Fernando Abad-Franch

London School of Hygiene and Tropical Medicine, Londinium, England, United Kingdom

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Publications (44)152.14 Total impact

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    ABSTRACT: Mosquito-borne pathogens pose major public health challenges worldwide. With vaccines or effective drugs still unavailable for most such pathogens, disease prevention heavily relies on vector control. To date, however, mosquito control has proven difficult, with low breeding-site coverage during control campaigns identified as a major drawback. A novel tactic exploits the egg-laying behavior of mosquitoes to have them disseminate tiny particles of a potent larvicide, pyriproxyfen (PPF), from resting to breeding sites, thus improving coverage. This approach has yielded promising results at small spatial scales, but its wider applicability remains unclear. We conducted a four-month trial within a 20-month study to investigate mosquito-driven dissemination of PPF dust-particles from 100 'dissemination stations' (DSs) deployed in a 7-ha sub-area to surveillance dwellings and sentinel breeding sites (SBSs) distributed over an urban neighborhood of about 50 ha. We assessed the impact of the trial by measuring juvenile mosquito mortality and adult mosquito emergence in each SBS-month. Using data from 1,075 dwelling-months, 2,988 SBS-months, and 29,922 individual mosquitoes, we show that mosquito-disseminated PPF yielded high coverage of dwellings (up to 100%) and SBSs (up to 94.3%). Juvenile mosquito mortality in SBSs (about 4% at baseline) increased by over one order of magnitude during PPF dissemination (about 75%). This led to a >10-fold decrease of adult mosquito emergence from SBSs, from approximately 1,000-3,000 adults/month before to about 100 adults/month during PPF dissemination. By expanding breeding-site coverage and boosting juvenile mosquito mortality, a strategy based on mosquito-disseminated PPF has potential to substantially enhance mosquito control. Sharp declines in adult mosquito emergence can lower vector/host ratios, reducing the risk of disease outbreaks. This approach is a very promising complement to current and novel mosquito control strategies; it will probably be especially relevant for the control of urban disease vectors, such as Aedes and Culex species, that often cause large epidemics.
    PLoS Neglected Tropical Diseases 04/2015; 9(4):e0003702. DOI:10.1371/journal.pntd.0003702 · 4.49 Impact Factor
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    ABSTRACT: Background Vector-borne diseases are major public health concerns worldwide. For many of them, vector control is still key to primary prevention, with control actions planned and evaluated using vector occurrence records. Yet vectors can be difficult to detect, and vector occurrence indices will be biased whenever spurious detection/non-detection records arise during surveys. Here, we investigate the process of Chagas disease vector detection, assessing the performance of the surveillance method used in most control programs – active triatomine-bug searches by trained health agents. Methodology/Principal Findings Control agents conducted triplicate vector searches in 414 man-made ecotopes of two rural localities. Ecotope-specific ‘detection histories’ (vectors or their traces detected or not in each individual search) were analyzed using ordinary methods that disregard detection failures and multiple detection-state site-occupancy models that accommodate false-negative and false-positive detections. Mean (±SE) vector-search sensitivity was ∼0.283±0.057. Vector-detection odds increased as bug colonies grew denser, and were lower in houses than in most peridomestic structures, particularly woodpiles. False-positive detections (non-vector fecal streaks misidentified as signs of vector presence) occurred with probability ∼0.011±0.008. The model-averaged estimate of infestation (44.5±6.4%) was ∼2.4–3.9 times higher than naïve indices computed assuming perfect detection after single vector searches (11.4–18.8%); about 106–137 infestation foci went undetected during such standard searches. Conclusions/Significance We illustrate a relatively straightforward approach to addressing vector detection uncertainty under realistic field survey conditions. Standard vector searches had low sensitivity except in certain singular circumstances. Our findings suggest that many infestation foci may go undetected during routine surveys, especially when vector density is low. Undetected foci can cause control failures and induce bias in entomological indices; this may confound disease risk assessment and mislead program managers into flawed decision making. By helping correct bias in naïve indices, the approach we illustrate has potential to critically strengthen vector-borne disease control-surveillance systems.
