scholarly journals Social-ecological factors and preventive actions decrease the risk of dengue infection at the household-level: results from a prospective dengue surveillance study in Machala, Ecuador

2017 ◽  
Author(s):  
Aileen Kenneson ◽  
Efraín Beltrán-Ayala ◽  
Mercy J. Borbor-Cordova ◽  
Mark E. Polhemus ◽  
Sadie J. Ryan ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Vector Control ◽  
Disease Outbreaks ◽  
Ecological Factors ◽  
Bed Nets ◽  
Household Level ◽  
Social Ecological ◽  
Piped Water ◽  
Abandoned Properties

ABSTRACTBackgroundIn Ecuador, dengue virus (DENV) infections transmitted by the Aedes aegypti mosquito are among the greatest public health concerns in urban coastal communities. Community- and household-level vector control is the principal means of controlling disease outbreaks. This study aimed to assess the impact of knowledge, attitudes, and practices (KAPs) and social-ecological factors on the presence or absence of DENV infections in the household..MethodsIn 2014 and 2015, individuals with DENV infections from sentinel clinics were invited to participate in the study, as well as members of their household and members of four neighboring households located within 200 meters. We conducted diagnostic testing for DENV on all study participants; we surveyed heads of households (HOHs) regarding demographics, housing conditions and KAPs. We compared KAPs and social-ecological factors between households with (n=139) versus without (n=80) DENV infections, using bivariate analyses and multivariate logistic regression models with and without interactions.ResultsSignificant risk factors in multivariate models included proximity to abandoned properties, interruptions in piped water, and shaded patios (p<0.05). Significant protective factors included use of mosquito bed nets, fumigation inside the home, piped water inside the home (p<0.05). In bivariate analyses (but not multivariate modeling), DENV infections was positively associated with HOHs who were male, employed, and of younger age than households without infections (p<0.05). DENV infections were not associated with knowledgeattitude, or reported barriers to prevention activities.DiscussionSpecific actions that can be considered to decrease the risk of DENV infections in the household include targeting vector control in highly shaded properties, fumigating inside the home, and use of mosquito bed nets. Community-level interventions include clean-up of abandoned properties, daily trash pick-up, and reliable piped water inside houses. These findings can inform interventions to reduce the risk of other diseases transmitted by the Ae. aegypti mosquito, such as chikungunya and Zika fever.Author summaryDengue, chikungunya and Zika viruses are transmitted to people primarily by the Aedes aegypti mosquitoes in tropical and subtropical regions. Diseases transmitted by the Ae. aegypti mosquito are a growing public health concern. Mosquito control is the principal means of preventing and controlling disease outbreaks. In this study, we compared the characteristics of households with and without DENV infections in the city of Machala, Ecuador. We found that risk factors for DENV infection included proximity to abandoned properties, interruptions in the piped water supply, and a highly shaded patio. Protective factors included the use of mosquito bed nets, fumigation inside the home, and piped water inside the home. These findings can be used to inform targeted vector control interventions by the public health sector at the household and community levels.

scholarly journals Exploring the utility of social-ecological and entomological risk factors for dengue infection as surveillance indicators in the dengue hyper-endemic city of Machala, Ecuador

2020 ◽  
Author(s):  
Catherine Lippi ◽  
Anna M. Stewart-Ibarra ◽  
Timothy P. Endy ◽  
Mark Abbott ◽  
Cinthya Cueva ◽  
...  
Keyword(s):  
Risk Factors ◽  
Aedes Aegypti ◽  
Dengue Infection ◽  
Good Condition ◽  
Ecological Factors ◽  
Dengue Case ◽  
Infection Status ◽  
Household Level ◽  
Targeted Interventions ◽  
Social Ecological

