Integrating participatory community mobilization processes to improve dengue prevention: an eco-bio-social scaling up of local success in Machala, Ecuador

This project investigates the effectiveness and feasibility of scaling-up an eco-bio-social approach for implementing an integrated community-based approach for dengue prevention in comparison with existing insecticide-based and emerging biolarvicide-based programs in an endemic setting in Machala, Ecuador

Household and climate factors influence Aedes aegypti presence in the arid city of Huaquillas, Ecuador

Funding: This study was funded by NSF EEID DEB 1518681 to SJR, EAM, AMS. EAM was also supported by NIH R35GM133439, NSF DEB-2011147, the Terman Award, the Helman Faculty Fellowship, and the Stanford Center for Innovation in Global Health.Arboviruses transmitted by Aedes aegypti (e.g., dengue, chikungunya, Zika) are of major public health concern on the arid coastal border of Ecuador and Peru. This high transit border is a critical disease surveillance site due to human movement-associated risk of transmission. Local level studies are thus integral to capturing the dynamics and distribution of vector populations and social-ecological drivers of risk, to inform targeted public health interventions. Our study examines factors associated with household-level Ae. aegypti presence in Huaquillas, Ecuador, while accounting for spatial and temporal effects. From January to May of 2017, adult mosquitoes were collected from a cohort of households (n = 63) in clusters (n = 10), across the city of Huaquillas, using aspirator backpacks. Household surveys describing housing conditions, demographics, economics, travel, disease prevention, and city services were conducted by local enumerators. This study was conducted during the normal arbovirus transmission season (January-May), but during an exceptionally dry year. Household level Ae. aegypti presence peaked in February, and counts were highest in weeks with high temperatures and a week after increased rainfall. Univariate analyses with proportional odds logistic regression were used to explore household social-ecological variables and female Ae. aegypti presence. We found that homes were more likely to have Ae. aegypti when households had interruptions in piped water service. Ae. aegypti presence was less likely in households with septic systems. Based on our findings, infrastructure access and seasonal climate are important considerations for vector control in this city, and even in dry years, the arid environment of Huaquillas supports Ae. aegypti breeding habitat.Publisher PDFPeer reviewe

The 2018–2019 weak El Niño: Predicting the risk of a dengue outbreak in Machala, Ecuador

Between October 2018 - May 2019, sea surface temperature conditions in the central-eastern tropical Pacific indicated a mild El Niño event. In May 2019, the global El Niño Southern Oscillation (ENSO) forecast consensus was that these generally weak warm patterns will persist at least until the end of the northern hemisphere summer. El Niño and its impact on local climatic conditions in southern coastal Ecuador influence the inter-annual transmission of dengue fever in the region. In this study, we use an ENSO model to issue forecasts of El Niño for the year 2019, which are then used to predict local climate variables, precipitation and minimum temperature, in the city of Machala, Ecuador. All these forecasts are incorporated in a dengue transmission model, specifically developed and tested for this area, to produce out-of-sample predictions of dengue risk. Predictions are issued at the beginning of January 2019 for the whole year, thus providing the longest forecast lead time of 12 months. Preliminary results indicate that the mild and ongoing El Niño event did not provide the optimum climate conditions for dengue transmission, with the model predicting a very low probability of a dengue outbreak during the typical peak season in Machala in 2019. This is contrary to 2016, when a large El Niño event resulted in excess rainfall and warmer temperatures in the region, and a dengue outbreak occurred 3 months earlier than expected. This event was successfully predicted using a similar prediction framework to the one applied here. With the present study, we continue our efforts to build and test a climate service tool to issue early warnings of dengue outbreaks in the region

Climate predicts geographic and temporal variation in mosquito-borne disease dynamics on two continents

Funding: J.M.C., A.D.L., E.F.L., and E.A.M. were supported by a Stanford Woods Institute for the Environment—Environmental Ventures Program grant (PIs: E.A.M., A.D.L., and E.F.L.). E.A.M. was also supported by a Hellman Faculty Fellowship and a Terman Award. A.D.L., B.A.N., F.M.M., E.N.G.S., M.S.S., A.R.K., R.D., A.A., and H.N.N. were supported by a National Institutes of Health R01 grant (AI102918; PI: A.D.L.). E.A.M., A.M.S.I., and S.J.R. were supported by a National Science Foundation (NSF) Ecology and Evolution of Infectious Diseases (EEID) grant (DEB-1518681), and A.M.S.I. and S.J.R. were also supported by an NSF DEB RAPID grant (1641145). E.A.M. was also supported by a National Institute of General Medical Sciences Maximizing Investigators’ Research Award grant (R35GM133439) and an NSF and Fogarty International Center EEID grant (DEB-2011147).Climate drives population dynamics through multiple mechanisms, which can lead to seemingly context-dependent effects of climate on natural populations. For climate-sensitive diseases, such as dengue, chikungunya, and Zika, climate appears to have opposing effects in different contexts. Here we show that a model, parameterized with laboratory measured climate-driven mosquito physiology, captures three key epidemic characteristics across ecologically and culturally distinct settings in Ecuador and Kenya: the number, timing, and duration of outbreaks. The model generates a range of disease dynamics consistent with observed Aedes aegypti abundances and laboratory-confirmed arboviral incidence with variable accuracy (28-85% for vectors, 44-88% for incidence). The model predicted vector dynamics better in sites with a smaller proportion of young children in the population, lower mean temperature, and homes with piped water and made of cement. Models with limited calibration that robustly capture climate-virus relationships can help guide intervention efforts and climate change disease projections.Publisher PDFPeer reviewe