Transition in the Cause of Fever from Malaria to Dengue, Northwestern Ecuador, 1990–2011

Cifuentes, Sara G.; Trostle, James; Trueba, Gabriel; Milbrath, Meghan O.; Baldeón, Manuel E.; Coloma, Joséfina; Eisenberg, Joseph N. S.

doi:10.3201/eid1910.130137

Cited by 18 publications

(16 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Dengue is a major public health problem in Ecuador, 1 , 2 with a diverse array of contributing factors and a lack of intersectoral organization within governance systems exacerbating it. Ecuador has identified all four dengue serotypes within its borders and the vector, Aedes aegypti , is distributed throughout the tropical, subtropical regions of the country as well as all of its islands.…”

Section: Introductionmentioning

confidence: 99%

“…Ecuador has identified all four dengue serotypes within its borders and the vector, Aedes aegypti , is distributed throughout the tropical, subtropical regions of the country as well as all of its islands. 1 , 3 , 4 Moreover, there has been poor integration of approaches to dengue prevention; especially with regard to primary education, social mobilization, poverty and deficiency of basic public services as determinants for dengue transmission. 2 , 5 Dengue control programs in Ecuador, as with many countries in the Americas, rely on government application of temephos larvicide, deltamethrine adulticide and Bacillus thuringiensis israelensis (bti) -based biolarvicide.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Integrating participatory community mobilization processes to improve dengue prevention: an eco-bio-social scaling up of local success in Machala, Ecuador

Mitchell-Foster

Ayala

Breilh

et al. 2015

Transactions of the Royal Society of Tropical Medicine and Hygi

View full text Add to dashboard Cite

BackgroundThis project investigates the effectiveness and feasibility of scaling-up an eco-bio-social approach for implementing an integrated community-based approach for dengue prevention in comparison with existing insecticide-based and emerging biolarvicide-based programs in an endemic setting in Machala, Ecuador.MethodsAn integrated intervention strategy (IIS) for dengue prevention (an elementary school-based dengue education program, and clean patio and safe container program) was implemented in 10 intervention clusters from November 2012 to November 2013 using a randomized controlled cluster trial design (20 clusters: 10 intervention, 10 control; 100 households per cluster with 1986 total households). Current existing dengue prevention programs served as the control treatment in comparison clusters. Pupa per person index (PPI) is used as the main outcome measure. Particular attention was paid to social mobilization and empowerment with IIS.ResultsOverall, IIS was successful in reducing PPI levels in intervention communities versus control clusters, with intervention clusters in the six paired clusters that followed the study design experiencing a greater reduction of PPI compared to controls (2.2 OR, 95% CI: 1.2 to 4.7). Analysis of individual cases demonstrates that consideration for contexualizing programs and strategies to local neighborhoods can be very effective in reducing PPI for dengue transmission risk reduction.ConclusionsIn the rapidly evolving political climate for dengue control in Ecuador, integration of successful social mobilization and empowerment strategies with existing and emerging biolarvicide-based government dengue prevention and control programs is promising in reducing PPI and dengue transmission risk in southern coastal communities like Machala. However, more profound analysis of social determination of health is called for to assess sustainability prospects.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Integrating participatory community mobilization processes to improve dengue prevention: an eco-bio-social scaling up of local success in Machala, Ecuador

Mitchell-Foster

Ayala

Breilh

et al. 2015

Transactions of the Royal Society of Tropical Medicine and Hygi

View full text Add to dashboard Cite

show abstract

“…The region also faces a public health crisis caused by Aedes aegypti transmitted febrile illnesses, including dengue fever, chikungunya and zika fever. Over the last two decades, dengue fever (DENV serotypes 1–4) has replaced malaria as the principal cause of vector-borne febrile illness in previously malarial coastal regions in Ecuador [35]. Over a 5-year period (2010–2014), 72,060 cases of dengue were reported in Ecuador (annual average of 14,412 cases).…”

