The importance of being urgent: The impact of surveillance target and scale on mosquito-borne disease control
The importance of being urgent: The impact of surveillance target and scale on mosquito-borne disease control
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DOI：
10.1016/j.epidem.2017.12.004
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发表时间：
2018-06-01
期刊：
影响因子：
3.8
通讯作者：
Fefferman, Nina H.
中科院分区：
文献类型：
--
作者：
Schwab, Samantha R.;Stone, Chris M.;Fefferman, Nina H.
近年来，随着众多蚊媒疾病的出现或重新出现，需要采取有效的紧急病媒控制方法来减少人类感染。目前的病媒控制做法在不同管辖区之间通常差异很大，并且是在不同空间尺度上独立执行的。尽管监测的目标和规模因地区而异，但各种类型的监测信息（例如人类感染或成年蚊子的数量）会触发控制措施的实施。这种控制措施的零散实施可能会改变控制的效果。我们模拟了六种不同的场景，根据不同类型和不同规模（例如整个景观或每个斑块）的监测数据进行幼虫蚊子控制。我们的研究结果表明： 在疾病风险升级后较早应用杀幼虫剂比后期实施控制能够更大程度地减少人类感染；与零散的控制应用相比，整个景观的统一控制可以更好地缓解疫情爆发；不同类型的监测数据在收集时需要不同程度的敏感度，以便有效地为控制措施提供信息。我们的模拟还证明了反应性、监视驱动的病媒控制的潜在逻辑谬误：措施一旦被认为有效就停止实施。这种错误的安全感导致控制工作不完整，对遏制未来媒介传播疾病的爆发规模无济于事。应加大投资收集高质量信息，以触发早期统一实施，同时研究人员努力发现更多信息丰富的人类风险指标，以触发更有效的控制。
With the emergence or re-emergence of numerous mosquito-borne diseases in recent years, effective methods for emergency vector control responses are necessary to reduce human infections. Current vector control practices often vary significantly between different jurisdictions, and are executed independently and at different spatial scales. Various types of surveillance information (e.g. number of human infections or adult mosquitoes) trigger the implementation of control measures, though the target and scale of surveillance vary locally. This patchy implementation of control measures likely alters the efficacy of control.We modeled six different scenarios, with larval mosquito control occurring in response to surveillance data of different types and at different scales (e.g. across the landscape or in each patch). Our results indicate that: earlier application of larvicide after an escalation of disease risk achieves much greater reductions in human infections than later control implementation; uniform control across the landscape provides better outbreak mitigation than patchy control application; and different types of surveillance data require different levels of sensitivity in their collection to effectively inform control measures. Our simulations also demonstrate a potential logical fallacy of reactive, surveillance-driven vector control: measures stop being implemented as soon as they are deemed effective. This false sense of security leads to patchier control efforts that will do little to curb the size of future vector-borne disease outbreaks. More investment should be placed in collecting high quality information that can trigger early and uniform implementation, while researchers work to discover more informative metrics of human risk to trigger more effective control.