Computer Science and Engineering, Tandon School of Engineering, New York University, Brooklyn, New York, United States of America.
Institut Pasteur, Paris, France.
PLoS Negl Trop Dis. 2020 May 11;14(5):e0008273. doi: 10.1371/journal.pntd.0008273. eCollection 2020 May.
Increasing urbanization is having a profound effect on infectious disease risk, posing significant challenges for governments to allocate limited resources for their optimal control at a sub-city scale. With recent advances in data collection practices, empirical evidence about the efficacy of highly localized containment and intervention activities, which can lead to optimal deployment of resources, is possible. However, there are several challenges in analyzing data from such real-world observational settings. Using data on 3.9 million instances of seven dengue vector containment activities collected between 2012 and 2017, here we develop and assess two frameworks for understanding how the generation of new dengue cases changes in space and time with respect to application of different types of containment activities. Accounting for the non-random deployment of each containment activity in relation to dengue cases and other types of containment activities, as well as deployment of activities in different epidemiological contexts, results from both frameworks reinforce existing knowledge about the efficacy of containment activities aimed at the adult phase of the mosquito lifecycle. Results show a 10% (95% CI: 1-19%) and 20% reduction (95% CI: 4-34%) reduction in probability of a case occurring in 50 meters and 30 days of cases which had Indoor Residual Spraying (IRS) and fogging performed in the immediate vicinity, respectively, compared to cases of similar epidemiological context and which had no containment in their vicinity. Simultaneously, limitations due to the real-world nature of activity deployment are used to guide recommendations for future deployment of resources during outbreaks as well as data collection practices. Conclusions from this study will enable more robust and comprehensive analyses of localized containment activities in resource-scarce urban settings and lead to improved allocation of resources of government in an outbreak setting.
城市化进程的加速正在对传染病风险产生深远影响，给政府带来了巨大挑战，需要在城市子区域尺度上合理分配有限的资源以实现最佳控制。随着数据收集实践的不断发展，我们可以利用实证证据来评估高度本地化的遏制和干预措施的效果，从而实现资源的最佳配置。然而，在对真实世界观测数据进行分析时，仍存在一些挑战。本研究利用 2012 年至 2017 年期间收集的 390 万例七种登革热病媒控制活动的数据，开发并评估了两种框架，以了解不同类型的控制活动在空间和时间上对新发病例产生的影响。这两种框架考虑了每种控制活动与登革热病例以及其他类型控制活动的非随机部署，以及在不同流行病学背景下的活动部署，其结果均证实了现有针对蚊子生命周期成虫阶段的控制活动的有效性。结果表明，与具有类似流行病学背景且附近无控制措施的病例相比，在附近进行室内滞留喷洒（IRS）和喷雾的情况下，病例发生在 50 米和 30 天内的概率分别降低了 10%（95%CI：1-19%）和 20%（95%CI：4-34%）。同时，由于活动部署的实际情况存在局限性，本研究还为未来暴发期间资源的部署以及数据收集实践提供了建议。本研究的结论将有助于在资源匮乏的城市环境中对本地化的控制措施进行更稳健和全面的分析，并改善政府在暴发期间的资源分配。
