Vanlerberghe Veerle, Gómez-Dantés Hector, Vazquez-Prokopec Gonzalo, Alexander Neal, Manrique-Saide Pablo, Coelho Giovanini, Toledo Maria Eugenia, Ocampo Clara B, Van der Stuyft Patrick
General Epidemiology and Disease Control Unit Institute of Tropical Medicine Antwerp Belgium General Epidemiology and Disease Control Unit, Institute of Tropical Medicine, Antwerp, Belgium.
Instituto Nacional de Salud Publica CuernavacaMorelos Mexico Instituto Nacional de Salud Publica, Cuernavaca, Morelos, Mexico.
Rev Panam Salud Publica. 2017 Feb 8;41:e16. doi: 10.26633/RPSP.2017.16. eCollection 2017.
Current dengue vector control strategies, focusing on reactive implementation of insecticide-based interventions in response to clinically apparent disease manifestations, tend to be inefficient, short-lived, and unsustainable within the worldwide epidemiological scenario of virus epidemic recrudescence. As a result of a series of expert meetings and deliberations, a paradigm shift is occurring and a new strategy, using risk stratification at the city level in order to concentrate proactive, sustained efforts in areas at high risk for transmission, has emerged. In this article, the authors 1) outline this targeted, proactive intervention strategy, within the context of dengue epidemiology, the dynamics of its transmission, and current Aedes control strategies, and 2) provide support from published literature for the need to empirically test its impact on dengue transmission as well as on the size of disease outbreaks. As chikungunya and Zika viruses continue to expand their range, the need for a science-based, proactive approach for control of urban Aedes spp. mosquitoes will become a central focus of integrated disease management planning.
当前的登革热病媒控制策略侧重于在临床明显疾病表现出现后，以杀虫剂为基础进行反应性干预，在全球病毒流行复发的流行病学背景下，这种策略往往效率低下、持续时间短且不可持续。经过一系列专家会议和讨论，正在发生范式转变，一种新的策略已经出现，即利用城市层面的风险分层，以便在高传播风险地区集中开展积极、持续的工作。在本文中，作者1）在登革热流行病学、传播动态以及当前伊蚊控制策略的背景下，概述这种有针对性的、积极的干预策略；2）提供已发表文献的支持，以证明有必要通过实证检验其对登革热传播以及疾病暴发规模的影响。随着基孔肯雅病毒和寨卡病毒不断扩大其传播范围，采用基于科学的、积极的方法来控制城市伊蚊属蚊子将成为综合疾病管理规划的核心重点。
