Infestation measured by Aedes aegypti larval surveys as an indication of future dengue epidemics: an evaluation for Brazil.

Abstract:

BACKGROUND:Aedes aegypti rapid larval surveys are mandatory in Brazil. Here, we retrospectively examined whether the house index estimated by larval surveys served as a useful tool in anticipating epidemics within Brazilian municipalities from 2009-2015. METHODS:We used correlation indices and classification analysis stratified by year, region, population size and time after the national larval survey. RESULTS:We found no association between the house index and the proportion of municipalities experiencing an epidemic. The sensitivity of a high score house index in predicting an epidemic was 7.20% (95% CI 6.22 to 8.33%) for all years combined. The positive predictive value of a high score house index to predict a 'true epidemic' was 38.96%, lower than the negative predictive values of a low score house index for predicting 'no epidemic' (56.96%). The highest overall sensitivity was observed in the North region (20.15%; 95% CI 17.14 to 23.53%). The sensitivity of a high score house index demonstrated a monotonic decrease with increasing time from larval collection. CONCLUSIONS:Larval surveys are surveillance tools with the potential to risk-stratify and guide dengue control programs towards judicious resource allocation. However, the national rapid larval survey performed in Brazil, in its present form, consistently underpredicts dengue epidemics.

authors

Enslen AW,Lima Neto AS,Castro MC

doi

10.1093/trstmh/traa021

subject

Has Abstract

pub_date

2020-07-01 00:00:00

pages

506-512

issue

7

eissn

0035-9203

issn

1878-3503

pii

5826585

journal_volume

114

pub_type

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