Section: Discussionmentioning

confidence: 99%

Successful malaria elimination in the Ecuador–Peru border region: epidemiology and lessons learned

Krisher

Ambuludi

et al. 2016

Malar J

View full text Add to dashboard Cite

BackgroundIn recent years, malaria (Plasmodium vivax and Plasmodium falciparum) has been successfully controlled in the Ecuador–Peru coastal border region. The aim of this study was to document this control effort and to identify the best practices and lessons learned that are applicable to malaria control and to other vector-borne diseases. A proximal outcome evaluation was conducted of the robust elimination programme in El Oro Province, Ecuador, and the Tumbes Region, Peru. Data collection efforts included a series of workshops with local public health experts who played central roles in the elimination effort, review of epidemiological records from Ministries of Health, and a review of national policy documents. Key programmatic and external factors are identified that determined the success of this eradication effort.Case descriptionFrom the mid 1980s until the early 2000s, the region experienced a surge in malaria transmission, which experts attributed to a combination of ineffective anti-malarial treatment, social-ecological factors (e.g., El Niño, increasing rice farming, construction of a reservoir), and political factors (e.g., reduction in resources and changes in management). In response to the malaria crisis, local public health practitioners from El Oro and Tumbes joined together in the mid-1990s to forge an unofficial binational collaboration for malaria control. Over the next 20 years, they effectively eradicated malaria in the region, by strengthening surveillance and treatment strategies, sharing of resources, operational research to inform policy, and novel interventions.Discussion and evaluationThe binational collaboration at the operational level was the fundamental component of the successful malaria elimination programme. This unique relationship created a trusting, open environment that allowed for flexibility, rapid response, innovation and resilience in times of crisis, and ultimately a sustainable control programme. Strong community involvement, an extensive microscopy network and ongoing epidemiologic investigations at the local level were also identified as crucial programmatic strategies.ConclusionThe results of this study provide key principles of a successful malaria elimination programme that can inform the next generation of public health professionals in the region, and serve as a guide to ongoing and future control efforts of other emerging vector borne diseases globally.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-016-1630-x) contains supplementary material, which is available to authorized users.

show abstract

“…Amazon basin), the predominant cause of fever has historically been malaria; however, significant progress towards malaria control during the last decades has resulted in decreased incidence [3], along with a higher proportion of patients with acute febrile illness (AFI) that do not present malaria [4]. The progression from malaria to nonmalaria febrile illness (NMFI) has shaped the fever epidemiology landscape and exposed new challenges for management and control in the region [5]. Hence, identifying the causes of NMFI is of paramount importance for improving patient care, for more efficient surveillance systems that include detection of emerging pathogens, and to guide implementation of diagnostic and preventive tools.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of acute febrile illness in Latin America

Moreira

Bressan

Brasil

et al. 2018

Clinical Microbiology and Infection

View full text Add to dashboard Cite

DENV fever is the febrile illness most frequently reported, reflecting its importance, while chikungunya and zika viruses present increasing trends since their emergence in the region. Studies with systematic and harmonized approaches for detection of multiple pathogens are needed and would probably reveal a higher burden of neglected pathogens such as Rickettsia spp. and arenaviruses. The lack of point-of-care tests and harmonized approach limits the care provided by health professionals and the efficacy of surveillance for AFI in the region.

show abstract

Transition in the Cause of Fever from Malaria to Dengue, Northwestern Ecuador, 1990–2011

Cited by 18 publications

References 9 publications

Integrating participatory community mobilization processes to improve dengue prevention: an eco-bio-social scaling up of local success in Machala, Ecuador

Integrating participatory community mobilization processes to improve dengue prevention: an eco-bio-social scaling up of local success in Machala, Ecuador

Successful malaria elimination in the Ecuador–Peru border region: epidemiology and lessons learned

Epidemiology of acute febrile illness in Latin America

Contact Info

Product

Resources

About