Reducing diarrhea in children and controlling dengue vector Aedes aegypti in rural schools in two municipalities in Colombia

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2 Reducing diarrhea in children and controlling dengue vector edes aegypti in rural schools in two municipalities in Colombia

3 Healthy Schools: Project Results ENTOOLOGY Víctor lberto Olano, aría Inés atiz, Neal lexander, Sandra Lucía Vargas, Juan Felipe Jaramillo, Diana Sarmiento, udrey Lenhart, Thor xel Stenström, Razak Seidu, Hans J. Overgaard

4 Introduction

Distribution of edes aegypti in Colombia - 2010 Source: orales.

5 Distribution of edes aegypti in Colombia Source: orales. Laboratorio de Entomología, INS IV > 4% IV < 4% reas inspeccionadas y negativas reas no inspeccionadas Source: Entomology Departmental Units. Entomology Laboratory, INS, inistry of Health. Jairo éndez. Virology Laboratory-INS.

edes aegypti in rural area of Colombia Vereda Santa Barbara, municipality of La esa (Cundinamarca), first record in the country of edes aegypti in rural area(1) (1) orales.

6 edes aegypti in rural area of Colombia Vereda Santa Barbara, municipality of La esa (Cundinamarca), first record in the country of edes aegypti in rural area(1) (1) orales. edes aegypti en zona rural del municipio de La esa (Cundinamarca) Colombia. Biomédica 1981:1:223-4 Vereda Santa Bárbara, municipio de La esa (Cundinamarca), primer registro en el país de edes aegypti en área rural (1)

7 Distribution of edes albopictus in Colombia 2011

8 Dengue Vector Surveillance Entomological Indices INTURE DULTS House Index (%) dult Index (%) Container Index (%) Density of adult female e. aegypti Breteau Index Pupae per Person Index

9 Objectives Reduce exposure to dengue risk factors in schools by: Reducing mosquito entry to school classrooms by insecticide-treated curtains Reducing dengue mosquito vector breeding through source reduction and larval control

10 Outcomes Primary outcome: Density of adult female e. aegypti in each school (number of females collected per time unit). Secondary outcome: Breteau index (number of containers with e. aegypti immatures/100 schools.

11 ethodology

12 Inspection of potential edes aegypti Breeding Sites

13 Collection and Package of Immature

14 edes aegypti dults Capture dult Forms Package

15 Identification in Laboratory

16 Interventions

17 Interventions

18 Interventions

19 Interventions

20 CDC ethodology

21 WHO Cone Bioassay Protocol

22 Interventions Follow - Up First follow - up ay-june/2012 Second follow -up October - November/2012 Third follow - up ay-june/2013 Fourth follow up October - November/2013

23 Results

24 edes aegypti Breeding Sites napoima-la esa Rural Schools

25 edes aegypti Breeding Sites napoima-la esa Rural Schools

26 Percent Positive Schools School Index Dengue Diarrea Dengue/diarrea Control

27 School Index ratio=0.28 (0.1, 0.8), p=0.02 school index Dengue 2.Diarrea 3.Denguediarrea 4.Control = napoima School = La esa School

28 Containers Number Type and Number of Containers Inspected DEN DI DIDEN CON Intervention Laundry Tanks "LBERCS" TNKS OTHERS

29 PERCENT OF POSITIVE CONTINERS Container Index DEN DI DIDEN CON

30 Positive containers/ 100 schools Breteau Index by Intervention rm I 2012-II 2013-I 2013-II Dengue Diarrea Dengue/diarrea Control

31 Breteau Index = napoima School = La esa School

32 Breteau Index

33 Pupae per Person Index* DENGUE DIRRE DENGUE/DIRRE CONTROL Total niños Total pupas e. aegypti Pupa per Person Index ,04 0,11 0,09 0,22 * The threshold value of e. aegypti pupae per person index for dengue transmisión: Source: Focks, D.. Transmission thresholds for dengue in terms of edes aegypti pupae per person with discussion of their utility in source reduction efforts. m. J. Trop. ed. Hyg. 62,11-18

34 Númber of females collected/per time unit Density of edes aegypti Females by Intervention rm 4,5 4 3,5 3 2,5 2 1,5 1 0, I 2012-II 2013-I 2013-II Dengue 1 3,6 0,8 1,2 Diarrea 0,3 1,2 2,3 2,3 Denguediarrea 0,5 3,6 1,6 2,9 Control 1,3 4,2 2 0,6

