Quantifying the localized relationship between vector containment activities and dengue incidence in a real-world setting: A spatial and time series modelling analysis based on geo-located data from Pakistan

PLoS Negl Trop Dis. 2020 May 11;14(5):e0008273. doi: 10.1371/journal.pntd.0008273. eCollection 2020 May.

Abstract

Increasing urbanization is having a profound effect on infectious disease risk, posing significant challenges for governments to allocate limited resources for their optimal control at a sub-city scale. With recent advances in data collection practices, empirical evidence about the efficacy of highly localized containment and intervention activities, which can lead to optimal deployment of resources, is possible. However, there are several challenges in analyzing data from such real-world observational settings. Using data on 3.9 million instances of seven dengue vector containment activities collected between 2012 and 2017, here we develop and assess two frameworks for understanding how the generation of new dengue cases changes in space and time with respect to application of different types of containment activities. Accounting for the non-random deployment of each containment activity in relation to dengue cases and other types of containment activities, as well as deployment of activities in different epidemiological contexts, results from both frameworks reinforce existing knowledge about the efficacy of containment activities aimed at the adult phase of the mosquito lifecycle. Results show a 10% (95% CI: 1-19%) and 20% reduction (95% CI: 4-34%) reduction in probability of a case occurring in 50 meters and 30 days of cases which had Indoor Residual Spraying (IRS) and fogging performed in the immediate vicinity, respectively, compared to cases of similar epidemiological context and which had no containment in their vicinity. Simultaneously, limitations due to the real-world nature of activity deployment are used to guide recommendations for future deployment of resources during outbreaks as well as data collection practices. Conclusions from this study will enable more robust and comprehensive analyses of localized containment activities in resource-scarce urban settings and lead to improved allocation of resources of government in an outbreak setting.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Cities / epidemiology
  • Dengue / epidemiology*
  • Dengue / prevention & control*
  • Humans
  • Incidence
  • Mosquito Control / methods*
  • Pakistan / epidemiology
  • Spatio-Temporal Analysis
  • Urban Population

Grants and funding

MUGK is supported by The Branco Weiss Fellowship - Society in Science, administered by the ETH Zurich and acknowledges funding from the Oxford Martin School and the European Horizon 2020 programme MOOD. RC and NAR were partially supported by a Gates Foundation Grand Challenges Explorations grant OPP1212374. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.