Influence of the Distribution of Host Species on Adult Abundance of Japanese Encephalitis Vectors Culex vishnui Subgroup and Culex gelidus in a Rice-Cultivating Village in Northern Vietnam

A field study was conducted in a village in northern Vietnam to investigate how host distribution influences Japanese encephalitis (JE) vector abundance. Indoor and outdoor collections were conducted from 50 compounds. We collected three JE vector species--Culex tritaeniorhynchus and Culex vishnui that comprised the Culex vishnui group and Culex gelidus. Spatial autocorrelation was not observed in the mosquito assemblies at any scale larger than the house compounds. Multivariate analyses revealed that the Cx. gelidus density correlated positively with both the host proximity to the breeding sites and cattle density; however, the Cx. vishnui subgroup density correlated positively only with cattle density. These results showed that the number of cattle in a compound influenced the JE vector abundance in that compound, and the abundance of Cx. gelidus, not of the Cx. vishnui subgroup, was affected by the host proximity to the breeding sites in the village

Validation of Mesocyclops (Copepoda) and community participation as an effective combination for Dengue control in Northern Vietnam

The “Programme Meso-Vietnam” was implemented in Vietnam from October 2007 to December 2010 to reduce dengue and dengue hemorrhagic fever incidence and to improve the quality of life in the four project communes. This dengue control project was based on biological control using Mesocyclops, a larvivorous micro-crustacean, as well as on the establishment of a strong community involvement to educate the population on dengue transmission and to reduce Aedes breeding by removal of containers. During three years, a network of collaborators was responsible for introducing Mesocyclops in all the containers defined as key breeding-sites, and regular activities such as community training workshops, school programmes, clean-up campaigns and health promotion through IEC programmess were performed. To make this programme sustainable, local leadership has been strengthened as well. The use of these larvivorous micro-crustaceans as a biological control strategy against dengue over the medium and long term, when combined with community participation and effective health promotion, demonstrated a significant reduction in dengue vector populations and dengue cases.  In Vietnam, this study reconfirms that there is an ecological alternative to systematic use of insecticides to control dengue vector population. (Abstract word count: 186)Le " Programme Meso-Vietnam " a été mis en œuvre au Vietnam entre octobre 2007 et décembre 2010. Ce programme vise à réduire l'incidence de la dengue et de la fièvre hémorragique de la dengue et à améliorer la qualité de vie dans les quatre communes sélectionnées pour le projet. Ce projet de lutte contre la dengue était basé sur un contrôle biologique assuré par des Mésocyclopes, micro-crustacés larvivores, et sur l'établissement d'une forte implication de la communauté pour éduquer la population sur la transmission de la dengue et pour réduire la reproduction des moustiques Aedes par élimination des conteneurs leur servant de site de ponte. Pendant trois ans, un réseau de collaborateurs a été chargé d'introduire des Mésocyclopes dans tous les conteneurs définis comme des sites de reproduction clés, et des activités régulières telles que des ateliers de formation communautaires, des programmes scolaires, des campagnes de nettoyage et des activités de promotion de la santé via les programmes IEC ont été mises en place. En outre, pour assurer la pérennité de ce programme, le leadership local a été renforcé. L'utilisation de ces micro-crustacés larvivores comme stratégie de contrôle biologique de la dengue à moyen et long terme, associée à une participation communautaire et à une promotion efficace de la santé, a permis d'aboutir à une réduction significative des populations vecteurs de la dengue et des cas de dengue. Au Vietnam, cette étude confirme une fois de plus qu'il existe une alternative écologique à l'utilisation systématique d'insecticides pour lutter contre les vecteurs de la dengue.El “Programa Meso-Vietnam” se implementó en Vietnam desde octubre de 2007 hasta diciembre de 2010 para reducir la incidencia del dengue y la fiebre hemorrágica del dengue y para mejorar la calidad de vida en los cuatro municipios del proyecto. Este proyecto de control del dengue se basaba en el control biológico usando Mesocyclops, un microcrustáceo larvívoro, así como en el establecimiento de una fuerte implicación comunitaria para educar a la población sobre la transmisión del dengue y para reducir la cría de Aedes mediante la eliminación de recipientes. Durante tres años, una red de colaboradores fue responsable de la introducción de Mesocyclops en todos los recipientes definidos como sitios clave para la cría, y se realizaron actividades regulares tales como talleres de formación comunitaria, programas escolares, campañas de limpieza y promoción de la salud a través de programas de IEC. Para hacer sostenible este programa, también se reforzó el liderazgo local. El uso de estos microcrustáceos larvívoros como estrategia de control biológico contra el dengue a medio y largo plazo demostró una reducción significativa de las poblaciones de vectores del dengue y los casos de dengue cuando se combinaba con la participación comunitaria y la promoción eficaz de la salud. En Vietnam, este estudio vuelve a confirmar que existe una alternativa ecológica al uso sistemático de insecticidas para controlar la población de vectores del dengue

Spatiotemporal and Socioeconomic Risk Factors for Dengue at the Province Level in Vietnam, 2013-2015: Clustering Analysis and Regression Model.