The management of mosquito-borne diseases is a challenge in southern coastal Ecuador, where dengue is hyper-endemic and co-circulates with other arboviral diseases. Prior work in the region has explored social-ecological factors, dengue case data, and entomological indices. In this study, we bring together entomological and epidemiological data to describe links between social-ecological factors associated with risk of dengue transmission at the household level in Machala, Ecuador. Households surveys were conducted from 2014-2016 to assess the presence of adult Aedes aegypti (collected via aspiration) and to enumerate housing conditions, demographics, and mosquito prevention behaviors. Household-level dengue infection status was determined by laboratory diagnostics in 2014-2015. Logistic models and multimodel selection were used to identify social-ecological variables associated with household presence of female Ae. aegypti and household dengue infection status, respectively. We identified significant risk factors for household-level dengue infection reflecting household condition, including bamboo cane construction material, shaded patios, and adjacency to abandoned properties, while housing structures in good condition were identified as protective against dengue infection. Aedes aegypti presence was associated with a greater than average number people per household and interrupted water supply, but was not associated with household level dengue infections. Models of Ae. aegypti presence were unstable, and not well resolved in ranking of competing models, suggesting that highly localized entomological surveillance indicators may not be indicative of risk in communities with hyperendemic dengue fever. These findings add to our understanding of the systems of mosquito-borne disease transmission in Machala, and in the larger region of southern Ecuador, aiding in the development of improved vector surveillance efforts, and targeted interventions.

scholarly journals Exploring the utility of social-ecological and entomological risk factors for dengue infection as surveillance indicators in the dengue hyper-endemic city of Machala, Ecuador

2021 ◽  
Vol 15 (3) ◽  
pp. e0009257
Author(s):  
Catherine A. Lippi ◽  
Anna M. Stewart-Ibarra ◽  
Timothy P. Endy ◽  
Mark Abbott ◽  
Cinthya Cueva ◽  
...  
Keyword(s):  
Risk Factors ◽  
Aedes Aegypti ◽  
Dengue Infection ◽  
Good Condition ◽  
Ecological Factors ◽  
Dengue Case ◽  
Infection Status ◽  
Household Level ◽  
Targeted Interventions ◽  
Social Ecological

The management of mosquito-borne diseases is a challenge in southern coastal Ecuador, where dengue is hyper-endemic and co-circulates with other arboviral diseases. Prior work in the region has explored social-ecological factors, dengue case data, and entomological indices. In this study, we bring together entomological and epidemiological data to describe links between social-ecological factors associated with risk of dengue transmission at the household level in Machala, Ecuador. Households surveys were conducted from 2014–2017 to assess the presence of adult Aedes aegypti (collected via aspiration) and to enumerate housing conditions, demographics, and mosquito prevention behaviors. Household-level dengue infection status was determined by laboratory diagnostics in 2014–2015. Bivariate analyses and multivariate logistic regression models were used to identify social-ecological variables associated with household presence of female Ae. aegypti and household dengue infection status, respectively. Aedes aegypti presence was associated with interruptions in water service and weekly trash collection, and household air conditioning was protective against mosquito presence. Presence of female Ae. aegypti was not associated with household dengue infections. We identified shaded patios and head of household employment status as risk factors for household-level dengue infection, while window screening in good condition was identified as protective against dengue infection. These findings add to our understanding of the systems of mosquito-borne disease transmission in Machala, and in the larger region of southern Ecuador, aiding in the development of improved vector surveillance efforts, and targeted interventions.

scholarly journals Household-Level Risk Factors for Aedes aegypti Pupal Density in Guayaquil, Ecuador

2020 ◽  
Author(s):  
Thien-An Ha ◽  
Tomás M. León ◽  
Karina Lalangui ◽  
Patricio Ponce ◽  
John M. Marshall ◽  
...  
Keyword(s):  
Risk Factors ◽  
Aedes Aegypti ◽  
Vector Control ◽  
Negative Binomial Regression Model ◽  
Control Methods ◽  
Municipal Services ◽  
Breeding Sites ◽  
Household Level ◽  
Level Model ◽  
The Impact

