Peña-García Víctor Hugo, LaBeaud A Desiree, Ndenga Bryson A, Mutuku Francis M, Bisanzio Donal, Andrews Jason R, Mordecai Erin A
Department of Biology, Stanford University, Stanford, CA, USA.
School of Medicine, Stanford University, Stanford, CA, USA.
R Soc Open Sci. 2025 Apr 16;12(4):241919. doi: 10.1098/rsos.241919. eCollection 2025 Apr.
The incidence of -borne pathogens has been increasing despite vector control efforts. Control strategies typically target households (HH), where mosquitoes breed in HH containers and bite indoors. However, our study in Kenyan cities of Kisumu and Ukunda (2019-2022) revealed high abundance in public spaces, prompting the question: How important are non-household (NH) environments for dengue transmission and control? Using field data and human activity patterns, we developed an agent-based model simulating transmission across HH and five types of NH environments, which was then used to evaluate preventive (before an epidemic) and reactive (after an epidemic commences) vector control scenarios. Our findings estimate over half of infections occurring in NH settings, particularly workplaces, markets and recreational sites. Container removal was more effective in NH than in HH areas, contrasting with the global focus on HH-based management. Greater reductions in dengue cases occurred with early, high-coverage interventions, especially in NH locations. Additionally, local ecological factors, such as uneven water container distribution, influence control outcomes. This study underscores the importance of vector control in both HH and NH environments in endemic settings. It highlights a specific approach to inform evidence-based decision-making to target limited vector control resources for optimal control.
尽管采取了病媒控制措施，但虫媒传播病原体的发病率仍在上升。控制策略通常以家庭为目标，因为蚊子在家庭容器中繁殖并在室内叮咬。然而，我们在肯尼亚基苏木和乌昆达市（2019 - 2022年）的研究发现公共场所的蚊子数量很多，这引发了一个问题：非家庭环境对登革热传播和控制有多重要？利用实地数据和人类活动模式，我们开发了一个基于主体的模型，模拟家庭和五种非家庭环境中的传播情况，然后用该模型评估预防性（疫情爆发前）和反应性（疫情开始后）病媒控制方案。我们的研究结果估计，超过一半的感染发生在非家庭环境中，特别是工作场所、市场和娱乐场所。在非家庭环境中清除容器比在家庭区域更有效，这与全球对基于家庭管理的关注形成对比。早期、高覆盖率的干预措施能更大程度地减少登革热病例，尤其是在非家庭场所。此外，当地的生态因素，如水容器分布不均，会影响控制效果。这项研究强调了在地方病流行地区家庭和非家庭环境中病媒控制的重要性。它突出了一种特定的方法，为基于证据的决策提供信息，以便将有限的病媒控制资源用于实现最佳控制。