    PLoS Neglected Tropical Diseases 09/2014; 8(9):e3187. DOI:10.1371/journal.pntd.0003187 · 4.49 Impact Factor
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    Letícia Soares, Fernando Abad-Franch, Gonçalo Ferraz
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    ABSTRACT: Cutaneous leishmaniasis (CL) is more frequently reported in men than in women; this may be due to male-biased exposure to CL vectors, female-biased resistance against the disease or both. We sought to determine whether gender-specific exposure to vector habitats explains male-biased CL incidence in two human populations of central Amazonia.
    Tropical Medicine & International Health 05/2014; DOI:10.1111/tmi.12337 · 2.30 Impact Factor
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    ABSTRACT: Understanding the drivers of habitat selection by insect disease vectors is instrumental to the design and operation of rational control-surveillance systems. One pervasive yet often overlooked drawback of vector studies is that detection failures result in some sites being misclassified as uninfested; naïve infestation indices are therefore biased, and this can confound our view of vector habitat preferences. Here, we present an initial attempt at applying methods that explicitly account for imperfect detection to investigate the ecology of Chagas disease vectors in man-made environments. We combined triplicate-sampling of individual ecotopes (n = 203) and site-occupancy models (SOMs) to test a suite of pre-specified hypotheses about habitat selection by Triatoma brasiliensis. SOM results were compared with those of standard generalized linear models (GLMs) that assume perfect detection even with single bug-searches. Triatoma brasiliensis was strongly associated with key hosts (native rodents, goats/sheep and, to a lesser extent, fowl) in peridomestic environments; ecotope structure had, in comparison, small to negligible effects, although wooden ecotopes were slightly preferred. We found evidence of dwelling-level aggregation of infestation foci; when there was one such focus, same-dwelling ecotopes, whether houses or peridomestic structures, were more likely to become infested too. GLMs yielded negatively-biased covariate effect estimates and standard errors; both were, on average, about four times smaller than those derived from SOMs. Our results confirm substantial population-level ecological heterogeneity in T. brasiliensis. They also suggest that, at least in some sites, control of this species may benefit from peridomestic rodent control and changes in goat/sheep husbandry practices. Finally, our comparative analyses highlight the importance of accounting for the various sources of uncertainty inherent to vector studies, including imperfect detection. We anticipate that future research on infectious disease ecology will increasingly rely on approaches akin to those described here.
    PLoS Neglected Tropical Diseases 05/2014; 8(5):e2861. DOI:10.1371/journal.pntd.0002861 · 4.49 Impact Factor
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    ABSTRACT: Triatoma brasiliensis is the most important vector of Chagas disease in the Caatinga eco-region of northeastern Brazil. Wild T. brasiliensis populations have been reported only from rocky outcrops. However, this species frequently infests/re-infests houses in rock-free sedimentary lowlands. We therefore hypothesized that it should also occupy other natural ecotopes. We show that a common Caatinga cactus, Pilosocereum gounellei, locally known as xiquexique, often harbors T. brasiliensis breeding colonies apparently associated with rodents (n = 44 cacti, infestation rate = 47.7%, 157 bugs captured). Our findings suggest that infested cacti might be involved in house re-infestation by T. brasiliensis in the Caatinga region.
    The American journal of tropical medicine and hygiene 04/2014; 90(6). DOI:10.4269/ajtmh.13-0204 · 2.74 Impact Factor
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    Natalisisy Espinoza, Rafael Borrás, Fernando Abad-Franch
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    ABSTRACT: Chagas disease has historically been hyperendemic in the Bolivian Department of Cochabamba. In the early 2000s, an extensive vector control program was implemented; 1.34 million dwelling inspections were conducted to ascertain infestation (2000-2001/2003-2011), with blanket insecticide spraying in 2003-2005 and subsequent survey-spraying cycles targeting residual infestation foci. Here, we assess the effects of this program on dwelling infestation rates (DIRs). Program records were used to calculate annual, municipality-level aggregate DIRs (39 municipalities); very high values in 2000-2001 (median: 0.77-0.69) dropped to ∼0.03 from 2004 on. A linear mixed model (with municipality as a random factor) suggested that infestation odds decreased, on average, by ∼28% (95% confidence interval [CI95] 6-44%) with each 10-fold increase in control effort. A second, better-fitting mixed model including year as an ordinal predictor disclosed large DIR reductions in 2001-2003 (odds ratio [OR] 0.11, CI95 0.06-0.19) and 2003-2004 (OR 0.22, CI95 0.14-0.34). Except for a moderate decrease in 2005-2006, no significant changes were detected afterwards. In both models, municipality-level DIRs correlated positively with previous-year DIRs and with the extent of municipal territory originally covered by montane dry forests. Insecticide-spraying campaigns had very strong, long-lasting effects on DIRs in Cochabamba. However, post-intervention surveys consistently detected infestation in ∼3% of dwellings, underscoring the need for continuous surveillance; higher DIRs were recorded in the capital city and, more generally, in municipalities dominated by montane dry forest - an eco-region where wild Triatoma infestans are widespread. Traditional strategies combining insecticide spraying and longitudinal surveillance are thus confirmed as very effective means for area-wide Chagas disease vector control; they will be particularly beneficial in highly-endemic settings, but should also be implemented or maintained in other parts of Latin America where domestic infestation by triatomines is still commonplace.