Dengue is a serious infectious disease threat in Vietnam, but its spatiotemporal and socioeconomic risk factors are not currently well understood at the province level across the country and on a multiannual scale. We explore spatial trends, clusters and outliers in dengue case counts at the province level from 2011-2015 and use this to extract spatiotemporal variables for regression analysis of the association between dengue case counts and selected spatiotemporal and socioeconomic variables from 2013-2015. Dengue in Vietnam follows anticipated spatial trends, with a potential two-year cycle of high-high clusters in some southern provinces. Small but significant associations are observed between dengue case counts and mobility, population density, a province's dengue rates the previous year, and average dengue rates two years previous in first and second order contiguous neighbours. Significant associations were not found between dengue case counts and housing pressure, access to electricity, clinician density, province-adjusted poverty rate, percentage of children below one vaccinated, or percentage of population in urban settings. These findings challenge assumptions about socioeconomic and spatiotemporal risk factors for dengue, and support national prevention targeting in Vietnam at the province level. They may also be of wider relevance for the study of other arboviruses, including Japanese encephalitis, Zika, and Chikungunya

Transmission of Japanese Encephalitis (JE) Virus in Gia Luong District, Ha Bac Province, Vietnam, After Je Vaccination, 1993-1994

A total of 15,183 children under 10 years old (37% of target population) was immunized with JE vaccine in Gia Luong District, Ha Bac Province, Vietnam, in 1993 to 1994. JE virus transmission was investigated by swine antibody survey and virus isolation from field mosquitoes. By the hemagglutination inhibition (HI) test, 73-90% of swine were antibody positive all year round, with high geometric mean titer (GMT) of 92.67-95.14 in May and June. By suckling mouse brain inoculation, 6 JE virus strains were isolated from Culex tritaeniorhynchus and Cx. vishuni, as well as laboratory reared F1 from field-caught Cx. tritaeniorhynchus. Serodiganosis by IgM-capture ELISA (MAC-ELISA) carried out on 60 of 85 clinical encephalitis cases detected 43 positives (71.66%). All these serologically confirmed JE cases had not been vaccinated. The results supported the vaccine efficacy to prevent overt JE

Spatiotemporal analysis of historical records (2001-2012) on dengue fever in Vietnam and development of a statistical model for forecasting risk

Background: Dengue fever is the most widespread infectious disease of humans transmitted by Aedes mosquitoes. It is the leading cause of hospitalization and death in children in the Southeast Asia and western Pacific regions. We analyzed surveillance records from health centers in Vietnam collected between 2001–2012 to determine seasonal trends, develop risk maps and an incidence forecasting model. Methods: The data were analyzed using a hierarchical spatial Bayesian model that approximates its posterior parameter distributions using the integrated Laplace approximation algorithm (INLA). Meteorological, altitude and land cover (LC) data were used as predictors. The data were grouped by province (n = 63) and month (n = 144) and divided into training (2001–2009) and validation (2010–2012) sets. Thirteen meteorological variables, 7 land cover data and altitude were considered as predictors. Only significant predictors were kept in the final multivariable model. Eleven dummy variables representing month were also fitted to account for seasonal effects. Spatial and temporal effects were accounted for using Besag-York-Mollie (BYM) and autoregressive (1) models. Their levels of significance were analyzed using deviance information criterion (DIC). The model was validated based on the Theil’s coefficient which compared predicted and observed incidence estimated using the validation data. Dengue incidence predictions for 2010–2012 were also used to generate risk maps. Results: The mean monthly dengue incidence during the period was 6.94 cases (SD 14.49) per 100,000 people. Analyses on the temporal trends of the disease showed regular seasonal epidemics that were interrupted every 3 years (specifically in July 2004, July 2007 and September 2010) by major fluctuations in incidence. Monthly mean minimum temperature, rainfall, area under urban settlement/build-up areas and altitude were significant in the final model. Minimum temperature and rainfall had non-linear effects and lagging them by two months provided a better fitting model compared to using unlagged variables. Forecasts for the validation period closely mirrored the observed data and accurately captured the troughs and peaks of dengue incidence trajectories. A favorable Theil’s coefficient of inequality of 0.22 was generated. Conclusions: The study identified temperature, rainfall, altitude and area under urban settlement as being significant predictors of dengue incidence. The statistical model fitted the data well based on Theil’s coefficient of inequality, and risk maps generated from its predictions identified most of the high-risk provinces throughout the country

Interactions between climate change, urban infrastructure and mobility are driving dengue emergence in Vietnam.

