Potential for a web-based management information system to improve malaria control: An exploratory study in the Lahat District, South Sumatra Province, Indonesia.

BACKGROUND: A web-based malaria reporting information system (MRIS) has the potential to improve malaria reporting and management. The aim of this study was to evaluate the existing manual paper-based MRIS and to provide a way to overcome the obstacles by developing a web-based MRIS in Indonesia. METHODS: An exploratory study was conducted in 2012 in Lahat District, South Sumatra Province of Indonesia. We evaluated the current reporting system and identified the potential benefits of using a web-based MRIS by in-depth interviews on selected key informants. Feasibility study was then conducted to develop a prototype system. A web-based MRIS was developed, integrated and synchronized, with suitability ranging from Primary Healthcare Centres (PHCs) to the Lahat District Health Office. RESULTS: The paper-based reporting system was sub-optimal due to a lack of transportation, communication, and human capacity. We developed a web-based MRIS to replace the current one. Although the web-based system has the potential to improve the malaria reporting information system, there were some barriers to its implementation, including lack of skilled operators, computer availability and lack of internet access. Recommended ways to overcome the obstacles are by training operators, making the application in an offline mode and able to be operated by mobile phone text messaging for malaria reporting. CONCLUSION: The web-based MRIS has the potential to be implemented as an enhanced malaria reporting information system and investment in the system to support timely management responses is essential for malaria elimination. The developed application can be cloned to other areas that have similar characteristics and MRIS with a built-in web base to aid its application in the 5G future.

Mosquito Control and Coastal Development: How they Have Coexisted and Matured in Florida and Australia.

The aims of this review were to compare planning for both mosquito control and land use in east-central Florida, USA, and in New South Wales, Queensland, and the Northern Territory, Australia. Saltwater mosquito production in mangroves and salt marsh is the predominant mosquito control concern in all the areas. Urban encroachment towards saltwater mosquito habitats is a problem in both Florida and Australia. In east-central Florida and the Northern Territory, mosquito control is supported by comprehensive source reduction programs, whereas in Queensland and New South Wales, larviciding is the main method of control. The long-term control by source reduction programs reduces vulnerability to mosquito issues as population encroaches towards wetlands, whereas larviciding programs have to respond repeatedly as problems arise. Problems from urban encroachment are exacerbated if mosquito control and land-use planning are not integrated. Further, urban planning that is not informed by mosquito management can lead to increased mosquito problems by inadvertent design or allowing residential development close to mosquito habitats. This increases the need for mosquito control and related resourcing. At the regional level of governance, Florida and the Northern Territory generally have greater integration between planning for development and mosquito control than at the local government level in New South Wales and Queensland, where there is a lack of integration between mosquito agencies and planners. It is concluded that coordination of planning and mosquito control is more effective at higher government levels than at local levels, which have less connectivity between management areas and/or insufficient resources. The lesson is that collaboration can assist in avoiding or resolving conflicts.

Social determinants of malaria in an endemic area of Indonesia.

BACKGROUND: Malaria is an increasing concern in Indonesia. Socio-demographic factors were found to strongly influence malaria prevalence. This research aimed to explore the associations between socio-demographic factors and malaria prevalence in Indonesia. METHODS: The study used a cross-sectional design and analysed relationships among the explanatory variables of malaria prevalence in five endemic provinces using multivariable logistic regression. RESULTS: The analysis of baseline socio-demographic data revealed the following independent risk variables related to malaria prevalence: gender, age, occupation, knowledge of the availability of healthcare services, measures taken to protect from mosquito bites, and housing condition of study participants. Multivariable analysis showed that participants who were unaware of the availability of health facilities were 4.2 times more likely to have malaria than those who were aware of the health facilities (adjusted odds ratio = 4.18; 95% CI 1.52-11.45; P = 0.005). CONCLUSIONS: Factors that can be managed and would favour malaria elimination include a range of prevention behaviours at the individual level and using the networks at the community level of primary healthcare centres. This study suggests that improving the availability of a variety of health facilities in endemic areas, information about their services, and access to these is essential.

Using Present Value as a Simple Approach to Compare Mosquito Larval Control Methods.

Simple economic-based comparisons of source reduction and larvicide treatment are generally lacking in the mosquito control literature. The aim is to address this by developing an Excel tool that calculates the total present value (PV) of control methods. We use 15 years as the time frame, but this can be varied. Total PV is calculated based on the cost of each method at the start. A 3% discount rate is applied to recurring costs, and one-off costs are included throughout because they are part of the total PV. The data are based on information provided by mosquito control agencies in southeast Queensland, Australia. Values in the tool can be simply edited to reflect specific program characteristics. The outcome for the data used showed that source reduction is an appropriate option if maintenance is minimal. When major maintenance is needed, then larviciding may be the better option, particularly if money is the main consideration. However, if the frequency of applying larvicides increases, then source reduction becomes an increasingly attractive option.

Impacts of El Niño Southern Oscillation and Indian Ocean Dipole on dengue incidence in Bangladesh.

