Wilder-Smith Annelies, Tissera Hasitha, AbuBakar Sazaly, Kittayapong Pattamaporn, Logan James, Neumayr Andreas, Rocklöv Joacim, Byass Peter, Louis Valérie R, Tozan Yesim, Massad Eduardo, Preet Raman
a Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine , Umeå University , Umeå , Sweden.
b Epidemiological Unit , Ministry of Health , Colombo , Sri Lanka.
Glob Health Action. 2018;11(1):1549930. doi: 10.1080/16549716.2018.1549930.
Dengue fever persists as a major global disease burden, and may increase as a consequence of climate change. Along with other measures, research actions to improve diagnosis, surveillance, prevention, and predictive models are highly relevant. The European Commission funded the DengueTools consortium to lead a major initiative in these areas, and this review synthesises the outputs and findings of this work conducted from 2011 to 2016. Research areas: DengueTools organised its work into three research areas, namely [1] Early warning and surveillance systems; [2] Strategies to prevent dengue in children; and [3] Predictive models for the global spread of dengue. Research area 1 focused on case-studies undertaken in Sri Lanka, including developing laboratory-based sentinel surveillance, evaluating economic impact, identifying drivers of transmission intensity, evaluating outbreak prediction capacity and developing diagnostic capacity. Research area 2 addressed preventing dengue transmission in school children, with case-studies undertaken in Thailand. Insecticide-treated school uniforms represented an intriguing potential approach, with some encouraging results, but which were overshadowed by a lack of persistence of insecticide on the uniforms with repeated washing. Research area 3 evaluated potential global spread of dengue, particularly into dengue-naïve areas such as Europe. The role of international travel, changing boundaries of vectors, developing models of vectorial capacity under different climate change scenarios and strategies for vector control in outbreaks was all evaluated.
DengueTools was able to make significant advances in methods for understanding and controlling dengue transmission in a range of settings. These will have implications for public health agendas to counteract dengue, including vaccination programmes.
Towards the end of the DengueTools project, Zika virus emerged as an unexpected epidemic in the central and southern America. Given the similarities between the dengue and Zika viruses, with vectors in common, some of the DengueTools thinking translated readily into the Zika situation.
登革热仍然是全球主要的疾病负担，并且可能因气候变化而增加。与其他措施一样，改善诊断、监测、预防和预测模型的研究行动具有高度相关性。欧盟委员会资助了登革热工具联盟，以在这些领域牵头开展一项重大倡议，本综述综合了2011年至2016年开展的这项工作的成果和发现。
登革热工具联盟将其工作分为三个研究领域，即[1]早期预警和监测系统；[2]儿童登革热预防策略；以及[3]登革热全球传播的预测模型。研究领域1侧重于在斯里兰卡开展的案例研究，包括建立基于实验室的哨点监测、评估经济影响、确定传播强度的驱动因素、评估疫情预测能力以及发展诊断能力。研究领域2致力于预防在校儿童的登革热传播，在泰国开展了案例研究。经杀虫剂处理的校服是一种颇具潜力的方法，取得了一些令人鼓舞的结果，但由于反复洗涤后杀虫剂在校服上缺乏持久性，这些结果受到了影响。研究领域3评估了登革热潜在的全球传播情况，特别是传播到欧洲等尚无登革热的地区。评估了国际旅行的作用、病媒分布范围的变化、在不同气候变化情景下建立病媒传播能力模型以及疫情中病媒控制策略。
登革热工具联盟能够在一系列环境中理解和控制登革热传播的方法上取得重大进展。这些将对对抗登革热的公共卫生议程产生影响，包括疫苗接种计划。
在登革热工具项目接近尾声时，寨卡病毒在中美洲和南美洲意外爆发。鉴于登革热病毒和寨卡病毒之间的相似性以及共同的病媒，登革热工具联盟的一些思路很容易应用于寨卡病毒疫情。