    PLoS Neglected Tropical Diseases 04/2014; 8(4):e2782. DOI:10.1371/journal.pntd.0002782 · 4.49 Impact Factor
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    ABSTRACT: Scientists, program managers and international agency officials we all share the same fundamental mandate: to come up with what is best for people living at risk of being infected by T. cruzi. But to help improve disease prevention and control programs we need to reassess the adequacy and implications of past and current evalua-tion practices and, when necessary, openly debate over innovative strategies to find the best way forward. Roots of the debate -Our opinion piece stemmed from a meeting held in Brasilia on June 2012 to discuss the possibility of certifying the interruption of T. cruzi transmission (CIT) by native, "secondary" vector spe-cies in Brazil. We sought to raise awareness about the dangers of making influential public health decisions based on achievements that are not properly documented and/or that may not be applicable under many common circumstances. In particular, we believe that formerly successful recipes against non-native vector popula-tions (Triatoma infestans in Brazil or Rhodnius prolixus in Central America) are unlikely to work against native vectors in current scenarios dominated by low political priority, decentralisation of health systems and weaker vector control services. Native vectors maintain widespread foci in natural habitats from which they regularly invade and sometimes colonise human dwellings. They play substantial roles in T. cruzi transmission to humans and we must incorporate this complexity into our strategies and policies. Impor-tantly, all New World triatomine species, including the main "domestic" vectors (T. infestans, R. prolixus and Triatoma dimidiata), are native to some region in the Americas. Our letter called attention to these issues and suggested a general strategic framework for the current and future scenarios of vector-borne Chagas disease. The elimination of non-native vector species relied on area-wide, blanket insecticide-spraying campaigns conducted by professional spray teams from vertically-structured control programs. This so-called "attack" phase worked well, although not everywhere and CITs were overall justified for some regions in the past sce-nario of the 1990s. Progress from the vertical attack phase to a longitudinal surveillance phase was based on an assessment of impact at various levels (locality and state, province or department). Unfortunately, the sur-veillance phase was often discontinued after CITs were issued; this happened, for instance, in many Brazilian municipalities. The powerful notion of "interruption of transmission" made it hard to justify efforts and invest-ment in vector and disease surveillance. The emergence and expansion of dengue, combined with decentralisa-tion of health services, also distracted resources away from Chagas disease control throughout Latin America (Yadón et al. 2006). The Brazilian case clearly illustrates one major potential side effect of CIT-based policies: the deactivation of longitudinal surveillance systems is a very likely outcome. Current scenarios of T. cruzi transmission and vec-tor control [summarised in Table of Abad-Franch et al. (2013)] differ in several ways from those that prevailed in the 1990s.