AbstractBackgroundVector-borne diseases are a major cause of disease burden in Guayaquil, Ecuador, especially arboviruses spread by Aedes aegypti mosquitoes. Understanding which household characteristics and risk factors lead to higher Ae. aegypti densities and consequent disease risk can help inform and optimize vector control programs.MethodsCross-sectional entomological surveys were conducted in Guayaquil between 2013 and 2016, covering household demographics, municipal services, potential breeding containers, presence of Ae. aegypti larvae and pupae, and history of using mosquito control methods. A zero-truncated negative binomial regression model was fitted to data for estimating the household pupal index. An additional model assessed the factors of the most productive breeding sites across all of the households.ResultsOf surveyed households, 610 satisfied inclusion criteria. The final household-level model found that collection of large solid items (e.g., furniture and tires) and rainfall the week of and 2 weeks before collection were negatively correlated with average pupae per container, while bed canopy use, unemployment, container water volume, and the interaction between large solid collection and rainfall 2 weeks before the sampling event were positively correlated. Selection of these variables across other top candidate models with ΔAICc < 1 was robust, with the strongest effects from large solid collection and bed canopy use. The final container-level model explaining the characteristics of breeding sites found that contaminated water is positively correlated with Ae. aegypti pupae counts while breeding sites composed of car parts, furniture, sewerage parts, vases, ceramic material, glass material, metal material, and plastic material were all negatively correlated.ConclusionHaving access to municipal services like bulky item pickup was effective at reducing mosquito proliferation in households. Association of bed canopy use with higher mosquito densities is unexpected, and may be a consequence of large local mosquito populations or due to limited use or effectiveness of other vector control methods. The impact of rainfall on mosquito density is multifaceted, as it may both create new habitat and “wash out” existing habitat. Providing services and social/technical interventions focused on monitoring and eliminating productive breeding sites is important for reducing aquatic-stage mosquito densities in households at risk for Ae. aegypti-transmitted diseases.

Assessing public health risk factors for internally displaced households in North Darfur, Sudan

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Elfadil Mohammed Mahmoud ◽  
Indraijt Pal ◽  
Mokbul Morshed Ahmad
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Health Risk ◽  
Vulnerable Groups ◽  
Health Risk Factors ◽  
Public Health Risk ◽  
Content Type ◽  
Internally Displaced ◽  
Household Level ◽  
The Public

PurposeThe purpose of this paper is to assess the public health risk factors of internally displaced households and suggest appropriate measures and strategies for health risk reduction in the context of IDPs.Design/methodology/approachThe composite Index (CI) method was used to compare the public health risk factors at the household level in three IDP camps. A set of 22 indicators were studied in 326 households. Households were selected by using a two-stage cluster sampling technique.FindingsThe findings indicate that the Shangil Tobaya camp is at the highest risk for communicable diseases (63.6%) followed by Zamzam (52.4%) and Abu Shouk (42.7%) at the household level. Eight indicators appeared to have made differential impacts between Abu Shouk and Shangil Tobaya, these include: level of education, walking time to health facilities, water source, latrines type, safe disposal of child feces, frequency of visit by pregnant women to antenatal care services, place of delivery and women delivering their children with the help of skilled birth attendants.Research limitations/implicationsSince the selection criteria of the camps were predefined; there are variations in the number of samples between the camps. Therefore, the generalizability may be compromised.Social implicationsIncreased access to healthcare services particularly reproductive health services to the most vulnerable groups (women). Community involvement in services management to promote ownership.Originality/valueThe methods used in this study is original and flexible and can be replicated for other emergency areas and risks.

scholarly journals Assessment of malaria as a public health problem in and around Arjo Didhessa Sugar Cane Plantation area, Western Ethiopia

2020 ◽  
Author(s):  
Mebrate Dufera ◽  
Regea Debsu ◽  
Gemechu Tiruneh
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Health Problem ◽  
Sugar Cane ◽  
Public Health Problem ◽  
Malaria Prevalence ◽  
Malaria Risk ◽  
Bed Nets ◽  
Western Ethiopia ◽  
Malaria Risk Factors