35 Density of edes aegypti/intervention rm ratio=0.97 (0.2, 4.71), p=0.963 female edes/hour (square root scale) Dengue 2.Diarrea 3.Denguediarrea 4.Control = napoima School = La esa School

36 Number of Females Collected by School

37 Number of females Number of edes aegypti Females Collected per Room Type DEN DI DIDEN CON Intervención 0 6 CLSSROOS DINING ROOS BEDROOS TOILETS KITCHENS OTHERS LIVING ROOS

38 Density of edes aegypti Females Collected per Room Type Classroom ratio=1.08 (0.31, 3.82), p=0.888 female edes/hour (square root scale) female edes/hour (square root scale) Dengue 2.Diarrea 3.Denguediarrea 4.Control Bathroom ratio=0.37 (0.37, 24.86), p=0.244 female edes/hour (square root scale) Dining room ratio=0.69 (0.07, 8.04), p= Dengue 2.Diarrea 3.Denguediarrea 4.Control = napoima School = La esa School 1.Dengue 2.Diarrea 3.Denguediarrea 4.Control

39 Density of edes aegypti Females Collected per Room Type female edes/hour (square root scale) Kitchen ratio=0.58 (0.09, 3.5), p=0.51 female edes/hour (square root scale) Teacher's bedroom ratio=2.55 (0.37, 24.86), p= Dengue 2.Diarrea 3.Denguediarrea 4.Control 1.Dengue 2.Diarrea 3.Denguediarrea 4.Control = napoima School = La esa School

40 Presence of e. aegypti females and ltitude (m) female edes aegypti capture rate intervention period) altitude (m)

41 Presence of e. aegypti and ltitude (m)

42 Percentage (%) Proportion and Number of Culex quinquefasciatus Females Collected in ll Rooms and Classrooms DEN DI DIDEN CON ll rooms Classrooms

43 Density of Cx. quinquefasciatus/ intervention rm ratio=0.79 (0.33, 1.83), p=0.564 female Culex/hour (square root scale) Dengue 2.Diarrea 3.Denguediarrea 4.Control = napoima School = La esa School

44 L ES NPOI WHO Cone Bioassay Protocol SCHOOL CURTINS INSTLLED No. SPLED CURTINS % Knock down SUN SHDOW % ortality La Palmichera El Cabral Golconda Lutaima Panamá El Higuerón La Esmeralda Santa na ndalucía TOTL Florián Laguna Verde El Rosario La Concha Santa Bárbara Buenavista La Vega lto de Flores San Esteban TOTL Residuality: months Curtains were washed once

45 osquito Species Registered nopheles pseudopunctipennis* edes fluviatilis edes angustivittatus Culex quinquefasciatus*** Culex nigripalpus Culex corniger * Secondary vector of malaria Culex coronator Haemagogus equinus** Limatus durhamii Psorophora ferox **** Toxorhynchites sp. Trichoprosopon lampropus **** Venezuelan equine encephalitis vector ** Vector of jungle yellow fever *** Vector of west Nile virus

46 Conclusions The principal breeding sites for e. aegypti were drinking water storage containers followed by containers classified as other (bottles, discarded food waste, plastic cups, cans) and cement wash basins (used for storing water for washing clothes). School and Breteau Indices were significant lower in the DENGUE and DIDEN arms compared to the DI and CONTROL arms (p <0.05).

Conclusions No significant difference in the density of e. aegypti females/school in the DEN and DIDEN arms (that received the curtain intervention) compared to the other arms.

47 Conclusions No significant difference in the density of e. aegypti females/school in the DEN and DIDEN arms (that received the curtain intervention) compared to the other arms. No significant differences between arms in the number of females mosquitoes collected in different rooms (p>0.05). Other mosquito species of public health importance were collected.

48 Limitations The main control method targeting edes aegypti females, i.e. insecticide treated curtains, did not perform well enough: There are many openings, e.g. doors, eaves, ventilation holes etc. that could not be covered by the curtains. osquitoes breed in habitats that were not targeted in our interventions and adult mosquitoes can fly to the schools from the surrounding areas.

49 Víctor lberto Olano artínez

UNDERSTANDING ZIKA AND MOSQUITO BORNE ILLNESSES

UNDERSTANDING ZIKA AND MOSQUITO BORNE ILLNESSES Dr. Roxanne Connelly, Professor Medical Entomology State Specialist University of Florida, IFAS, Florida Medical Entomology Laboratory http://fmel.ifas.ufl.edu/