Spatial analyses of vector-borne disease risk for allocation of disease prevention and control resources
Date
2009
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Abstract
Vector-borne diseases are major threats to human health and well-being, inflicting enormous health and economic burden around the world. Meeting the challenge of emerging and resurging vector-borne diseases is a difficult undertaking as vaccines are limited, and future vaccine prospects are slow in coming. This underscores the importance of appropriately applied vector control and disease prevention efforts to decrease morbidity and mortality caused by vector-borne diseases. The objective of this dissertation was, therefore, to investigate spatially and temporally-explicit methods to enhance targeting of vector control and disease prevention efforts. Three diseases were investigated: West Nile virus disease in Colorado, USA; human plague in the West Nile region of Uganda; and dengue in Merida, Mexico. Various methods were explored to present spatial information representing risk of vector-borne diseases. Spatial models were developed indicating the risk of human exposure to WNV in the state of Colorado; and Yersinia pestis, the causative agent of plague, in Uganda. The resulting models provided robust validations indicating that the spatial risk maps contained useful information for disease prevention and control efforts. The final chapter expanded from spatially-explicit methods to also account for the temporal aspect of disease outbreaks or epidemics. This chapter describes the evaluation of the feasibility of an early detection system to identify outbreaks in a timely fashion in Merida, Mexico. The early detection system has the potential to provide Merida public health authorities with a resource to clearly recognize when the current dengue burden is exceeding historical norms and may be applicable and useful in other dengue endemic areas. The chapters composing this dissertation describe the application of cross-cutting methods used to determine spatial risk in different vector-borne disease systems. Furthermore, the methods used are applicable to the current public health situation where new vector-borne diseases are emerging and "old" diseases are resurging, further underscoring the importance of targeting limited public health resources.
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Subject
dengue
disease prevention
plague
vector-borne disease
West Nile virus
public health
epidemiology
health risk assessment
disease prevention