Abstract Background: Although much progress has been made in reducing malaria morbidity and mortality worldwide in the last decade, nationally malaria still remains the third leading cause of death and still considered as major public health problem. Therefore, this study was aimed to assess malaria as a public health problem in and around sugar cane plantation area of Arjo Didhessa sugar factory, Western Ethiopia. Methods: A community based cross sectional study supplemented with clinical retrospective data, which included 452 study subjects was recruited and the study period was extended from May 2016 up to November of 2017. A standardized questionnaire was used to assess malaria risk factors and blood samples were received from all study participants and further subjected to Giemsa staining for determination of malaria prevalence. Data were analyzed by SPSS version 20.Malaria risk factors were identified by multivariate logistic regression at significance level of P < 0.05 . Results: The overall malaria prevalence was 3.1%; Plasmodium vivax being the main type of malaria parasite. Overnight outdoor sleeping and improper utilization of mosquito bed nets were found to be statistically significant as malaria risk factors in the community. In the retrospective studies of five years, the peak malaria cases (13.84%) were reported in 2013 and lowest cases (1.24%) in 2017. Conclusions: The figure of malaria witnessed in this area remains higher than the observed national malaria prevalence indicating malaria is still remains a public health problem.Therefore, we suggest the factory administrators and health care professionals to work more on raising awareness to avoid night outdoor sleeping and effective and appropriate utilization of insecticide treated nets and regular indoor residual spraying. Key words : Arjo Didhessa, malaria, malaria risk factors

scholarly journals The social and spatial ecology of dengue presence and burden during an outbreak in Guayaquil, Ecuador, 2012

2017 ◽  
Author(s):  
Catherine A. Lippi ◽  
Anna M. Stewart-Ibarra ◽  
Ángel G. Muñoz ◽  
Mercy J. Borbor ◽  
Raúl Mejía ◽  
...  
Keyword(s):  
Risk Factors ◽  
Dengue Fever ◽  
Garbage Collection ◽  
Significant Risk ◽  
Dengue Case ◽  
List Type ◽  
Housing Conditions ◽  
Social Ecological ◽  
Piped Water ◽  
Block Level

AbstractDengue fever, a mosquito-borne viral disease, is an ongoing public health problem in Ecuador and throughout the tropics, yet we have a limited understanding of the disease transmission dynamics in these regions. The objective of this study was to characterize the spatial dynamics and social-ecological risk factors associated with a recent dengue outbreak in Guayaquil, Ecuador. We examined georeferenced dengue cases (n = 4,248) and block-level census data variables to identify potential social-ecological variables associated with the presence and burden of dengue fever in Guayaquil in 2012. We applied LISA and Moran’s I tests to analyze hotspots of dengue cases and used multimodel selection in R computing language to identify covariates associated with dengue incidence at the census zone level. Significant hotspots of dengue transmission were found near the North Central and Southern portions of Guayaquil. Significant risk factors for presence of dengue included poor housing conditions (e.g., poor condition of ceiling, floors, and walls), access to paved roads, and receipt of remittances. Counterintuitive positive correlations with dengue presence were observed with several municipal services such as garbage collection and access to piped water. Risk factors for the increased burden of dengue included poor housing conditions, garbage collection, receipt of remittances, and sharing a property with more than one household. Social factors such as education and household demographics were negatively correlated with increased dengue burden. Our findings elucidate underlying differences with dengue presence and burden and indicate the potential to develop dengue vulnerability and risk maps to inform disease prevention and control - information that is also relevant for emerging epidemics of chikungunya and zika.HighlightsIn 2012, Guayaquil, Ecuador had a large outbreak of dengue casesDengue case presence and burden exhibited spatial heterogeneity at the census block levelSocial-ecological drivers of case presence and burden differed in this outbreak, highlighting the need to model both types of epidemiological dataAccess to municipal resources such as garbage collection and piped water had counterintuitive relationships with dengue presence, but poor housing, garbage collection and remittances correlated to dengue burden.Our findings inform risk mapping and vector control and surveillance allocation, relevant to this and other concurrent emergent epidemics such as chikungunya and zika

scholarly journals Questionnaire Survey on the Occurrence of Risk factors for Toxoplasma gondii infection amongst Farmers in Thika District, Kenya

