Biology subjects

Stewart-Ibarra, A. M.

Publications and source records attributed to Stewart-Ibarra, A. M..

8 recordsLinked to original sources

bioRxiv2018

Phenotypic and genotypic resistance to commonly used insecticides in Aedes aegypti among four cities in southern Ecuador

Insecticide resistance (IR) can undermine efforts to control vector species of public health importance. Aedes aegypti is the main vector of resurging diseases in the Americas such as yellow fever and dengue, as well as recently emerging chikungunya and Zika viruses, which have caused unprecedented epidemics in the region. Vector control remains the primary public health intervention to prevent outbreaks of Aedes transmitted diseases. In many high-risk regions, like southern Ecuador, we have limited information on IR in Ae. aegypti. In this study, IR status in Ae. aegypti was measured across four cities in El Oro Province in Ecuador using phenotypic assays and genetic screening for alleles associated with resistance to pyrethroid insecticides. Bottle bioassays showed significant inter-seasonal variation in resistance to deltamethrin, a pyrethroid insecticide commonly used by the Ministry of Health, and alpha cypermethrin, as well as differences in deltamethrin resistance between cities. There was also a significant difference in phenotypic response to the organophosphate, Malathion, between two of the cities during the second sampling season. Genotyping showed moderate to high frequencies of the V1016I and F1534C resistance alleles in all four cites. Frequency of resistance genotypes varied significantly between cities in the first sampling season, and not in the later seasons, suggesting a possible selective response to vector control activity. Overall, resistance levels were highest in Machala, a city where dengue is hyperendemic and where insecticide use has historically been more intense than in the other cities included in the study. Despite statistically significant evidence that resistance alleles conferred phenotypic resistance, there was not precise correspondence between these indicators. We found that 17.6% of F1534C and 45.6% of V1016I mutant mosquitoes were susceptible in the bottle bioassays. This study shows there is spatiotemporal variability in IR in southern Ecuador, and serves as an initial examination of the genotypic and phenotypic indicators of IR in this region, providing important information to guide the vector control interventions by the public health sector.

epidemiology↗

bioRxiv2018

Geographic shifts in Aedes aegypti habitat suitability in Ecuador using larval surveillance data and ecological niche modeling: implications of climate change for public health vector control

Arboviral disease transmission by Aedes mosquitoes poses a major challenge to public health systems in Ecuador, where constraints on health services and resource allocation call for spatially informed management decisions. Employing a unique dataset of larval occurrence records provided by the Ecuadorian Ministry of Health, we used ecological niche models (ENMs) to estimate the current geographic distribution of Aedes aegypti in Ecuador, using mosquito presence as a proxy for risk of disease transmission. ENMs built with the Genetic Algorithm for Rule-Set Production (GARP) algorithm and a suite of environmental variables were assessed for agreement and accuracy. The top model of larval mosquito presence was projected to the year 2050 under various combinations of greenhouse gas emissions scenarios and models of climate change. Under current climatic conditions, larval mosquitoes were not predicted in areas of high elevation in Ecuador, such as the Andes mountain range, as well as the eastern portion of the Amazon basin. However, all models projected to scenarios of future climate change demonstrated potential shifts in mosquito distribution, wherein range contractions were seen throughout most of eastern Ecuador, and areas of transitional elevation became suitable for mosquito presence. Encroachment of Ae. aegypti into mountainous terrain was estimated to affect up to 4,215 km2 under the most extreme scenario of climate change, an area which would put over 12,000 people currently living in transitional areas at risk. This distributional shift into communities at higher elevations indicates an area of concern for public health agencies, as targeted interventions may be needed to protect vulnerable populations with limited prior exposure to mosquito-borne diseases. Ultimately, the results of this study serve as a tool for informing public health policy and mosquito abatement strategies in Ecuador.\n\nAuthor summaryThe yellow fever mosquito (Aedes aegypti) is a medically important vector of arboviral diseases in Ecuador, such as dengue fever and chikungunya. Managing Ae. aegypti is a challenge to public health agencies in Latin America, where the use of limited resources must be planned in an efficient, targeted manner. The spatial distribution of Ae. aegypti can be used as a proxy for risk of disease exposure, guiding policy formation and decision-making. We used ecological niche models in this study to predict the range of Ae. aegypti in Ecuador, based on agency larval mosquito surveillance records and layers of environmental predictors (e.g. climate, altitude, and human population). The best models of current range were then projected to the year 2050 under a variety of greenhouse gas emissions scenarios and models of climate change. All modeled future scenarios predicted shifts in the range of Ae. aegypti, allowing us to assess human populations that may be at risk of becoming exposed to Aedes vectored diseases. As climate changes, we predict that communities living in areas of transitional elevation along the Andes mountain range are vulnerable to the expansion of Aedes aegypti.

