Abstract
Dengue, Zika and chikungunya are diseases of global health significance caused by arboviruses and transmitted by the mosquito Aedes aegypti, which is of worldwide circulation. The arrival of the Zika and chikungunya viruses to South America increased the complexity of transmission and morbidity caused by these viruses co-circulating in the same vector mosquito species. Here we present an integrated analysis of the reported arbovirus cases between 2007 and 2017 and local climate and socio-economic profiles of three distinct Colombian municipalities (Bello, Cúcuta and Moniquirá). These locations were confirmed as three different ecosystems given their contrasted geographic, climatic and socio-economic profiles. Correlational analyses were conducted with both generalised linear models and generalised additive models for the geographical data. Average temperature, minimum temperature and wind speed were strongly correlated with disease incidence. The transmission of Zika during the 2016 epidemic appeared to decrease circulation of dengue in Cúcuta, an area of sustained high incidence of dengue. Socio-economic factors such as barriers to health and childhood services, inadequate sanitation and poor water supply suggested an unfavourable impact on the transmission of dengue, Zika and chikungunya in all three ecosystems. Socio-demographic influencers were also discussed including the influx of people to Cúcuta, fleeing political and economic instability from neighbouring Venezuela. Aedes aegypti is expanding its range and increasing the global threat of these diseases. It is therefore vital that we learn from the epidemiology of these arboviruses and translate it into an actionable local knowledge base. This is even more acute given the recent historical high of dengue cases in the Americas in 2019, preceding the COVID-19 pandemic, which is itself hampering mosquito control efforts.
Highlights
Vector-borne diseases are one of the most significant public health burdens globally, with 80% of the total world population at risk [1]
The primary method of controlling the spread of these arboviruses is through mosquito control
Understanding factors associated with risk of these viruses is key for informing control programmes and predicting when outbreaks may occur
Summary
Vector-borne diseases are one of the most significant public health burdens globally, with 80% of the total world population at risk [1]. Arboviruses, including dengue, Zika and chikungunya, are of particular concern due to the recent increase in global cases promoted by the rapid spread of both their primary mosquito vector Aedes aegypti as well as their secondary vector Aedes albopictus [2]. Dengue infection can be asymptomatic but clinical presentations range from mild dengue fever (DF), a febrile illness similar to influenza, to the severe forms of dengue; dengue shock syndrome (DSS) and dengue haemorrhagic fever (DHF) [3]. The clinical presentations of symptomatic ZIKV can include Zika fever, congenital Zika syndrome and Guillain-Barresyndrome. Congenital Zika syndrome refers to a group of birth defects, notably Microcephaly, which have been associated with ZIKV infection during pregnancy [6,7]. Infection with the chikungunya virus (CHIKV) is characterised by sudden onset fever, rash and arthralgia [8]. Joint pain associated with CHIKV is debilitating and whilst typically lasting a few days can last for many months or even years [9]
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