2013 ◽  
Vol 84 (1) ◽  
Author(s):  
Edwin Ogendi ◽  
Naomi Maina ◽  
John Kagira ◽  
Maina Ngotho ◽  
Gabriel Mbugua ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Toxoplasma Gondii ◽  
Questionnaire Survey ◽  
Public Health Education ◽  
Transmission Mechanism ◽  
Household Level ◽  
Toxoplasma Gondii Infection ◽  
Cooked Meat ◽  
Structured Questionnaire

A survey was conducted to determine the occurrence of risk factors for Toxoplasma gondii infection amongst farmers in Thika District, Kenya. Interviews were conducted in a total of 385 households using a structured questionnaire. The water consumed at household level originated from taps (74.3%), rivers or streams (15.1%), wells (5.4%) and boreholes (5.2%). A number of households (46.8%) consumed water without boiling or applying any form of treatment. All respondents washed vegetables before cooking, whilst 99.0% washed fruits before eating. Boiled milk was preferred by 99.5% of the farmers. The majority (85.2%) consumed beef more often, whilst 1.6% consumed pork. The majority (98.7%) consumed thoroughly cooked meat. Meat was preserved by 17% of farmers. Only four farmers (1.2%) who practised mixed farming used gloves when handling livestock manure. Five farmers (1.6%) reported the occurrence of abortion in ruminants and pigs on their farms within the last two years before the study. Almost half (44.9%) of the households owned cats, which were kept mainly as pets (79.8%) and for deterring rodents (20.2%). The majority of households (91.3%) fed the cats on leftovers, whilst 8.1% fed cats with raw offal. Sixteen households (9.2%) provided housing for cats. Only five households (2.8%) had litter boxes, but none of the households with litter boxes used gloves when cleaning them out. Disposal of cat faeces was done mainly by women (55.5%). Only one farmer (0.3%) had some knowledge about toxoplasmosis, but was not aware of the transmission mechanism. The study highlights the need for public health education to raise awareness of risk factors for toxoplasmosis.

scholarly journals Multilevel modelling, prevalence, and predictors of hypertension in Ghana: Evidence from Wave 2 of the World Health Organization’s Study on Global AGEing and adult health

2020 ◽  
Author(s):  
Justice Moses Kwaku Aheto ◽  
Getachew A. Dagne
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Lifestyle Modification ◽  
World Health ◽  
Public Health Issue ◽  
Health State ◽  
Adult Health ◽  
Binary Logistic Regression Model ◽  
Household Level ◽  
Global Ageing

Abstract Background Hypertension is a major public health issue, a critical risk factor for cardiovascular diseases and stroke, especially in developing countries where the rates remain unacceptably high. In Africa, hypertension is the leading driver of cardiovascular disease and stroke deaths. Identification of critical risk factors of hypertension can help formulate targeted public health programmes and policies aimed at reducing the prevalence and its associated morbidity, disability, and mortality. This study attempts to develop multilevel binary logistic regression model, an in-depth statistical model to identify critical risk factors of hypertension to inform interventions aimed at improving cardiovascular health outcomes among adults. Methods This study used data on 4667 individuals aged ≥ 18 years from the nationally representative World Health Organization Study on global AGEing and adult health (SAGE) Ghana Wave 2 conducted in 2014/2015. Multilevel regression modelling was applied on final sample of 4381 individuals residing in 3790 households to identify critical risk factors for hypertension based on systolic blood pressure (SBP) (i.e. SBP > 140 mmHg). Results A total of 1273(27.3%) were hypertensive. Critical risk factors for hypertension identified were aged ≥ 50 years (OR = 5.4, 95% CI: 4.11–7.09), obese (OR = 1.51, 95% CI: 1.19–1.91), currently married (OR = 0.75, 95% CI: 0.64–0.89), individuals in moderate (OR = 1.38, 95% CI: 1.15–1.65) or bad/very bad health state (OR = 1.35, 95% CI: 1.0-1.83) and moderate difficulty with self-care (OR = 1.64, 95% CI: 1.1–2.44). Strong unobserved household-level residual variations were found. The results from the variation analyses showed that over 12% of variance in hypertension could be attributable to residual household-level variations. Conclusion Hypertension remains high in Ghana. Addressing the problem of obesity, targeting specific interventions to those aged over 50 years, and improvement in the general health of Ghanaians are paramount to reducing the prevalence and its associated morbidity, disability, and mortality. Lifestyle modification in the form of dietary intake, knowledge provision supported with strong public health message and political will could be beneficial to the management and prevention of hypertension.

