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Dynamic modelling of personal protection control strategies for vector-borne disease limits the role of diversity amplification.

ABSTRACT: Personal protection measures, such as bed nets and repellents, are important tools for the suppression of vector-borne diseases like malaria and Zika, and the ability of health agencies to distribute protection and encourage its use plays an important role in the efficacy of community-wide disease management strategies. Recent modelling studies have shown that a counterintuitive diversity-driven amplification in community-wide disease levels can result from a population's partial adoption of personal protection measures, potentially to the detriment of disease management efforts. This finding, however, may overestimate the negative impact of partial personal protection as a result of implicit restrictive model assumptions regarding host compliance, access to and longevity of protection measures. We establish a new modelling methodology for incorporating community-wide personal protection distribution programmes in vector-borne disease systems which flexibly accounts for compliance, access, longevity and control strategies by way of a flow between protected and unprotected populations. Our methodology yields large reductions in the severity and occurrence of amplification effects as compared to existing models.

SUBMITTER: Demers J

PROVIDER: S-EPMC6127172 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Dynamic modelling of personal protection control strategies for vector-borne disease limits the role of diversity amplification.

Demers Jeffery J Bewick Sharon S Calabrese Justin J Fagan William F WF

Journal of the Royal Society, Interface 20180801 145

Personal protection measures, such as bed nets and repellents, are important tools for the suppression of vector-borne diseases like malaria and Zika, and the ability of health agencies to distribute protection and encourage its use plays an important role in the efficacy of community-wide disease management strategies. Recent modelling studies have shown that a counterintuitive diversity-driven amplification in community-wide disease levels can result from a population's partial adoption of per ...[more]

PMID: 30135260

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Project description:BackgroundVector-borne diseases are important public health issues and, consequently, in silico models that simulate them can be useful. The susceptible-infected-recovered (SIR) model simulates the population dynamics of an epidemic and can be easily adapted to vector-borne diseases, whereas the Hardy-Weinberg model simulates allele frequencies and can be used to study insecticide resistance evolution. The aim of the present study is to develop a coupled system that unifies both models, therefore enabling the analysis of the effects of vector population genetics on the population dynamics of an epidemic.MethodsOur model consists of an ordinary differential equation system. We considered the populations of susceptible, infected and recovered humans, as well as susceptible and infected vectors. Concerning these vectors, we considered a pair of alleles, with complete dominance interaction that determined the rate of mortality induced by insecticides. Thus, we were able to separate the vectors according to the genotype. We performed three numerical simulations of the model. In simulation one, both alleles conferred the same mortality rate values, therefore there was no resistant strain. In simulations two and three, the recessive and dominant alleles, respectively, conferred a lower mortality.ResultsOur numerical results show that the genetic composition of the vector population affects the dynamics of human diseases. We found that the absolute number of vectors and the proportion of infected vectors are smaller when there is no resistant strain, whilst the ratio of infected people is larger in the presence of insecticide-resistant vectors. The dynamics observed for infected humans in all simulations has a very similar shape to real epidemiological data.ConclusionThe population genetics of vectors can affect epidemiological dynamics, and the presence of insecticide-resistant strains can increase the number of infected people. Based on the present results, the model is a basis for development of other models and for investigating population dynamics.

Project description:After a request from the European Commission, EFSA's Panel on Animal Health and Welfare summarised the main characteristics of 36 vector-borne diseases (VBDs) in https://efsa.maps.arcgis.com/apps/PublicGallery/index.html?appid=dfbeac92aea944599ed1eb754aa5e6d1. The risk of introduction in the EU through movement of livestock or pets was assessed for each of the 36 VBDs individually, using a semiquantitative Method to INTegrate all relevant RISK aspects (MINTRISK model), which was further modified to a European scale into the http://www3.lei.wur.nl/mintrisk/ModelMgt.aspx. Only eight of the 36 VBD-agents had an overall rate of introduction in the EU (being the combination of the rate of entry, vector transmission and establishment) which was estimated to be above 0.001 introductions per year. These were Crimean-Congo haemorrhagic fever virus, bluetongue virus, West Nile virus, Schmallenberg virus, Hepatozoon canis, Leishmania infantum, Bunyamwera virus and Highlands J. virus. For these eight diseases, the annual extent of spread was assessed, assuming the implementation of available, authorised prevention and control measures in the EU. Further, the probability of overwintering was assessed, as well as the possible impact of the VBDs on public health, animal health and farm production. For the other 28 VBD-agents for which the rate of introduction was estimated to be very low, no further assessments were made. Due to the uncertainty related to some parameters used for the risk assessment or the instable or unpredictability disease situation in some of the source regions, it is recommended to update the assessment when new information becomes available. Since this risk assessment was carried out for large regions in the EU for many VBD-agents, it should be considered as a first screening. If a more detailed risk assessment for a specific VBD is wished for on a national or subnational level, the EFSA-VBD-RISK-model is freely available for this purpose.

Project description:BackgroundAn estimated 2·5 billion people are at risk of dengue. Incidence of dengue is especially high in resource-constrained countries, where control relies mainly on insecticides targeted at larval or adult mosquitoes. We did epidemiological and economic assessments of different vector control strategies.MethodsWe developed a dynamic model of dengue transmission that assesses the evolution of insecticide resistance and immunity in the human population, thus allowing for long-term evolutionary and immunological effects of decreased dengue transmission. We measured the dengue health burden in terms of disability-adjusted life-years (DALYs) lost. We did a cost-effectiveness analysis of 43 insecticide-based vector control strategies, including strategies targeted at adult and larval stages, at varying efficacies (high-efficacy [90% mortality], medium-efficacy [60% mortality], and low-efficacy [30% mortality]) and yearly application frequencies (one to six applications). To assess the effect of parameter uncertainty on the results, we did a probabilistic sensitivity analysis and a threshold analysis.FindingsAll interventions caused the emergence of insecticide resistance, which, with the loss of herd immunity, will increase the magnitude of future dengue epidemics. In our model, one or more applications of high-efficacy larval control reduced dengue burden for up to 2 years, whereas three or more applications of adult vector control reduced dengue burden for up to 4 years. The incremental cost-effectiveness ratios of the strategies for two high-efficacy adult vector control applications per year was US$615 per DALY saved and for six high-efficacy adult vector control applications per year was $1267 per DALY saved. Sensitivity analysis showed that if the cost of adult control was more than 8·2 times the cost of larval control then all strategies based on adult control became dominated.InterpretationSix high-efficacy adult vector control applications per year has a cost-effectiveness ratio that will probably meet WHO's standard for a cost-effective or very cost-effective intervention. Year-round larval control can be counterproductive, exacerbating epidemics in later years because of evolution of insecticide resistance and loss of herd immunity. We suggest the reassessment of vector control policies that are based on larval control only.FundingThe Fulbright Programme, CAPES (Brazilian federal agency for post-graduate education), the Miriam Burnett trust, and the Notsew Orm Sands Foundation.

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Dynamic modelling of personal protection control strategies for vector-borne disease limits the role of diversity amplification.

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Dynamic modelling of personal protection control strategies for vector-borne disease limits the role of diversity amplification.

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