Costos de un programa de control del vector Aedes aegypti en municipios de Colombia: el caso de Girón y Guadalajara de Buga, 2016 / Costs of an Aedes aegypti vector control program in municipalities in Colombia: a case study in Girón and Guadalajara de Buga, 2016 / Custos de um programa de controle ao vetor Aedes aegypti em municípios da Colômbia: o caso de Girón e Guadalajara de Buga, 2016

Resumen: El objetivo de este estudio fue cuantificar los costos de los programas de control de enfermedades transmitidas por vectores a nivel local en Colombia (2016). Para ello, fue realizado un análisis de costos desde la perspectiva del hacedor de política en los municipios de Girón y Guadalajara de Buga, específicamente para el programa de control del Aedes aegypti, principal vector trasmisor del dengue, Zika y chikungunya. Este análisis implicó la cuantificación de todos los costos requeridos para cada una de las estrategias de prevención y control de enfermedades transmitidas por vectores. Los costos fueron clasificados en recurrentes y de capital, además, con fines comparativos se obtuvo el costo por caso y a nivel per cápita. El costo total estimado de los programas fue de USD 146.651 en el municipio de Girón y USD 97.936 en el municipio de Guadalajara de Buga; a nivel per cápita el costo fue de USD 0,88 en Girón y en Guadalajara de Buga fue de USD 0,99. En general, las estrategias predominantes en costos fueron el control químico de vectores adultos, con un 26% del total de los costos en Girón y un 47% en Guadalajara de Buga, esta fue intensiva en costos recurrentes, con un costo de personal 40% del total de costos para esta estrategia en Girón y un 66% de costos operacionales en Guadalajara de Buga.

Abstract: The aim of this study was to measure the costs of vector-borne disease control programs at the local level in Colombia (2016). A cost analysis was performed for this purpose from the policymaker's perspective in the municipalities (counties) of Girón and Guadalajara de Buga, specifically for the Aedes aegypti control program, the principal mosquito vector of dengue, Zika, and chikungunya. The analysis involved the quantification of all the costs required for each of the prevention and control strategies in vector-borne diseases. The costs were classified as operating and capital costs, and for purposes of comparison the costs were also calculated per case and per capita. The programs' total estimated costs were USD 146,651 in Girón and USD 97,936 in Guadalajara de Buga. Per capita cost was USD 0.88 in Girón and USD 0.99 in Guadalajara de Buga. In general, the predominant cost strategies were chemical spraying of adult mosquitos, accounting for 26% of the total costs in Girón and 47% in Guadalajara de Buga, with personnel representing 40% of the total costs for this strategy in Girón and 66% of the operating costs in Guadalajara de Buga.

Resumo: O objetivo deste estudo foi quantificar os custos dos programas de controle de doenças transmitidas por vetores ao nível local na Colômbia em (2016). Para isso, foi realizada uma análise de custos desde a perspectiva do criador de políticas nos municípios de Girón e Guadalajara de Buga, especificamente para o programa de controle do Aedes aegypti, principal vector transmissor da dengue, Zika e chikungunya. Esta análise implicou a quantificação de todos os custos requeridos para cada uma das estratégias de prevenção e controle de doenças transmitidas por vetores. Os custos foram classificados em recorrentes e do capital, ademais, para fins comparativos foi obtido o custo por caso e nível per capita. O custo total estimado dos programas foi de USD 146.651 no Município de Girón e USD 97.936 no Município de Guadalajara de Buga; ao nível per capita o custo foi de USD 0,88 em Girón e em Guadalajara de Buga foi de USD 0,99. Em geral, as estratégias predominantes em custos foram o controle químico de vetores adultos, com um 26% do total dos custos em Girón e um 47% em Guadalajara de Buga, essa foi intensiva em custos recorrentes, com um custo de pessoal de um 40% do total de custos para esta estratégia em Girón e um 66% de custos operacionais em Guadalajara de Buga.

