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Social-ecological influences on dengue fever and a comparison of surveillance indicators in Machala, Ecuador

Authors: Catherine Lippi*, University of Florida, Anna M Stewart-Ibarra, InterAmerican Institute for Global Change Research, Efraín Beltrán Ayala, Universidad Técnica de Machala
Topics: Medical and Health Geography, Latin America
Keywords: Dengue fever, Ecuador, Aedes, Surveillance, Social-ecological
Session Type: Poster
Presentation File: No File Uploaded

Arboviral diseases are a major threat to public health in Machala, Ecuador (pop. ~280,000), where officials contend with high annual dengue fever burden. Vector control is the primary method of controlling dengue, and management decisions are typically triggered by entomological surveillance and reported human cases. We examined household level social-ecological characteristics to identify factors that promote dengue transmission, and to determine if mosquito presence predicts household dengue cases. Household data on mosquito presence, housing conditions, demography, and dengue prevention practices were collected from 2014–2016 in collaboration with the Ecuadorian Ministry of Health; case data were collected for enrolled households from 2014–2015. Household cluster data were assessed for intraclass correlation, and logistic multimodel selection (criterion=AICc) was conducted to identify factors influencing the presence of mosquitoes or dengue cases, respectively. Protective factors for Ae. aegypti presence in the top model (AICc=536.72) included window screening in good repair, cane housing construction, and air conditioning. Risk factors for dengue cases in the top model (AICc=156.12) included cane housing construction, abandoned housing, shaded patios, and air conditioning, while good housing condition was identified as a protective factor. The relationships between household characteristics and mosquito presence were less defined than those for dengue cases, as evidenced by small effect sizes and model instability (k=240.38). These results highlight the importance of choosing appropriate indicators of transmission activity for public health programs. In locations with hyperendemic transmission, like Machala, targeting vector control based on human surveillance rather than mosquito counts may be a better management strategy.

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