Making Vector-Borne Disease Surveillance Work: New Opportunities From the SDG Perspectives.

Surveillance of vector-borne diseases (VBDs) exemplifies a One Health approach, which entails coordinated, collaborative, multidisciplinary, and cross-sectoral approaches to address potential or existing health risks originating at the animal-human-ecosystem interface. However, at the intervention stage of the surveillance system, it is sometimes difficult or even impossible to act. The human dimension of VBD control makes them wicked problems requiring an interdisciplinary systems approach beyond the One Health domain. Here, we make a case that the agenda of the UN Sustainable Development Goals (SDGs) can offer new opportunities to address these issues. The health of the population is a concern to us all and is more or less related to all 17 SDGs. The SDGs can provide a common language by which the interests of various stakeholders can be matched and the challenges that society faces identified, studied, and alleviated. To illustrate, the control and prevention of two VBDs, dengue and Lyme borreliosis, were selected and related to specific SDGs. Further, we use the framework proposed by the International Council of Science to: (1) show synergies and trade-offs between the various SDGs; and (2) present SDG 3 to identify policy that can be related to prevention. Engaging in an integrated approach will confront stakeholders with various viewpoints and through these oppositions, innovation can be nurtured. By adhering to the SDG agenda, we present policy advice including new opportunities for vector-borne disease control to reach its own health goals, while simultaneously supporting other sustainable development goals.

The use of historical vital statistics when analyzing African-descended population heterogeneity.

This paper explores population substructure through an analysis of 726 individual death certificates representing African-American and West-Indian immigrant populations who died from tubercular infection in Manhattan, New York City, NY, 1890-1930. From the death certificate data, four classes of tubercular infection were derived: pulmonary, chronic pulmonary, acute/miliary tuberculosis and tubercular meningitis. Individuals were classified according to color and place of birth. Using these data, the correlation among color, region of birth and the type of tubercular infection causing death was examined. Through a Chi-squared analysis, the data demonstrated that: 1) color did not significantly influence the type of tuberculosis an individual died from, and 2) region of birth influenced the type of tuberculosis an individual died from. The results of this analysis lead to the conclusion that historical vital records, specifically death certificate data, are useful when exploring historical population substructure.

An analysis of community perceptions of mosquito-borne disease control and prevention in Sint Eustatius, Caribbean Netherlands.

BACKGROUND: In the Caribbean, mosquito-borne diseases are a public health threat. In Sint Eustatius, dengue, Chikungunya and Zika are now endemic. To control and prevent mosquito-borne diseases, the Sint Eustatius Public Health Department relies on the community to assist with the control of Aedes aegypti mosquito. Unfortunately, community based interventions are not always simple, as community perceptions and responses shape actions and influence behavioural responses Objective: The aim of this study was to determine how the Sint Eustatius population perceives the Aedes aegypti mosquito, mosquito-borne diseases and prevention and control measures and hypothesized that increased knowledge of the virus, vector, control and prevention should result in a lower AQ1 prevalence and incidence of mosquito-borne diseases. METHODS: This study was conducted in Sint Eustatius island in the Eastern Caribbean. We combined qualitative and quantitative designs. We conducted interviews and focus groups discussions among community member and health professional in 2013 and 2015. We also conducted cross-sectional survey to assess local knowledge on the vector, virus, and control and prevention. RESULTS: The population is knowledgeable; ©however, mosquito-borne diseases are not the highest health priority. While local knowledge is sometimes put into action, it happens on the 20 household/individual level as opposed to the community level. After the 2014 CHIK outbreak, there was an increase in knowledge about mosquito control and mosquito-borne diseases. DISCUSSION: In the context of Sint Eustatius, when controlling the Aedes population it may be a strategic option to focus on the household level rather than the community and build collaborations with households by supporting them when they actively practice mosquito 25 control. To further increase the level of knowledge on the significance of mosquito-borne diseases, it may also be an option to contextualize the issue of the virus, vector, prevention and control into a broader context. CONCLUSION: As evidenced by the increasing number of mosquito-borne diseases on the island, it appears that knowledge amongst the lay community may not be transferred into 30 action. This may be attributed to the perception of the Sint Eustatius populations that mosquitoes and the viruses they carry are not a high priority in comparison to other health concerns.