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    Memórias do Instituto Oswaldo Cruz 02/2014; 109(1):125-30. · 1.57 Impact Factor
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    ABSTRACT: Rhodnius barretti , a new triatomine species, is described based on adult specimens collected in rainforest environments within the Napo ecoregion of western Amazonia (Colombia and Ecuador). R. barretti resembles Rhodnius robustus s.l. , but mitochondrial cytochrome b gene sequences reveal that it is a strongly divergent member of the "robustus lineage", i.e., basal to the clade encompassing Rhodnius nasutus , Rhodnius neglectus , Rhodnius prolixus and five members of the R. robustus species complex. Morphometric analyses also reveal consistent divergence from R. robustus s.l. , including head and, as previously shown, wing shape and the length ratios of some anatomical structures. R. barretti occurs, often at high densities, in Attalea butyracea and Oenocarpus bataua palms. It is strikingly aggressive and adults may invade houses flying from peridomestic palms. R. barretti must therefore be regarded as a potential Trypanosoma cruzi vector in the Napo ecoregion, where Chagas disease is endemic.
    Memórias do Instituto Oswaldo Cruz 12/2013; 108 Suppl 1(Suppl 1):92-9. DOI:10.1590/0074-0276130434 · 1.57 Impact Factor
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    ABSTRACT: Triatoma dimidiata is among the main vectors of Chagas disease in Latin America. However, and despite important advances, there is no consensus about the taxonomic status of phenotypically divergent T. dimidiata populations, which in most recent papers are regarded as subspecies. A total of 126 cyt b sequences (621 bp long) were produced for specimens from across the species range. Forty-seven selected specimens representing the main cyt b clades observed (after a preliminary phylogenetic analysis) were also sequenced for an ND4 fragment (554 bp long) and concatenated with their respective cyt b sequences to produce a combined data set totalling 1175 bp/individual. Bayesian and Maximum-Likelihood phylogenetic analyses of both data sets (cyt b, and cyt b+ND4) disclosed four strongly divergent (all pairwise Kimura 2-parameter distances >0.08), monophyletic groups: Group I occurs from Southern Mexico through Central America into Colombia, with Ecuadorian specimens resembling Nicaraguan material; Group II includes samples from Western-Southwestern Mexico; Group III comprises specimens from the Yucatán peninsula; and Group IV consists of sylvatic samples from Belize. The closely-related, yet formally recognized species T. hegneri from the island of Cozumel falls within the divergence range of the T. dimidiata populations studied. We propose that Groups I-IV, as well as T. hegneri, should be regarded as separate species. In the Petén of Guatemala, representatives of Groups I, II, and III occur in sympatry; the absence of haplotypes with intermediate genetic distances, as shown by multimodal mismatch distribution plots, clearly indicates that reproductive barriers actively promote within-group cohesion. Some sylvatic specimens from Belize belong to a different species - likely the basal lineage of the T. dimidiata complex, originated ∼8.25 Mya. The evidence presented here strongly supports the proposition that T. dimidiata is a complex of five cryptic species (Groups I-IV plus T. hegneri) that play different roles as vectors of Chagas disease in the region.
    PLoS ONE 10/2013; 8(8):e70974. DOI:10.1371/journal.pone.0070974 · 3.53 Impact Factor
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    Felipe Guerra-Silveira, Fernando Abad-Franch
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    ABSTRACT: Infectious disease incidence is often male-biased. Two main hypotheses have been proposed to explain this observation. The physiological hypothesis (PH) emphasizes differences in sex hormones and genetic architecture, while the behavioral hypothesis (BH) stresses gender-related differences in exposure. Surprisingly, the population-level predictions of these hypotheses are yet to be thoroughly tested in humans. For ten major pathogens, we tested PH and BH predictions about incidence and exposure-prevalence patterns. Compulsory-notification records (Brazil, 2006-2009) were used to estimate age-stratified ♂:♀ incidence rate ratios for the general population and across selected sociological contrasts. Exposure-prevalence odds ratios were derived from 82 published surveys. We estimated summary effect-size measures using random-effects models; our analyses encompass ∼0.5 million cases of disease or exposure. We found that, after puberty, disease incidence is male-biased in cutaneous and visceral leishmaniasis, schistosomiasis, pulmonary tuberculosis, leptospirosis, meningococcal meningitis, and hepatitis A. Severe dengue is female-biased, and no clear pattern is evident for typhoid fever. In leprosy, milder tuberculoid forms are female-biased, whereas more severe lepromatous forms are male-biased. For most diseases, male bias emerges also during infancy, when behavior is unbiased but sex steroid levels transiently rise. Behavioral factors likely modulate male-female differences in some diseases (the leishmaniases, tuberculosis, leptospirosis, or schistosomiasis) and age classes; however, average exposure-prevalence is significantly sex-biased only for Schistosoma and Leptospira. Our results closely match some key PH predictions and contradict some crucial BH predictions, suggesting that gender-specific behavior plays an overall secondary role in generating sex bias. Physiological differences, including the crosstalk between sex hormones and immune effectors, thus emerge as the main candidate drivers of gender differences in infectious disease susceptibility.
