Abstract

Urbanization is one of the major drivers of dengue epidemics globally. In Kenya, an intriguing pattern of urban dengue virus epidemics has been documented in which recurrent epidemics are reported from the coastal city of Mombasa, whereas no outbreaks occur in the two major inland cities of Kisumu and Nairobi. In an attempt to understand the entomological risk factors underlying the observed urban dengue epidemic pattern in Kenya, we evaluated vector density, human feeding patterns, vector genetics, and prevailing environmental temperature to establish how these may interact with one another to shape the disease transmission pattern. We determined that (i) Nairobi and Kisumu had lower vector density and human blood indices, respectively, than Mombasa, (ii) vector competence for dengue-2 virus was comparable among Ae. aegypti populations from the three cities, with no discernible association between susceptibility and vector cytochrome c oxidase subunit 1 gene variation, and (iii) vector competence was temperature-dependent. Our study suggests that lower temperature and Ae. aegypti vector density in Nairobi may be responsible for the absence of dengue outbreaks in the capital city, whereas differences in feeding behavior, but not vector competence, temperature, or vector density, contribute in part to the observed recurrent dengue epidemics in coastal Mombasa compared to Kisumu.

Highlights

  • Dengue virus (DENV) is a global public health threat with epidemics mostly reported in urban and semi-urban areas [1,2]

  • In Kenya, repeated outbreaks of the disease have occurred in the urban areas of Mombasa but not in Nairobi and Kisumu, despite the presence of susceptible human hosts and the primary vector, Aedes aegypti throughout these areas

  • Based on the total number of female Ae. aegypti mosquitoes collected using the BG-Sentinel traps from each of the three cities (n = 1,432, n = 1,686, and n = 661 in Mombasa, Kisumu, and Nairobi respectively), the estimated vector density per trap was comparable in Mombasa and Kisumu, 8.0 and 9.4 Ae. aegypti/trap (T-test, p = 0.186), with each being ~ 2-fold higher than in Nairobi, 3.7 Ae. aegypti/trap (T-test, p < 0.001) (Table 1)

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Summary

Introduction

Dengue virus (DENV) is a global public health threat with epidemics mostly reported in urban and semi-urban areas [1,2]. There are a number of factors such as temperature, vector bionomics (survival, density, feeding frequency/behavior), extrinsic incubation period (EIP), and vector competence that can affect DENV transmission [10,11,12,13,14,15,16,17]. Whilst determination of individual factors is valuable, they are rarely studied in parallel, yet their combined effects may be critical to fully understanding the complex interrelationships influencing DENV transmission risk. Studies investigating the various dengue risk factors in parallel are lacking in many endemic areas, including Kenya

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