Effectiveness and economic assessment of routine larviciding for prevention of chikungunya and dengue in temperate urban settings in Europe.
Effectiveness and economic assessment of routine larviciding for prevention of chikungunya and dengue in temperate urban settings in Europe.
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DOI：
10.1371/journal.pntd.0005918
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发表时间：
2017-09
影响因子：
3.8
通讯作者：
Melegaro A
中科院分区：
文献类型：
--
作者：
Guzzetta G;Trentini F;Poletti P;Baldacchino FA;Montarsi F;Capelli G;Rizzoli A;Rosà R;Merler S;Melegaro A
在过去的几十年里，几个虫媒病毒感染不是地方病的欧洲国家面临着基孔肯雅病和登革热等疾病的爆发，这些疾病最初是由来自热带流行地区的传染性旅行者引入的，然后通过蚊子叮咬在当地传播。为了控制流行病风险，地方当局可以采取针对控制病媒丰度的干预措施。我们使用白纹伊蚊种群和病毒传播的数学模型，根据2014年和2015年从意大利北方十个城市收集的昆虫学监测数据进行校准。我们发现，对公共集水池进行常规杀幼虫可以限制本地传播的风险，潜在流行病的规模。理想的杀幼虫剂干预措施应在7月份进行。最佳时机的杀幼虫剂可以减少20% - 33%的基孔肯雅病的局部传播病例（登革热：18-22%），如果在整个季节重复治疗四次，则可高达43% - 65%（登革热：31-51%）。在较大的城市（> 35 000名居民），在整个城市地区全面杀幼虫的成本超过了与预防疾病病例有关的潜在健康效益，这表明应采取更局部的干预措施。蚊子数量多的中小城镇可能会有积极的成本效益平衡。普通公民参与常规的杀幼虫活动进一步降低了传播风险，但干预成本过高。国际旅行和蚊媒疾病的发病率在全球范围内不断增加，使越来越多的欧洲公民面临更高的潜在疫情风险。这项研究的结果可能会支持干预措施的规划和时机，旨在减少本土传播的可能性以及对生活在欧洲温带地区的当地人口的滋扰。杀幼虫剂是防止蚊子数量增长和减少蚊媒疾病爆发风险以及叮咬造成的滋扰的关键工具。为了协助城市从温带地区在欧洲有效地规划病媒控制方案，我们模拟了在公共区域的杀幼虫对白纹伊蚊种群的影响，使用蚊子收集数据，从10个城市在北方意大利，在两年多的温度条件非常不同。然后，我们评估了基孔肯雅热和登革热潜在爆发的可能性及其预期的最终规模，并将干预成本与避免临床病例所带来的经济和健康效益进行了比较。通过评估几种不同的干预策略，我们发现，最佳时机应集中在7月，对应的蚊子种群的最大增长期。在中小城镇（居民少于35 000人），即使蚊虫侵扰程度不高，全城市范围的干预措施也可能具有成本效益，而在较大的城市，应考虑采取以居民区为基础的干预措施。让公民参与在私人房舍内使用杀幼虫剂的做法取得了成效，但一般来说费用太高。
In the last decades, several European countries where arboviral infections are not endemic have faced outbreaks of diseases such as chikungunya and dengue, initially introduced by infectious travellers from tropical endemic areas and then spread locally via mosquito bites. To keep in check the epidemiological risk, interventions targeted to control vector abundance can be implemented by local authorities. We assessed the epidemiological effectiveness and economic costs and benefits of routine larviciding in European towns with temperate climate, using a mathematical model of Aedes albopictus populations and viral transmission, calibrated on entomological surveillance data collected from ten municipalities in Northern Italy during 2014 and 2015.We found that routine larviciding of public catch basins can limit both the risk of autochthonous transmission and the size of potential epidemics. Ideal larvicide interventions should be timed in such a way to cover the month of July. Optimally timed larviciding can reduce locally transmitted cases of chikungunya by 20% - 33% for a single application (dengue: 18–22%) and up to 43% - 65% if treatment is repeated four times throughout the season (dengue: 31–51%). In larger municipalities (>35,000 inhabitants), the cost of comprehensive larviciding over the whole urban area overcomes potential health benefits related to preventing cases of disease, suggesting the adoption of more localized interventions. Small/medium sized towns with high mosquito abundance will likely have a positive cost-benefit balance. Involvement of private citizens in routine larviciding activities further reduces transmission risks but with disproportionate costs of intervention. International travels and the incidence of mosquito-borne diseases are increasing worldwide, exposing a growing number of European citizens to higher risks of potential outbreaks. Results from this study may support the planning and timing of interventions aimed to reduce the probability of autochthonous transmission as well as the nuisance for local populations living in temperate areas of Europe. Larvicides are a key tool to prevent the growth of mosquito populations and decrease both the risks of outbreaks of mosquito-borne diseases and the nuisance deriving from bites. In order to assist municipalities from temperate areas in Europe in effectively planning vector control programs, we modelled the effect of larviciding in public areas on populations of Aedes albopictus using mosquito collection data from 10 municipalities in Northern Italy, over two years with very different temperature conditions. We then evaluated the resulting probabilities of potential outbreaks of chikungunya and dengue and their expected final sizes, and we compared the intervention costs to the economic and health benefits due to the avoidance of clinical cases. By assessing several different intervention strategies, we found that the optimal timing should be centred on the month of July, corresponding to the period of maximal growth of the mosquito population. Municipality-wide interventions are likely to be cost-effective in small-to-medium towns (below 35,000 inhabitants) even where mosquito infestation is moderate, whereas for larger cities a neighbourhood-based intervention should be considered. The involvement of citizens to apply larvicides within private premises resulted effective but generally too costly.
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影响因子：
3.3
作者：
Labeaud AD;Bashir F;King CH
通讯作者：
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影响因子：
3.8
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1
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通讯作者：
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3.8
作者：
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影响因子：
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作者：
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