Insecticide-treated house screening protects against zika-infected aedes aegypti in Merida, Mexico

Houses protected with screens were 80% less infested with Aedes females and very importantly, had significantly less infected female Ae. aegypti during the peak of the Zika epidemic. Integration of house-screening and long-lasting insecticidal nets, known as insecticide treated screening (ITS), can provide simple, safe, and low-tech Aedes aegypti control. Cluster randomised controlled trials in two endemic localities for Ae. aegypti of south Mexico, show that ITS conferred both immediate and sustained impact on indoor-female Ae. aegypti infestations. Such encouraging results require further validation with studies quantifying more epidemiologically-related endpoints, including arbovirus infection in Ae. Aegypti.Canadian Institutes of Health Research (CIHR

Use and acceptance of long lasting insecticidal net screens for dengue prevention in Acapulco, Guerrero, Mexico

Background Dengue, recognized by the WHO as the most important mosquito-borne viral disease in the world, is a growing problem. Currently, the only effective way of preventing dengue is vector control. Standard methods have shown limited effect, and there have been calls to develop new integrated vector management approaches. One novel tool, protecting houses with long lasting insecticidal screens on doors and windows, is being trialled in a cluster randomised controlled trial by a joint UADY/WHO TDR/IDRC study in various districts of Acapulco, Mexico, with exceptionally high levels of crime and insecurity. This study investigated the community’s perspectives of long lasting insecticidal screens on doors and windows in homes and in schools, in order to ascertain their acceptability, to identify challenges to further implementation and opportunities for future improvements. Methods This was a sequential mixed-methods study. The quantitative arm contained a satisfaction survey administered to 288 houses that had received the intervention examining their perspectives of both the intervention and dengue prevention in general. The qualitative arm consisted of Focus Group Discussions (FGDs) with those who had accepted the intervention and key informant interviews with: schoolteachers to discuss the use of the screens in schools, program staff, and community members who had refused the intervention. Results Overall satisfaction and acceptance of the screens was very high, with only some operational and technical complaints relating to screen fragility and the installation process. However, the wider social context of urban violence and insecurity was a major barrier to screen acceptance. Lack of information dissemination and community collaboration were identified as project weaknesses. Conclusions The screens are widely accepted by the population, but the project implementation could be improved by reassuring the community of its legitimacy in the context of insecurity. More community engagement and better information sharing structures are needed. The screens could be a major new dengue prevention tool suitable for widespread use, if further research supports their entomological and epidemiological effectiveness and their acceptability in different social and environmental contexts. Further research is needed looking at the impact of insecurity of dengue prevention programmes

Efficacy of novel indoor residual spraying methods targeting pyrethroid-resistant aedes aegypti within experimental houses

Challenges in maintaining high effectiveness of classic vector control in urban areas has renewed the interest in indoor residual spraying (IRS) as a promising approach for Aedes-borne disease prevention. While IRS has many benefits, application time and intrusive indoor applications make its scalability in urban areas difficult. Modifying IRS to account for Ae. aegypti resting behavior, named targeted IRS (TIRS, spraying walls below 1.5 m and under furniture) can reduce application time; however, an untested assumption is that modifications to IRS will not negatively impact entomological efficacy. We conducted a comparative experimental study evaluating the residual efficacy of classically-applied IRS (as developed for malaria control) compared to two TIRS application methods using a carbamate insecticide against a pyrethroid-resistant, field-derived Ae. aegypti strain. We performed our study within a novel experimental house setting (n = 9 houses) located in Merida (Mexico), with similar layouts and standardized contents. Classic IRS application (insecti-cide applied to full walls and under furniture) was compared to: a) TIRS: insecticide applied to walls below 1.5 m and under furniture, and b) Resting Site TIRS (RS-TIRS): insecticide applied only under furniture. Mosquito mortality was measured eight times post-application (out to six months post-application) by releasing 100 Ae. aegypti females/house and collecting live and dead individuals after 24 hrs exposure. Compared to Classic IRS, TIRS and RS-TIRS took less time to apply (31% and 82% reduction, respectively) and used less insecticide (38% and 85% reduction, respectively). Mortality of pyrethroid-resistant Ae. aegypti did not significantly differ among the three IRS application methods up to two months post application, and did not significantly differ between Classic IRS and TIRS up to four months post application. These data illustrate that optimizing IRS to more efficiently target Ae. aegypti

House screening with insecticide-treated netting provides sustained reductions in domestic populations of Aedes aegypti in Merida, Mexico.

