We conducted interviews and focus groups discussions among community member and health professional in 2013 and 2015. We also conducted cross-sectional survey to assess local knowledge on the vector, virus, and control and prevention.

RESULTS

The population is knowledgeable; ©however, mosquito-borne diseases are not the highest health priority. While local knowledge is sometimes put into action, it happens on the 20 household/individual level as opposed to the community level. After the 2014 CHIK outbreak, there was an increase in knowledge about mosquito control and mosquito-borne diseases.

DISCUSSION

In the context of Sint Eustatius, when controlling the Aedes population it may be a strategic option to focus on the household level rather than the community and build collaborations with households by supporting them when they actively practice mosquito 25 control. To further increase the level of knowledge on the significance of mosquito-borne diseases, it may also be an option to contextualize the issue of the virus, vector, prevention and control into a broader context.

CONCLUSION

As evidenced by the increasing number of mosquito-borne diseases on the island, it appears that knowledge amongst the lay community may not be transferred into 30 action. This may be attributed to the perception of the Sint Eustatius populations that mosquitoes and the viruses they carry are not a high priority in comparison to other health concerns.

Exposure of a diurnal mosquito vector to floral mimics: Foraging responses, feeding patterns, and significance for sugar bait technology

Food location by mosquitoes is mediated by resource-derived olfactory and visual signals. Smell sensation is intermittent and dependent on the environment, whereas visual signals are continual and precede olfactory cues. Success of mosquito bait technology, where olfactory cues are used for attraction, is being impeded by reduced attractiveness. Despite proof that mosquitoes respond to colored objects, including those mimicking floral shape, and that they can discriminate among flowers, the impacts of artificial flowers on foraging remain unexplored. Using artificial flowers with sugar rewards, we examined the foraging responses of Aedes aegypti to various colors in equal choice bioassays. Starved adults were exposed to single flowers with petals of a given color (Single Blue Flowers [SBFs]; Single Red Flowers [SRFs]; Single Yellow Flowers [SYFs]; Single Pink Flowers [SPIFs]; and Single Purple Flowers [SPFs]) and two others with white petals (SWFs). Discrepancies in response time, visitation, feeding, and resting of both sexes were compared between colored flowers and SWFs. Ae. aegypti exhibited shorter response times to colored flowers compared to SWFs, but this behavior was mostly seen for SBFs or SYFs in females, and SRFs, SYFs, SPIFs, or SPFs in males. When provided an option to land on colored flowers and SWFs, female visitation occurred at high rates on SBFs, SRFs, SYFs, SPIFs, and SPFs; for males, this preference for colored flowers was seen to a lesser degree on SBF and SPIFs. Both sexes exhibited preference for colored flowers as sugar sources, but with different patterns: SPIFs, SRFs, SYFs, and SPFs for females; SYFs, SPFs, SPIFs and SRFs for males. Females preferentially rested on colored flowers when in competition with SWFs, but this preference was more pronounced for SPFs, SRFs, and SBFs. Males exhibited an increased preference for SRFs, SPFs, and SYFs as resting sites. Our results indicated the attraction of Ae. aegypti to rewarding artificial flowers, in some cases in ways similar to live flowering plants. The discovery that both male and female Ae. aegypti can feed on nectar mimics held by artificial flowers opens new avenues for improving sugar bait technology and for developing new attract-and-kill devices.

Occurrence of sweet refuse at disposal sites: rainwater retention capacity and potential breeding opportunities for Aedes aegypti

Nectar is the staple diet of adult mosquitoes in the wild, but its availability is inconsistent and can be affected by rainfall. In urban centers, Aedes vectors commonly use man-made containers as their major habitat; however, they can colonize any items replenished by rainfall. Garbage output has increased significantly in recent years, at a time when collection frequency is reducing. Such garbage usually includes organic components, some of which are sweet and can be fed upon by other animals or become can containers for rainwater. Despite evidence that Aedes larvae can thrive in containers comprised of organic waste material, which can be produced by rodents gnawing on fruits or vegetables, and that adults can survive on sweet waste fluids, the capacity of organic waste materials to accumulate rainwater and act as egg deposition sites has not been examined. It is also unknown for how long sweet extracts can sustain the life of adult vectors. Here, we investigated the abundance of sweet leftovers at garbage sites and the rainwater retention capacity of some organic materials through a field survey and laboratory bioassays. We also examined whether sweet waste fluids impact egg hatching success and longevity of Aedes aegypti. The results of this study indicated that sweet products with leftovers are highly prevalent in garbage. When exposed to rain, food items (BAFrc, banana fruit resembling container; and BSPrc, boiled sweet potato resembling container) and the packaging of sweet foods (SMIc, sweetened condensed milk can) retained water. When provided an opportunity to oviposit in cups containing BAF extract (BAFex), BSP extract (BSPex), and SMI extract (SMIex), eggs were deposited in all media. Egg maturation in the BAFex environment resulted in similar larval eclosion success to that resulting from embryo development in a water milieu. Adults maintained on sweet waste extracts had long lifespans, although shorter than that of their sugar solution (SUS)-fed counterparts. Taken together, these results indicated that sweet waste materials are useful to dengue mosquitoes, acting both as oviposition sites and energy sources.