    PLoS ONE 04/2013; 8(4):e62390. DOI:10.1371/journal.pone.0062390 · 3.53 Impact Factor
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    ABSTRACT: Certifying the absence of Chagas disease transmission by native vectors lacks scientific grounds and weakens long-term control-surveillance systems to the detriment of people living under risk conditions. Instead, a regular "certification of good practice" (including vector control-surveillance, case detection/patient care and blood safety) could help achieve sustained disease control.
    Memórias do Instituto Oswaldo Cruz 04/2013; 108(2):251-4. DOI:10.1590/0074-0276108022013022 · 1.57 Impact Factor
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    ABSTRACT: and are the vectors of dengue, the most important arboviral disease of humans. To date, ecology studies have assumed that the vectors are truly absent from sites where they are not detected; since no perfect detection method exists, this assumption is questionable. Imperfect detection may bias estimates of key vector surveillance/control parameters, including site-occupancy (infestation) rates and control intervention effects. We used a modeling approach that explicitly accounts for imperfect detection and a 38-month, 55-site detection/non-detection dataset to quantify the effects of municipality/state control interventions on site-occupancy dynamics, considering meteorological and dwelling-level covariates. site-occupancy estimates (mean 0.91; range 0.79-0.97) were much higher than reported by routine surveillance based on 'rapid larval surveys' (0.03; 0.02-0.11) and moderately higher than directly ascertained with oviposition traps (0.68; 0.50-0.91). Regular control campaigns based on breeding-site elimination had no measurable effects on the probabilities of dwelling infestation by dengue vectors. Site-occupancy fluctuated seasonally, mainly due to the negative effects of high maximum () and minimum () summer temperatures (June-September). Rainfall and dwelling-level covariates were poor predictors of occupancy. The marked contrast between our estimates of adult vector presence and the results from 'rapid larval surveys' suggests, together with the lack of effect of local control campaigns on infestation, that many breeding sites were overlooked by vector control agents in our study setting. Better sampling strategies are urgently needed, particularly for the reliable assessment of infestation rates in the context of control program management. The approach we present here, combining oviposition traps and site-occupancy models, could greatly contribute to that crucial aim.
    PLoS ONE 03/2013; 8(3):e58420. DOI:10.1371/journal.pone.0058420 · 3.53 Impact Factor
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    ABSTRACT: [This corrects the article on p. e1822 in vol. 6.].
    PLoS Neglected Tropical Diseases 12/2012; 6(12). DOI:10.1371/annotation/f9e422fc-25c1-45dc-a558-35763a944c0d · 4.49 Impact Factor
  • Sofia I. Muoz, Fernando Abad-Franch, Mario J. Grijalva
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    ABSTRACT: Chagas disease (CD) is a parasitic infection caused by the flagellate protozoan Trypanosoma cruzi. The disease is distributed from southern United States to Argentina. Rhodnius ecuadoriensis, the most important CD vector in Ecuador, occurs in both artificial and sylvatic habitats. This study was conducted in 8 communities in the province of Manab, aiming to assess the applicability of microsatellites designed for Rhodnius pallescens to determine whether there is genetic differentiation among synanthropic and wild populations of R. ecuadoriensis. We evaluated six microsatellites, but only two markers were polymorphic in R. ecuadoriensis, two were difficult to read and the other two were monomorphic markers. Polymorphic microsatellites L13 and L47 showed no significant differences between synanthropic and sylvatic populations or among localities (FST = 0.08; p = 0.05). This suggests high rates of gene flow among R. ecuadoriensis populations in Manab, which probably represent a single metapopulation. This lack of population genetic structuring is consistent with morphological analyses of R. ecuadoriensis specimens from Manab and data from R. prolixus in Venezuela. The results presented here open the way for the development of specific microsatellites for R. ecuadoriensis, and therefore for the detailed study of the population dynamics of this local CD vector.