epidemiology↗

bioRxiv2018

Zika Virus Outbreak, Barbados, 2015 - 2016

Barbados is a Caribbean island country of approximately 285,000 people, with a thriving tourism industry. In 2015, Zika spread rapidly throughout the Americas, and its proliferation through the Caribbean islands followed suit. Barbados reported its first confirmed autochthonous Zika transmission to the Pan American Health Organization (PAHO) in January 2016, a month before the global public health emergency was declared. Following detection of suspected Zika cases on Barbados in 2015, 926 individuals were described as suspected cases, and 147 lab confirmed cases were reported through December 2016, the end of the most recent epidemiological year. In this short report, we describe the epidemiological characteristics of 926 clinical case records which were originally suspected as cases of Zika, and which were subsequently sent for testing and confirmation; 147 were found positive for Zika, using RT-PCR methods, another 276 tested negative, and the remaining 503 were either pending results or still in the suspected category. Women were represented at about twice the rate of men in case records where sex was reported (71.9%), and confirmed cases (78.2%), and 19 of the confirmed positive cases were children under the age of 10.

epidemiology↗

bioRxiv2017

Quantifying Seasonal and Diel Variation in Anopheline and Culex Human Biting Rates in Southern Ecuador

BackgroundQuantifying mosquito biting rates for specific locations enables estimation of mosquito-borne disease risk, and can inform intervention efforts. Measuring biting itself is fraught with ethical concerns, so the landing rate of mosquitoes on humans is often used as a proxy measure. Southern coastal Ecuador was historically endemic for malaria (P. falciparum and P. vivax), although successful control efforts in the 2000s eliminated autochthonous transmission (since 2011). This study presents an analysis of data collected during the elimination period.\n\nMethodsWe examined human landing catch (HLC) data for three mosquito taxa: 2 malaria vectors, Anopheles albimanus and Anopheles punctimacula, and grouped Culex spp. These data were collected by the National Vector Control Service of the Ministry of Health over a 5-year time span (2007 - 2012) in five cities in southern coastal Ecuador, at multiple households, in all months of the year, during dusk-dawn (18:00-6:00) hours, often at both indoor and outdoor locations. Hurdle models were used to determine if biting activity was fundamentally different for the three taxa, and to identify spatial and temporal factors influencing bite rate. Due to the many different approaches to studying and quantifying bite rates in the literature, we also created a glossary of terms, to facilitate comparative studies in the future.\n\nResultsBiting trends varied significantly with species and time. All taxa exhibited exophagic feeding behavior, and outdoor locations increased both the odds and incidence of bites across taxa. An. albimanus was most frequently observed biting, with an average of 4.7 bites per hour. The highest and lowest respective months for significant biting activity were March and July for An. albimanus, July and August for An. punctimacula, and February and July for Culex spp.\n\nConclusionsFine-scale spatial and temporal differences exist in biting patterns among mosquito taxa in southern coastal Ecuador. This analysis provides detailed information for targeting vector control and household level behavioral interventions. These data were collected as part of routine vector surveillance conducted by the Ministry of Health, but such data have not been collected since. Reinstating such surveillance measures would provide important information to aid in preventing malaria re-emergence.

epidemiology↗

bioRxiv2017

Could The Recent Zika Epidemic Have Been Predicted?

Given knowledge at the time, the recent 2015-2016 zika virus (ZIKV) epidemic probably could not have been predicted. Without the prior knowledge of ZIKV being already present in South America, and given the lack of understanding of key epidemiologic processes and long-term records of ZIKV cases in the continent, the best related prediction was for potential risk of an Aedes-borne disease epidemic. Here we use a recently published two-vector capacity model to assess the predictability of the conditions conducive to epidemics of diseases like zika, chikungunya or dengue, transmitted by the independent or concurrent presence of Aedes aegypti and Aedes albopictus. We compare the potential risk of transmission forcing the model with the observed climate and with state-of-the-art operational forecasts from the North American Multi Model Ensemble (NMME), finding that the predictive skill of this new seasonal forecast system is highest for multiple countries in Latin America and the Caribbean during the December-February and March-May seasons, and slightly lower -but still of potential use to decision-makers- for the rest of the year. In particular, we find that above-normal suitable conditions for the occurrence of the zika epidemic at the beginning of 2015 could have been successfully predicted for several zika hotspots, and in particular for Northeast Brazil: the heart of the epidemic. Nonetheless, the initiation and spread of an epidemic depends on the effect of multiple factors beyond climate conditions, and thus this type of approach must be considered as a guide and not as a formal predictive tool of vector-borne epidemics.

epidemiology↗

bioRxiv2017

The social and spatial ecology of dengue presence and burden during an outbreak in Guayaquil, Ecuador, 2012

