Scoping review on vector-borne diseases in urban areas: transmission dynamics, vectorial capacity and co-infection.

BACKGROUND: Transmission dynamics, vectorial capacity, and co-infections have substantial impacts on vector-borne diseases (VBDs) affecting urban and suburban populations. Reviewing key factors can provide insight into priority research areas and offer suggestions for potential interventions. MAIN BODY: Through a scoping review, we identify knowledge gaps on transmission dynamics, vectorial capacity, and co-infections regarding VBDs in urban areas. Peer-reviewed and grey literature published between 2000 and 2016 was searched. We screened abstracts and full texts to select studies. Using an extraction grid, we retrieved general data, results, lessons learned and recommendations, future research avenues, and practice implications. We classified studies by VBD and country/continent and identified relevant knowledge gaps. Of 773 articles selected for full-text screening, 50 were included in the review: 23 based on research in the Americas, 15 in Asia, 10 in Africa, and one each in Europe and Australia. The largest body of evidence concerning VBD epidemiology in urban areas concerned dengue and malaria. Other arboviruses covered included chikungunya and West Nile virus, other parasitic diseases such as leishmaniasis and trypanosomiasis, and bacterial rickettsiosis and plague. Most articles retrieved in our review combined transmission dynamics and vectorial capacity; only two combined transmission dynamics and co-infection. The review identified significant knowledge gaps on the role of asymptomatic individuals, the effects of co-infection and other host factors, and the impacts of climatic, environmental, and socioeconomic factors on VBD transmission in urban areas. Limitations included the trade-off from narrowing the search strategy (missing out on classical modelling studies), a lack of studies on co-infections, most studies being only descriptive, and few offering concrete public health recommendations. More research is needed on transmission risk in homes and workplaces, given increasingly dynamic and mobile populations. The lack of studies on co-infection hampers monitoring of infections transmitted by the same vector. CONCLUSIONS: Strengthening VBD surveillance and control, particularly in asymptomatic cases and mobile populations, as well as using early warning tools to predict increasing transmission, were key strategies identified for public health policy and practice.

Increase in Reported Prevalence of Microcephaly in Infants Born to Women Living in Areas with Confirmed Zika Virus Transmission During the First Trimester of Pregnancy - Brazil, 2015.

Widespread transmission of Zika virus by Aedes mosquitoes has been recognized in Brazil since late 2014, and in October 2015, an increase in the number of reported cases of microcephaly was reported to the Brazil Ministry of Health.* By January 2016, a total of 3,530 suspected microcephaly cases had been reported, many of which occurred in infants born to women who lived in or had visited areas where Zika virus transmission was occurring. Microcephaly surveillance was enhanced in late 2015 by implementing a more sensitive case definition. Based on the peak number of reported cases of microcephaly, and assuming an average estimated pregnancy duration of 38 weeks in Brazil (1), the first trimester of pregnancy coincided with reports of cases of febrile rash illness compatible with Zika virus disease in pregnant women in Bahia, Paraíba, and Pernambuco states, supporting an association between Zika virus infection during early pregnancy and the occurrence of microcephaly. Pregnant women in areas where Zika virus transmission is occurring should take steps to avoid mosquito bites. Additional studies are needed to further elucidate the relationship between Zika virus infection in pregnancy and microcephaly.

[Breast feeding determinants on the first year of life of children in a city of Midwestern Brazil]. / Determinantes da amamentação no primeiro ano de vida em Cuiabá, Mato Grosso.

OBJECTIVE: To assess risk factors for breastfeeding discontinuation and weaning among children less than one year old. METHODS: A cross-sectional study was carried out in children under one year of age brought by their caregivers to immunization units in the city of Cuiabá, Midwestern Brazil, in 2004. Sampling first comprised drawing immunization units and then children in each unit were systematically drawn. Data was collected through semi-structured questionnaires applied to children's caregivers investigating social and demographic variables, as well as variables related to birth and maternal characteristics, pacifier use and feeding on the first day at home. Descriptive statistical and logistic regression analyses of risk factors by age group were conducted and odds ratios and 95% confidence intervals were estimated. RESULTS: A total of 920 children under one year of age were studied, of which 205 were less than 120 days old and 275 were less than 180 days old. Pacifier use, offering tea to children on their first day at home, and being a child of a mother with first or second grade schooling or primapara posed an increased risk for not being on exclusive breastfeeding at the age of 120 days. All these factors were also significantly associated in those under 180 days old, except tea offering, which was not investigated for this age group. Among children less than one year old, pacifier use was the only variable that remained significant. CONCLUSIONS: Social and cultural factors were determinants of breastfeeding status. Maternal education and awareness are crucial to prevent practices that can negatively affect breastfeeding.