    Entomological Society of America Annual Meeting 2012; 11/2012
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    ABSTRACT: The mosquito Aedes aegypti, the dengue virus vector, has spread throughout the tropics in historical times. While this suggests man-mediated dispersal, estimating contemporary connectivity among populations has remained elusive. Here, we use a large mtDNA dataset and a Bayesian coalescent framework to test a set of hypotheses about gene flow among American Ae. aegypti populations. We assessed gene flow patterns at the continental and subregional (Amazon basin) scales. For the Americas, our data favor a stepping-stone model in which gene flow is higher among adjacent populations but in which, at the same time, North American and southeastern Brazilian populations are directly connected, likely via sea trade. Within Amazonia, the model with highest support suggests extensive gene flow among major cities; Manaus, located at the center of the subregional transport network, emerges as a potentially important connecting hub. Our results suggest substantial connectivity across Ae. aegypti populations in the Americas. As long-distance active dispersal has not been observed in this species, our data support man-mediated dispersal as a major determinant of the genetic structure of American Ae. aegypti populations. The inferred topology of interpopulation connectivity can inform network models of Ae. aegypti and dengue spread.
    Evolutionary Applications 11/2012; 5(7):664-76. DOI:10.1111/j.1752-4571.2012.00244.x · 4.57 Impact Factor
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    ABSTRACT: Arboviral diseases are major global public health threats. Yet, our understanding of infection risk factors is, with a few exceptions, considerably limited. A crucial shortcoming is the widespread use of analytical methods generally not suited for observational data - particularly null hypothesis-testing (NHT) and step-wise regression (SWR). Using Mayaro virus (MAYV) as a case study, here we compare information theory-based multimodel inference (MMI) with conventional analyses for arboviral infection risk factor assessment. A cross-sectional survey of anti-MAYV antibodies revealed 44% prevalence (n = 270 subjects) in a central Amazon rural settlement. NHT suggested that residents of village-like household clusters and those using closed toilet/latrines were at higher risk, while living in non-village-like areas, using bednets, and owning fowl, pigs or dogs were protective. The "minimum adequate" SWR model retained only residence area and bednet use. Using MMI, we identified relevant covariates, quantified their relative importance, and estimated effect-sizes (β±SE) on which to base inference. Residence area (β(Village) = 2.93±0.41; β(Upland) = -0.56±0.33, β(Riverbanks) = -2.37±0.55) and bednet use (β = -0.95±0.28) were the most important factors, followed by crop-plot ownership (β = 0.39±0.22) and regular use of a closed toilet/latrine (β = 0.19±0.13); domestic animals had insignificant protective effects and were relatively unimportant. The SWR model ranked fifth among the 128 models in the final MMI set. Our analyses illustrate how MMI can enhance inference on infection risk factors when compared with NHT or SWR. MMI indicates that forest crop-plot workers are likely exposed to typical MAYV cycles maintained by diurnal, forest dwelling vectors; however, MAYV might also be circulating in nocturnal, domestic-peridomestic cycles in village-like areas. This suggests either a vector shift (synanthropic mosquitoes vectoring MAYV) or a habitat/habits shift (classical MAYV vectors adapting to densely populated landscapes and nocturnal biting); any such ecological/adaptive novelty could increase the likelihood of MAYV emergence in Amazonia.