scholarly journals Household and climate factors influence Aedes aegypti risk in the arid city of Huaquillas, Ecuador

2020 ◽  
Author(s):  
James L. Martin ◽  
Anna M. Stewart-Ibarra ◽  
Efraín Beltrán Ayala ◽  
Erin A. Mordecai ◽  
Rachel Sippy ◽  
...  
Keyword(s):  
Public Health ◽  
Aedes Aegypti ◽  
High Temperatures ◽  
Health Concern ◽  
Septic Systems ◽  
Mosquito Vector ◽  
Household Level ◽  
Social Ecological ◽  
Heads Of Household ◽  
Water Tanks

AbstractArboviruses transmitted by Aedes aegypti (e.g., dengue, chikungunya, Zika) are of major public health concern on the arid coastal border of Ecuador and Peru. This high transit border is a critical disease surveillance site due to human movement-associated risk of transmission. Local level studies are thus integral to capturing the dynamics and distribution of vector populations and social-ecological drivers of risk, to inform targeted public health interventions. Our study examines factors associated with household-level Ae. aegypti presence in Huaquillas, Ecuador, while accounting for spatial and temporal effects. From January to May of 2017, adult mosquitoes were collected from a cohort of households (n = 63) in clusters (n = 10), across the city of Huaquillas, using aspirator backpacks. Household surveys describing housing conditions, demographics, economics, travel, disease prevention, and city services were conducted by local enumerators. This study was conducted during the normal arbovirus transmission season (January - May), but during an exceptionally dry year. Household level Ae. aegypti presence peaked in February, and counts were highest in weeks with high temperatures and a week after increased rainfall. Presence of Ae. aegypti was highly variable between clusters. Hierarchical generalized linear models were used to explore household social-ecological variables and female Ae. aegypti presence. Houses with Ae. aegypti used larvicide in water tanks and had high awareness of dengue transmission. We found that homes were more likely to have Ae. aegypti when heads of household had lived in the neighborhoods for longer than average (>22 years), when households had more occupants than average (>4.5), had a female head of household, and received more frequent garbage collection. Ae. aegypti presence was less likely in households with reliable water supply and septic systems. Based on our findings, infrastructure access, urban occupancy patterns, and seasonal climate are important considerations for vector control in this city, and even in dry years, this arid environment supports Ae. aegypti breeding habitat.Author summaryMosquito transmitted infectious diseases are a growing concern around the world. The yellow fever mosquito (Aedes aegypti) has been responsible for recent major outbreaks of disease, including dengue fever and Zika. This mosquito prefers to bite humans and lay its eggs in artificial containers such as water tanks and planters. This makes Ae. aegypti well suited to become established in growing urban areas. Controlling these mosquitoes has been an important way to reduce the risk of disease transmission. Studies that are undertaken to understand local factors that contribute to the continued survival of the mosquito can be used to inform control practices. We conducted a study in the largest city on the border of Ecuador and Peru where we collected adult mosquitoes from houses and surveyed household members about their behaviors, perceptions, and housing infrastructure associated with the mosquito vector. Mosquitoes were most numerous in weeks with high temperatures and a week after increased rainfall. Larvicide was a commonly used control strategy in homes where Ae. aegypti was present. We found that houses that had more people, female heads of household, heads of household that had lived in the neighborhood for a long time, and had unreliable water service, were more likely have mosquitoes present, while houses that used septic systems were less likely to have mosquitoes present.

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