Detection of West Nile Virus and other common equine viruses in three locations from the Leeward Islands, West Indies.

Equines in the West Indies are used for recreational purposes, tourism industry, racing and agriculture or can be found in feral populations. Little is known in the Caribbean basin about the prevalence of some major equine infectious diseases, some with zoonotic potential, listed as reportable by the OIE. Our objective was to study the prevalence of antibodies for West Nile Virus (WNV), Equine Herpes Virus-1 and 4 (EHV-1 and EHV-4), Equine Influenza (EI), Equine Viral Arteritis (EVA) and Equine Infectious Anemia Virus (EIAV) using a retrospective serological convenience study. We used 180 equine serum samples, 140 from horses and 40 from donkeys in St. Kitts, Nevis, and Sint Eustatius, collected between 2006 and 2015 that were tested with ELISA kits and virus neutralization (for WNV and EVA). Combining ELISA with virus neutralization testing, 25 (13.8%) equine sera were WNV positive (a mixture of indigenous and imported equines) and 3 sera (1.6%) showed doubtful results. For EHV-1, 41 equines (23.7%), mean age 6.7 years, were seropositive. For EHV-4, 138 equines were found seropositive (82.8%), mean age 6.3 years. For EI, 49 equines (27.2%), mean age 7.5 years, were seropositive on ELISA, some previously vaccinated horses. No antibodies against EAV were found on virus neutralization testing, although one animal (0.6%), was EAV positive on ELISA. All samples were EIAV negative. The seroprevalence for EHV-1 and EHV-4 is similar to other parts of the world. For the first time in the study location serologic evidence of antibodies against WNV and EI is reported. This was found in both indigenous and imported animals, highlighting the need for developing proper surveillance plans based on complementary methods of virus detection. Further studies will be needed to define the prevalence, rates of transmission, characterize local virus strains, and study their impact on these populations.

Dengue serosurvey in Sint Eustatius.

Four distinct serotypes of dengue viruses (DENV) are the cause of re-emerging dengue fever (DF) and dengue hemorrhagic fever (DHF). Dengue circulation in the Caribbean has gone from none or single serotype to multiple serotypes co-circulating with reports of continuing cycles of progressively more severe disease in the region. Few studies have investigated dengue on Sint Eustatius. Blood samples were collected to determine the prevalence of antibodies against dengue in the Sint Eustatius population. Greater than 90% of the serum samples (184 of 204) were positive for anti-flavivirus antibodies by enzyme linked immunosorbance assay (ELISA). Plaque reduction neutralization test (PRNT), specific for dengue viruses, showed that 171 of these 184 flavivirus antibody positive sera had a neutralization titer against one or more DENV serotypes. A majority of the sera (62%) had neutralizing antibody to all four dengue serotypes. Only 26 PRNT positive sera (15%) had monotypic dengue virus neutralizing antibody, most of which (20 of 26) were against DENV2. Evidence of infection with all four serotypes was observed across all age groups except in the youngest age group (10-19 years) which contained only DENV2 positive individuals. In a multiple logistic regression model, only the length of residence on the island was a predictor of a positive dengue PRNT50 result. To our knowledge this is the first dengue serosurveillance study conducted on Sint Eustatius since the 1970s. The lack of antibodies to the DEN1, 3, and 4 in the samples collected from participants under 20 years of age suggests that only DEN2 has circulated on island since the early 1990s. The high prevalence of antibodies against dengue (83.8%) and the observation that the length of time on the island was the strongest predictor of infection suggests dengue is endemic on Sint Eustatius and a public health concern that warrants further investigation.