Dengue is expanding globally, but how dengue emergence is shaped locally by interactions between climatic and socio-environmental factors is not well understood. Here, we investigate the drivers of dengue incidence and emergence in Vietnam, through analysing 23 years of district-level case data spanning a period of significant socioeconomic change (1998-2020). We show that urban infrastructure factors (sanitation, water supply, long-term urban growth) predict local spatial patterns of dengue incidence, while human mobility is a more influential driver in subtropical northern regions than the endemic south. Temperature is the dominant factor shaping dengue's distribution and dynamics, and using long-term reanalysis temperature data we show that warming since 1950 has expanded transmission risk throughout Vietnam, and most strongly in current dengue emergence hotspots (e.g., southern central regions, Ha Noi). In contrast, effects of hydrometeorology are complex, multi-scalar and dependent on local context: risk increases under either short-term precipitation excess or long-term drought, but improvements in water supply mitigate drought-associated risks except under extreme conditions. Our findings challenge the assumption that dengue is an urban disease, instead suggesting that incidence peaks in transitional landscapes with intermediate infrastructure provision, and provide evidence that interactions between recent climate change and mobility are contributing to dengue's expansion throughout Vietnam

Probabilistic seasonal dengue forecasting in Vietnam: A modelling study using superensembles

Background: With enough advanced notice, dengue outbreaks can be mitigated. As a climate-sensitive disease, environmental conditions and past patterns of dengue can be used to make predictions about future outbreak risk. These predictions improve public health planning and decision-making to ultimately reduce the burden of disease. Past approaches to dengue forecasting have used seasonal climate forecasts, but the predictive ability of a system using different lead times in a year-round prediction system has been seldom explored. Moreover, the transition from theoretical to operational systems integrated with disease control activities is rare. Methods and findings: We introduce an operational seasonal dengue forecasting system for Vietnam where Earth observations, seasonal climate forecasts, and lagged dengue cases are used to drive a superensemble of probabilistic dengue models to predict dengue risk up to 6 months ahead. Bayesian spatiotemporal models were fit to 19 years (2002–2020) of dengue data at the province level across Vietnam. A superensemble of these models then makes probabilistic predictions of dengue incidence at various future time points aligned with key Vietnamese decision and planning deadlines. We demonstrate that the superensemble generates more accurate predictions of dengue incidence than the individual models it incorporates across a suite of time horizons and transmission settings. Using historical data, the superensemble made slightly more accurate predictions (continuous rank probability score [CRPS] = 66.8, 95% CI 60.6–148.0) than a baseline model which forecasts the same incidence rate every month (CRPS = 79.4, 95% CI 78.5–80.5) at lead times of 1 to 3 months, albeit with larger uncertainty. The outbreak detection capability of the superensemble was considerably larger (69%) than that of the baseline model (54.5%). Predictions were most accurate in southern Vietnam, an area that experiences semi-regular seasonal dengue transmission. The system also demonstrated added value across multiple areas compared to previous practice of not using a forecast. We use the system to make a prospective prediction for dengue incidence in Vietnam for the period May to October 2020. Prospective predictions made with the superensemble were slightly more accurate (CRPS = 110, 95% CI 102–575) than those made with the baseline model (CRPS = 125, 95% CI 120–168) but had larger uncertainty. Finally, we propose a framework for the evaluation of probabilistic predictions. Despite the demonstrated value of our forecasting system, the approach is limited by the consistency of the dengue case data, as well as the lack of publicly available, continuous, and long-term data sets on mosquito control efforts and serotype-specific case data. Conclusions: This study shows that by combining detailed Earth observation data, seasonal climate forecasts, and state-of-the-art models, dengue outbreaks can be predicted across a broad range of settings, with enough lead time to meaningfully inform dengue control. While our system omits some important variables not currently available at a subnational scale, the majority of past outbreaks could be predicted up to 3 months ahead. Over the next 2 years, the system will be prospectively evaluated and, if successful, potentially extended to other areas and other climate-sensitive disease systems

Quantifying the Emergence of Dengue in Hanoi, Vietnam: 1998–2009

Dengue is the most common vector-borne viral disease of humans, causing an estimated 50 million cases per year. The number of countries affected by dengue has increased dramatically in the last 50 years and dengue is now a major public health problem in large parts of the tropical and subtropical world. It is of considerable importance to understand the factors that determine how dengue becomes newly established in areas where the risk of dengue was previously small. Hanoi in North Vietnam is a large city where dengue appears to be emerging. We analyzed 12 years of dengue surveillance data in order to characterize the temporal and spatial epidemiology of dengue in Hanoi and to establish if dengue incidence has been increasing. After excluding the two major outbreak years of 1998 and 2009 and correcting for changes in population age structure over time, we found there was a significant annual increase in the incidence of notified dengue cases over the period 1999–2008. Dengue cases were concentrated in young adults in the highly urban central areas of Hanoi. This study indicates that dengue transmission is increasing in Hanoi and provides a platform for further studies of the underlying drivers of this emergence