Dengue fever, a mosquito-borne viral disease, is an ongoing public health problem in Ecuador and throughout the tropics, yet we have a limited understanding of the disease transmission dynamics in these regions. The objective of this study was to characterize the spatial dynamics and social-ecological risk factors associated with a recent dengue outbreak in Guayaquil, Ecuador. We examined georeferenced dengue cases (n = 4,248) and block-level census data variables to identify potential social-ecological variables associated with the presence and burden of dengue fever in Guayaquil in 2012. We applied LISA and Morans I tests to analyze hotspots of dengue cases and used multimodel selection in R computing language to identify covariates associated with dengue incidence at the census zone level. Significant hotspots of dengue transmission were found near the North Central and Southern portions of Guayaquil. Significant risk factors for presence of dengue included poor housing conditions (e.g., poor condition of ceiling, floors, and walls), access to paved roads, and receipt of remittances. Counterintuitive positive correlations with dengue presence were observed with several municipal services such as garbage collection and access to piped water. Risk factors for the increased burden of dengue included poor housing conditions, garbage collection, receipt of remittances, and sharing a property with more than one household. Social factors such as education and household demographics were negatively correlated with increased dengue burden. Our findings elucidate underlying differences with dengue presence and burden and indicate the potential to develop dengue vulnerability and risk maps to inform disease prevention and control - information that is also relevant for emerging epidemics of chikungunya and zika.\n\nHighlightsO_LIIn 2012, Guayaquil, Ecuador had a large outbreak of dengue cases\nC_LIO_LIDengue case presence and burden exhibited spatial heterogeneity at the census block level\nC_LIO_LISocial-ecological drivers of case presence and burden differed in this outbreak, highlighting the need to model both types of epidemiological data\nC_LIO_LIAccess to municipal resources such as garbage collection and piped water had counterintuitive relationships with dengue presence, but poor housing, garbage collection and remittances correlated to dengue burden.\nC_LIO_LIOur findings inform risk mapping and vector control and surveillance allocation, relevant to this and other concurrent emergent epidemics such as chikungunya and zika\nC_LI

epidemiology↗

bioRxiv2017

Environmental cholera (Vibrio cholerae) dynamics in an estuarine system in southern coastal Ecuador

Cholera emergence is strongly linked to local environmental and ecological context. The 1991-2004 pandemic emerged in Peru and spread north into Ecuadors El Oro province, making this a key site for potential re-emergence. Machala, El Oro, is a port city of 250,000, near the Peruvian border. Many livelihoods depend on the estuarine system, from fishing for subsistence and trade, to domestic water use. In 2014, we conducted biweekly sampling for 10 months in five estuarine locations, across a gradient of human use, and ranging from inland to ocean. We measured water characteristics implicated in V. cholerae growth and persistence: pH, temperature, salinity, and algal concentration, and evaluated samples in five months for pathogenic and non-pathogenic Vibrio cholerae, by polymerase chain reaction (PCR). We found environmental persistence of strains O1 and O139, but no evidence for toxigene presence. V. cholerae presence was coupled to algal and salinity concentration, and sites exhibited considerable seasonal and spatial heterogeneity. This study indicates that environmental conditions in Machala are optimal for human cholera re-emergence, with risk peaking during September, and higher risk near urban periphery low-income communities. This highlights a need for surveillance of this coupled cholera- estuarine system to anticipate potential future outbreaks.

epidemiology↗

bioRxiv2017

The high burden of dengue and chikungunya in southern coastal Ecuador: Epidemiology, clinical presentation, and phylogenetics from a prospective study in Machala in 2014 and 2015

Here we report the findings from the first two years of an arbovirus surveillance study conducted in Machala, Ecuador, a dengue endemic region (2014-2015). Patients with suspected dengue virus (DENV) infections (index cases, n=324) were referred from five Ministry of Health clinical sites. A subset of DENV positive index cases (n = 44) were selected, and individuals from the index household and four neighboring homes within 200-meters were recruited (n = 400). Individuals who entered the study, other than index cases, are referred to as associates. In 2014, 70.9% of index cases and 35.6% of associates had acute or recent DENV infections. In 2015, 28.3% of index cases and 12.8% of associates had acute or recent DENV infections. For every DENV infection captured by passive surveillance, we detected an additional three acute or recent DENV infections in associates. Of associates with acute DENV infections, 68% reported dengue-like symptoms, with the highest prevalence of symptomatic acute infections in children under 10 years of age. The first chikungunya virus (CHIKV) infections were detected on epidemiological week 12 in 2015. 43.1% of index cases and 3.5% of associates had acute CHIKV infections. No Zika virus infections were detected. Phylogenetic analyses of isolates of DENV from 2014 revealed genetic relatedness and shared ancestry of DENV1, DENV2 and DENV4 genomes from Ecuador with those from Venezuela and Colombia, indicating presence of viral flow between Ecuador and surrounding countries. Enhanced surveillance studies, such as this, provide high-resolution data on symptomatic and inapparent infections across the population.

epidemiology↗