    PLoS Neglected Tropical Diseases 10/2012; 6(10):e1846. DOI:10.1371/journal.pntd.0001846 · 4.49 Impact Factor
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    ABSTRACT: Chagas disease prevention critically depends on keeping houses free of triatomine vectors. Insecticide spraying is very effective, but re-infestation of treated dwellings is commonplace. Early detection-elimination of re-infestation foci is key to long-term control; however, all available vector-detection methods have low sensitivity. Chemically-baited traps are widely used in vector and pest control-surveillance systems; here, we test this approach for Triatoma spp. detection under field conditions in the Gran Chaco. Using a repeated-sampling approach and logistic models that explicitly take detection failures into account, we simultaneously estimate vector occurrence and detection probabilities. We then model detection probabilities (conditioned on vector occurrence) as a function of trapping system to measure the effect of chemical baits. We find a positive effect of baits after three (odds ratio [OR] 5.10; 95% confidence interval [CI(95)] 2.59-10.04) and six months (OR 2.20, CI(95) 1.04-4.65). Detection probabilities are estimated at p≈0.40-0.50 for baited and at just p≈0.15 for control traps. Bait effect is very strong on T. infestans (three-month assessment: OR 12.30, CI(95) 4.44-34.10; p≈0.64), whereas T. sordida is captured with similar frequency in baited and unbaited traps. Chemically-baited traps hold promise for T. infestans surveillance; the sensitivity of the system at detecting small re-infestation foci rises from 12.5% to 63.6% when traps are baited with semiochemicals. Accounting for imperfect detection, infestation is estimated at 26% (CI(95) 16-40) after three and 20% (CI(95) 11-34) after six months. In the same assessments, traps detected infestation in 14% and 8.5% of dwellings, whereas timed manual searches (the standard approach) did so in just 1.4% of dwellings only in the first survey. Since infestation rates are the main indicator used for decision-making in control programs, the approach we present may help improve T. infestans surveillance and control program management.
    PLoS Neglected Tropical Diseases 09/2012; 6(9):e1822. DOI:10.1371/journal.pntd.0001822 · 4.49 Impact Factor
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    ABSTRACT: Vector control has substantially reduced Chagas disease (ChD) incidence. However, transmission by household-reinfesting triatomines persists, suggesting that entomological surveillance should play a crucial role in the long-term interruption of transmission. Yet, infestation foci become smaller and harder to detect as vector control proceeds, and highly sensitive surveillance methods are needed. Community participation (CP) and vector-detection devices (VDDs) are both thought to enhance surveillance, but this remains to be thoroughly assessed. We searched Medline, Web of Knowledge, Scopus, LILACS, SciELO, the bibliographies of retrieved studies, and our own records. Data from studies describing vector control and/or surveillance interventions were extracted by two reviewers. Outcomes of primary interest included changes in infestation rates and the detection of infestation/reinfestation foci. Most results likely depended on study- and site-specific conditions, precluding meta-analysis, but we re-analysed data from studies comparing vector control and detection methods whenever possible. Results confirm that professional, insecticide-based vector control is highly effective, but also show that reinfestation by native triatomines is common and widespread across Latin America. Bug notification by householders (the simplest CP-based strategy) significantly boosts vector detection probabilities; in comparison, both active searches and VDDs perform poorly, although they might in some cases complement each other. CP should become a strategic component of ChD surveillance, but only professional insecticide spraying seems consistently effective at eliminating infestation foci. Involvement of stakeholders at all process stages, from planning to evaluation, would probably enhance such CP-based strategies.
    PLoS Neglected Tropical Diseases 06/2011; 5(6):e1207. DOI:10.1371/journal.pntd.0001207 · 4.49 Impact Factor
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    ABSTRACT: Adult triatomines occasionally fly into artificially lit premises in Amazonia. This can result in Trypanosoma cruzi transmission to humans either by direct contact or via foodstuff contamination, but the frequency of such behaviour has not been quantified. To address this issue, a light-trap was set 45 m above ground in primary rainforest near Manaus, state of Amazonas, Brazil and operated monthly for three consecutive nights over the course of one year (432 trap-hours). The most commonly caught reduviids were triatomines, including 38 Panstrongylus geniculatus, nine Panstrongylus lignarius, three Panstrongylus rufotuberculatus, five Rhodnius robustus, two Rhodnius pictipes, one Rhodnius amazonicus and 17 Eratyrus mucronatus. Males were collected more frequently than females. The only month without any catches was May. Attraction of most of the known local T. cruzi vectors to artificial light sources is common and year-round in the Amazon rainforest, implying that they may often invade premises built near forest edges and thus become involved in disease transmission. Consequently, effective Chagas disease prevention in Amazonia will require integrating entomological surveillance with the currently used epidemiological surveillance.
    Memórias do Instituto Oswaldo Cruz 12/2010; 105(8):1061-4. DOI:10.1590/S0074-02762010000800019 · 1.57 Impact Factor