Presence of a predator image in potential breeding sites and oviposition responses of a dengue vector

In dengue vector control, attempts to minimize or replace the use of pesticides have mostly involved use of predators, but success has been severely impeded by difficulties associated with financial and environmental costs, predator mass production, and persistence in target habitats. Visual deterrents have been used successfully to control animal pests, in some cases in an effort to replace pesticide use. Despite evidence that visual signals are crucial in site choice for egg deposition by dengue vectors, and that female mosquitoes respond to artificial predation, the role of predator intimidation as it affects the oviposition behavior of dengue vectors remains largely unexplored. Here, we examined the oviposition responses of Aedes aegypti exposed to various mosquito predator pictures. Gravid females were presented with equal opportunities to oviposit in two cups with predator images [Toxorhynchites splendens-TXI, Goldfish (Carassius auratus)-small (SFI) and large (LFI) and Tx. splendens+Goldfish-TXFI] and two others without pictures. Differences in egg deposition were examined between sites with and without these images. When given a chance to oviposit in cups with and without TXI, Ae. aegypti females were similarly attracted to both sites. When provided an opportunity to oviposit in cups displaying pictures of fish (SFI or LFI) and blank cups, egg deposition rates were much lower in the fish picture sites. Females showed a preference for blank cups over TXFI for egg deposition. They also equally avoided cups with pictures of fish, regardless of the size of the picture. Our results indicate that the presence of images of goldfish and their association with Tx. larvae significantly reduced egg deposition by Ae. aegypti, and this was not the case with the predatory larvae alone. The observations that the images of natural predators can repel gravid females of a dengue vector provide novel possibilities to develop effective and inexpensive alternative tools to harmful insecticides.

Sweet waste extract uptake by a mosquito vector: Survival, biting, fecundity responses, and potential epidemiological significance

In nature, adult mosquitoes typically utilize nectar as their main energy source, but they can switch to other as yet unidentified sugary fluids. Contemporary lifestyles, with their associated unwillingness to consume leftovers and improper disposal of waste, have resulted in the disposal of huge amounts of waste into the environment. Such refuse often contains unfinished food items, many of which contain sugar and some of which can collect water from rain and generate juices. Despite evidence that mosquitoes can feed on sugar-rich suspensions, semi-liquids, and decaying fruits, which can be abundant in garbage sites, the impacts of sweet waste fluids on dengue vectors are unknown. Here, we investigated the effects of extracts from some familiar sweet home waste items on key components of vectorial capacity of Aedes aegypti. Adult mosquitoes were fed one of five diets in this study: water (WAT); sucrose (SUG); bakery product (remnant of chocolate cake, BAK); dairy product (yogurt, YOG); and fruit (banana (BAN). Differences in survival, response time to host, and egg production were examined between groups. For both males and females, maintenance on BAK extract resulted in marked survival levels that were similar to those seen with SUG. Sweet waste extracts provided better substrates for survival compared to water, but this superiority was mostly seen with BAK. Females maintained on BAK, YOG, and BAN exhibited shorter response times to a host compared to their counterparts maintained on SUG. The levels of egg production were equivalent in waste extract- and SUG-fed females. The findings presented here illustrate the potential of sweet waste-derived fluids to contribute to the vectorial capacity of dengue vectors and suggest the necessity of readdressing the issue of waste disposal, especially that of unfinished sweet foods. Such approaches can be particularly relevant in dengue endemic areas where rainfall is frequent and waste collection infrequent.

The cross-cutting contribution of the end of neglected tropical diseases to the sustainable development goals

The Sustainable Development Goals (SDGs) call for an integrated response, the kind that has defined Neglected Tropical Diseases (NTDs) efforts in the past decade.NTD interventions have the greatest relevance for SDG3, the health goal, where the focus on equity, and its commitment to reaching people in need of health services, wherever they may live and whatever their circumstances, is fundamentally aligned with the target of Universal Health Coverage. NTD interventions, however, also affect and are affected by many of the other development areas covered under the 2030 Agenda. Strategies such as mass drug administration or the programmatic integration of NTD and WASH activities (SDG6) are driven by effective global partnerships (SDG17). Intervention against the NTDs can also have an impact on poverty (SDG1) and hunger (SDG2), can improve education (SDG4), work and economic growth (SDG8), thereby reducing inequalities (SDG10). The community-led distribution of donated medicines to more than 1 billion people reinforces women's empowerment (SDG5), logistics infrastructure (SDG9) and non-discrimination against disability (SDG16). Interventions to curb mosquito-borne NTDs contribute to the goals of urban sustainability (SDG11) and resilience to climate change (SDG13), while the safe use of insecticides supports the goal of sustainable ecosystems (SDG15). Although indirectly, interventions to control water- and animal-related NTDs can facilitate the goals of small-scale fishing (SDG14) and sustainable hydroelectricity and biofuels (SDG7).NTDs proliferate in less developed areas in countries across the income spectrum, areas where large numbers of people have little or no access to adequate health care, clean water, sanitation, housing, education, transport and information. This scoping review assesses how in this context, ending the epidemic of the NTDs can impact and improve our prospects of attaining the SDGs.