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Vector-borne Disease Surveillance in Southeast Asia – Challenges and Opportunities in Vector Collection and Pathogen Detection MAJ Brian Evans, Ph.D.; Jim McAvin; Alongkot Ponlawat, PhD; Ratree Takhampunya, PhD; LTC Jason Richardson, PhD . Mission Intelligence requirements
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Vector-borne Disease Surveillance in Southeast Asia – Challenges and Opportunities in Vector Collection and Pathogen Detection MAJ Brian Evans, Ph.D.; Jim McAvin; Alongkot Ponlawat, PhD; Ratree Takhampunya, PhD; LTC Jason Richardson, PhD
Mission Intelligence requirements PM detachment capabilities Detection capabilities (JBAIDS) Value of pathogen assays Where is the gap? Conclusion Agenda
To accurately asses the risk of vector-borne disease in an AO and to recommend/ implement measures that reduce the disease threat among soldiers. Mission
Human case data Vector data (presence/absence) Pathogen data (presence/absence) Environmental data Intelligence Requirements
Pre-deployment intelligence Gather case data (non-specific/specific) Limited vector surveillance Limited or no pathogen detection capability. PM Detachment Capabilities
Value of Pathogen Assays Assumptions: Case data is specific in number and location. Vector surveillance, pathogen detection tools, and control tools are effective.
Case data is valuable!
Adult mosquito/sand fly collection devices minimally effective; taxonomic keys 1 or 2 Ae. aegypti /house (15 mins/house); countless man-hours and houses needed for sufficient sample sizes (1 in 1000 infected); this is an area where there is transmission of dengue year-round. Where is the gap?
Where is the gap? BG Sentinel (BG Lure) Bed net trap - NAMRU-2
Rodent-baited traps as a tool for collecting chigger mites, vectors of scrub typhus. Where is the gap? Figure 13: Field caught rodent on snap trap & Figure 4: Rodent with chiggers
Low densities; seasonality? How does pathogen/vector data translate into risk? What does it mean to have 6 in 1000 infected; should I be concerned? Even when we know the vector locations and where the pathogen is most prevalent in the vector, do we understand the biology? Not one-size fits all solutions; same species from different locations may have evolved independently; different vector ecology Other Challenges?
Bottom-line: Pathogen detection has greatest added value for risk determination and control efficacy in instances where there is limited or no case data. If disease is seasonal, a valuable forecasting tool. Challenge: Relevancy of pathogen detection data is highly-dependent on the vector surveillance tool. Pathogen surveillance should be a critical part of the PM mission; need more effective surveillance tools to complement this mission; need trained soldiers who can interpret information/data. Where time/resources/money are limited, should be very selective about when and where to use pathogen detection assays. Conclusion