There is a need for effective methods to control Aedes aegypti and prevent the transmission of dengue, chikungunya, yellow fever and Zika viruses. Insecticide treated screening (ITS) is a promising approach, particularly as it targets adult mosquitoes to reduce human-mosquito contact. A cluster-randomised controlled trial evaluated the entomological efficacy of ITS based intervention, which consisted of the installation of pyrethroid-impregnated long-lasting insecticide-treated netting material fixed as framed screens on external doors and windows. A total of 10 treatment and 10 control clusters (100 houses/cluster) were distributed throughout the city of Merida, Mexico. Cross-sectional entomological surveys quantified indoor adult mosquito infestation at baseline (pre-intervention) and throughout four post-intervention (PI) surveys spaced at 6-month intervals corresponding to dry/rainy seasons over two years (2012-2014). A total of 844 households from intervention clusters (86% coverage) were protected with ITS at the start of the trial. Significant reductions in the indoor presence and abundance of Ae. aegypti adults (OR = 0.48 and IRR = 0.45, P<0.05 respectively) and the indoor presence and abundance of Ae. aegypti female mosquitoes (OR = 0.47 and IRR = 0.44, P<0.05 respectively) were detected in intervention clusters compared to controls. This high level of protective effect was sustained for up to 24 months PI. Insecticidal activity of the ITS material declined with time, with ~70% mortality being demonstrated in susceptible mosquito cohorts up to 24 months after installation. The strong and sustained entomological impact observed in this study demonstrates the potential of house screening as a feasible, alternative approach to a sustained long-term impact on household infestations of Ae. aegypti. Larger trials quantifying the effectiveness of ITS on epidemiological endpoints are warranted and therefore recommended

Estimating absolute indoor density of Aedes aegypti using removal sampling

Exhaustive removal sampling represents a promising method for quantification of absolute indoor Aedes aegypti density, leading to improved entomological estimates of mosquito distribution. The study describes the use of sequential removal sampling to estimate absolute numbers of indoor resting Aedes in the city of Merida, Mexico. The study was performed in 200 houses based on recent occurrence of Aedes-borne viral illness in residents. The lack of a numerical association between relative and absolute density of adult Ae. aegypti represent a significant gap in vector surveillance. Merida is highly endemic for dengue and other Aedes-borne viruses.Bureau for Global HealthU.S Agency for International Development (USAID)US Centers for Disease Control and Prevention (CDC)Canadian Institutes of Health Research (CIHR

Insecticide-Treated House Screens to Reduce Infestations of Dengue Vectors

The public health importance of the endophilic mosquito Aedes aegypti increased dramatically in the recent decade, because it is the vector of dengue, chikungunya, Zika and yellow fever. The use of long-lasting insecticidal nets (LLINs) fixed on doors and windows, as insecticide-treated screening (ITS), is one innovative approach recently evaluated for Aedes control in South Mexico. From 2009 to 2014, cluster-randomised controlled trials were conducted in Acapulco and Merida. Intervention clusters received Aedes-proof houses (‘Casas a prueba de Aedes’) with ITS and were followed up during 2 years. Overall, results showed significant and sustained reductions on indoor adult vector densities in the treated clusters with ITS after 2 years: ca. 50% on the presence (OR ≤ 0.62, P < 0.05) and abundance (IRR ≤ 0.58, P < 0.05). ITS on doors and windows are ‘user-friendly’ tool, with high levels of acceptance, requiring little additional work or behavioural change by householders. Factors that favoured these interventions were (a) house construction, (b) high coverage achieved due to the excellent acceptance by the community and (c) collaboration of the vector control services; and only some operational complaints relating to screen fragility and the installation process. ITS is a housing improvement that should be part of the current paradigms for urban vector-borne disease control

Efectividad de repelentes comerciales disponibles contra el mosquito Aedes aegypti (L.) en Yucatán, México

Objetivo. Determinar la eficacia de repelentes comerciales disponibles en Yucatán contra el mosquito Aedes aegypti, vector del dengue, Chikungunya y Zika. Material y métodos. Se determinó el tiempo de protección con base en el protocolo WHO/CTD/WHOPES/IC y la NOM-032- SSA2-2014. Resultados. Sólo el repelente con DEET (N, N-dietil-3-metilbenzamida) al 25% cumplió con la protección recomendada. La eficacia fue directamente proporcional a la concentración del DEET; aquéllos con componentes botánicos fueron poco o nada protectores. Conclusiones. Los resultados muestran que los repelentes con DEET proveen protección contra Ae. Aegypti; los repelentes botánicos, incluyendo las pulseras impregnadas, ofrecen nula protección. ABSTRACT Objective. We assessed the efficacy of commercial repellents available in Yucatan against Aedes aegypti, vector of dengue, Chikungunya and Zika. Materials and methods. Protection time was determined based on WHO/CTD/ WHOPES/IC y la NOM-032-SSA2-2014. Results. Products with DEET (N, N-diethyl-3-methylbenzamide) at 25% met the recommended protection. Efficacy was directly proportional to the concentration of DEET; botanicals repellents resulted no protective. Conclusions. Repellents with DEET provided more protection against Ae. aegypti and botanical repellents, including impregnated wristbands, provided no protection