Spatial modeling of cutaneous leishmaniasis in the Andean region of Colombia

The objective of this research was to identify environmental risk factors for cutaneous leishmaniasis (CL) in Colombia and map high-risk municipalities. The study area was the Colombian Andean region, comprising 715 rural and urban municipalities. We used 10 years of CL surveillance: 2000-2009. We used spatial-temporal analysis - conditional autoregressive Poisson random effects modelling - in a Bayesian framework to model the dependence of municipality-level incidence on land use, climate, elevation and population density. Bivariable spatial analysis identified rainforests, forests and secondary vegetation, temperature, and annual precipitation as positively associated with CL incidence. By contrast, livestock agroecosystems and temperature seasonality were negatively associated. Multivariable analysis identified land use - rainforests and agro-livestock - and climate - temperature, rainfall and temperature seasonality - as best predictors of CL. We conclude that climate and land use can be used to identify areas at high risk of CL and that this approach is potentially applicable elsewhere in Latin America.

Difusión masiva de reportes situacionales sobre dengue: efectos de la intervención en Guadalajara de Buga, Colombia / Mass communication of dengue surveillance data: effect of an intervention in Guadalajara de Buga, Colombia

Introducción. La retroalimentación a las comunidades de la situación de dengue en su localidad, podría ser útil para mantener la motivación para su participación en el control del dengue y disminuir los índices entomológicos de Aedes . Objetivos. Evaluar la cobertura y el alcance de una intervención basada en la difusión masiva de reportes situacionales sobre el dengue y su efecto en la presencia de criaderos intradomiciliarios de Aedes spp. en Guadalajara de Buga, Colombia. Materiales y métodos. Se llevó a cabo un estudio observacional de corte transversal en 1.426 viviendas, para establecer la presencia de criaderos intradomiciliarios y caracterizar la exposición a la intervención. El efecto de la intervención se evaluó en un estudio de casos y controles. Los casos obedecieron al total de viviendas con criaderos positivos y, entre las viviendas sin criaderos positivos ubicadas en la misma manzana del caso, se seleccionaron aleatoriamente cuatro controles por caso. Resultados. El índice de viviendas positivas fue de 2,5 %. La cobertura fue del 59,4 % y el alcance del 22,3 %. El contacto con la intervención no se asoció con la ausencia de criaderos intradomiciliarios positivos. La presencia de matas con agua o floreros se asoció con criaderos positivos (p=0,01) y el uso de anjeos se consideró como factor protector (p=0,02). Conclusiones. Aunque la cobertura de la intervención fue adecuada, no se observó que tuviera efecto sobre la ausencia de criaderos intradomiciliarios positivos. Por lo tanto, se requiere la evaluación de la intervención en términos de su fidelidad, diseño y proceso de implementación.

Introduction: Maintaining communities abreast of their local dengue situation could help to keep them motivated to participate in dengue control and to decrease Aedes entomological indexes. Objectives: To evaluate the coverage and reach of an intervention based on mass-media communication of dengue surveillance reports and its effect on the presence of intra-domiciliary breeding sites for Aedes in Guadalajara de Buga, Colombia. Materials and methods: An observational cross-sectional study was conducted in 1,426 households to identify the intra-domiciliary breeding sites and to characterize the intervention exposure. To evaluate the effect of the intervention, a case-control study was performed. All households with positive breeding sites were considered as cases. Four controls per case were randomly selected among the non-positive breeding site households located on the same block of the case. Results: The positive house index was 2.5%; coverage was 59.4% and reach was 22.3%. There was no association between the intervention and the presence of intra-domiciliary breeding sites. The presence of water plants and flower pots were associated to positive breeding sites (p=0.01) and the use of screens was associated to the absence of breeding sites (p=0.02). Conclusions: Although intervention coverage was adequate, the lack of association between the intervention and the absence of positive breeding sites requires assessing its fidelity, factors related to the design, and the implementation process.