Detección molecular de Rickettsia typhi en perros de una comunidad rural de Yucatán, México

Introduction: Rickettsia typhi causes murine or endemic typhus, which is transmitted to humans primarily through flea bites contaminated with feces. Synanthropic and domestic animals also contribute to the infection cycle of R. typhi. Cases of murine typhus in humans were reported in the rural community of Bolmay, Yucatán, México, between 2007 and 2010. Objective: To identify the presence of R. typhi and estimate the frequency of infection in dogs from Bolmay, México, a locality with previous reports of murine typhus in humans. Materials and methods: Whole blood samples were taken from 128 dogs. Total DNA was extracted for use in the polymerase chain reaction (PCR) to amplify fragments of the 17 kDa and omp B genes and confirms the presence of Rickettsia spp. The reaction products were sequenced, and alignment analysis was performed using the BLAST tool. Results: The frequency of R. typhi infection in dogs was 5.5 % (7/128). The alignment identified 99% and 100% homology to the R. typhi 17 kDa and omp B genes, respectively. Conclusion: We confirmed the presence of R. typhi in dogs in the studied community but at a low frequency. However, there is potential risk of transmission to humans.Introducción. Rickettsia typhi es la bacteria causante del tifus múrido o endémico, el cual es transmitido al ser humano principalmente por medio de las heces infectadas de pulgas y en cuyo ciclo de infección se encuentran involucrados distintos animales sinantrópicos y domésticos. En la comunidad rural de Bolmay, Yucatán, México, se reportaron casos de tifus múrido en seres humanos durante el periodo 2007-2010.Objetivo. Identificar la presencia de R. typhi y estimar la frecuencia de infección en perros de Bolmay, México.Materiales y métodos. Se tomaron muestras de sangre completa de 128 perros, se les extrajo el ADN total y se analizaron mediante reacción en cadena de la polimerasa (PCR) para amplificar los fragmentos del gen de 17 kDa y omp B, y confirmar la presencia de Rickettsia spp. Los productos de las reacciones se enviaron a secuenciación y se les hizo un análisis de alineamiento con Basic Local Alignment Search Tool (BLAST).Resultados. Se encontró una frecuencia de infección de 5,5 % (7/128). El alineamiento demostró 99 % de homologación para el gen de 17 kDa y 100 % para el gen omp B en R. typhi.Conclusión. Se detectó la presencia de R. typhi pero una baja frecuencia de infección en perros de la comunidad de estudio; sin embargo, la especie podría representar un riesgo de transmisión para los seres humanos

Insecticide-treated house screening protects against Zika-infected Aedes aegypti in Merida, Mexico

There is strong and unquestionable epidemiological evidence of the protective efficacy of insecticide treated screens (ITS) against an arboviral disease of major relevance. Houses with ITS were 79-85% less infested with Aedes females than control houses during the peak of the zika epidemic, an effect that was significant up to a year. A similar significant trend was observed for blood-fed Ae. aegypti females (76-82%). Communities strongly accepted the intervention, due to its perceived mode of action, the prevalent risk for Aedes-borne diseases in the area, and the positive feedback from neighbours receiving ITS. The paper provides details of the study

Low-Cost Materials for Do-It-Yourself (DIY) Installation of House Screening against <em>Aedes aegypti</em>

House-screening (HS) using fixed-aluminium frames to reduce the risk of indoor infestation with Aedes aegypti mosquitoes as well as the risk of Aedes-transmitted diseases in communities living in endemic areas. However, the success of this approach has been hindered by the elevated cost of the aluminium-based materials as well as their professional installation, which cannot be afforded by people living under vulnerable conditions. Cost-saving strategies such as the use of low-cost materials including wood, PVC, and Velcro are within the list of HS options available and offered by HS businesses and/or Do-it-yourself (DIY) packages verbi gratia ready-made and ready-to-install mosquito-screens. Here, we evaluated the efficacy of low-cost frames constructed with different materials to protect against Ae. aegypti indoor infestation using experimental huts. The efficacy of protection in preventing female mosquito passing inside the huts of any of the options of frames was high (>93%) compared to the control with no-screen. People’s perceptions on the different materials showed the most “popular” alternative was the frame made of wood (62%). All the prototype-frames of HS made of different materials were effective at blocking Ae. aegypti entering-mosquitoes particularly, low-cost options like magnets and Velcro