Dengue dynamics are driven by complex interactions between hosts, vectors and viruses that are influenced by environmental and climatic factors. Several studies examined the role of El Niño Southern Oscillation (ENSO) in dengue incidence. However, the role of Indian Ocean Dipole (IOD), a coupled ocean atmosphere phenomenon in the Indian Ocean, which controls the summer monsoon rainfall in the Indian region, remains unexplored. Here, we examined the effects of ENSO and IOD on dengue incidence in Bangladesh. According to the wavelet coherence analysis, there was a very weak association between ENSO, IOD and dengue incidence, but a highly significant coherence between dengue incidence and local climate variables (temperature and rainfall). However, a distributed lag nonlinear model (DLNM) revealed that the association between dengue incidence and ENSO or IOD were comparatively stronger after adjustment for local climate variables, seasonality and trend. The estimated effects were nonlinear for both ENSO and IOD with higher relative risks at higher ENSO and IOD. The weak association between ENSO, IOD and dengue incidence might be driven by the stronger effects of local climate variables such as temperature and rainfall. Further research is required to disentangle these effects.

Multi-agency perspectives on managing mangrove wetlands and the mosquitoes they produce.

A group of researchers, mosquito and coastal managers, and consultants joined together to explore issues of concern to coastal and mosquito management in mangrove forests. At a 1-day workshop in Florida, participants identified issues that are important for their roles. The issues were subsequently compiled into a matrix and the participants were asked to individually assess the importance and urgency of each. The most important issues for everyone included habitat responses to management, community attitude, public education, interaction between agencies, local connectivity, sea-level rise (SLR) loss of wetlands, and conservation. Most urgent were public education, conservation easements, local connectivity, SLR, loss of wetland, restoration, and conservation. There were differing viewpoints among the roles that appeared to be related to responsibility for and ability to influence on-ground outcomes. This is reflected in mosquito and coastal managers who viewed issues broadly and ascribed higher levels of importance and urgency to them than did researchers and consultants. We concluded that collaboration is a key issue. Barriers to collaboration include knowledge differences between agencies. Facilitators of collaboration include interaction, trust, and shared goals.

Epidemiologic patterns of Ross River virus disease in Queensland, Australia, 2001-2011.

Ross River virus (RRV) infection is a debilitating disease that has a significant impact on population health, economic productivity, and tourism in Australia. This study examined epidemiologic patterns of RRV disease in Queensland, Australia, during January 2001-December 2011 at a statistical local area level. Spatio-temporal analyses were used to identify the patterns of the disease distribution over time stratified by age, sex, and space. The results show that the mean annual incidence was 54 per 100,000 persons, with a male:female ratio of 1:1.1. Two space-time clusters were identified: the areas adjacent to Townsville, on the eastern coast of Queensland, and the southeast areas. Thus, although public health intervention should be considered across all areas in which RRV occurs, it should specifically focus on high-risk regions, particularly during summer and autumn to reduce the social and economic impacts of RRV infection.

Spatial and temporal patterns of locally-acquired dengue transmission in northern Queensland, Australia, 1993-2012.

BACKGROUND: Dengue has been a major public health concern in Australia since it re-emerged in Queensland in 1992-1993. We explored spatio-temporal characteristics of locally-acquired dengue cases in northern tropical Queensland, Australia during the period 1993-2012. METHODS: Locally-acquired notified cases of dengue were collected for northern tropical Queensland from 1993 to 2012. Descriptive spatial and temporal analyses were conducted using geographic information system tools and geostatistical techniques. RESULTS: 2,398 locally-acquired dengue cases were recorded in northern tropical Queensland during the study period. The areas affected by the dengue cases exhibited spatial and temporal variation over the study period. Notified cases of dengue occurred more frequently in autumn. Mapping of dengue by statistical local areas (census units) reveals the presence of substantial spatio-temporal variation over time and place. Statistically significant differences in dengue incidence rates among males and females (with more cases in females) (χ(2) = 15.17, d.f.  = 1, p<0.01). Differences were observed among age groups, but these were not statistically significant. There was a significant positive spatial autocorrelation of dengue incidence for the four sub-periods, with the Moran's I statistic ranging from 0.011 to 0.463 (p<0.01). Semi-variogram analysis and smoothed maps created from interpolation techniques indicate that the pattern of spatial autocorrelation was not homogeneous across the northern Queensland. CONCLUSIONS: Tropical areas are potential high-risk areas for mosquito-borne diseases such as dengue. This study demonstrated that the locally-acquired dengue cases have exhibited a spatial and temporal variation over the past twenty years in northern tropical Queensland, Australia. Therefore, this study provides an impetus for further investigation of clusters and risk factors in these high-risk areas.

Climate change and dengue: a critical and systematic review of quantitative modelling approaches.

BACKGROUND: Many studies have found associations between climatic conditions and dengue transmission. However, there is a debate about the future impacts of climate change on dengue transmission. This paper reviewed epidemiological evidence on the relationship between climate and dengue with a focus on quantitative methods for assessing the potential impacts of climate change on global dengue transmission. METHODS: A literature search was conducted in October 2012, using the electronic databases PubMed, Scopus, ScienceDirect, ProQuest, and Web of Science. The search focused on peer-reviewed journal articles published in English from January 1991 through October 2012. RESULTS: Sixteen studies met the inclusion criteria and most studies showed that the transmission of dengue is highly sensitive to climatic conditions, especially temperature, rainfall and relative humidity. Studies on the potential impacts of climate change on dengue indicate increased climatic suitability for transmission and an expansion of the geographic regions at risk during this century. A variety of quantitative modelling approaches were used in the studies. Several key methodological issues and current knowledge gaps were identified through this review. CONCLUSIONS: It is important to assemble spatio-temporal patterns of dengue transmission compatible with long-term data on climate and other socio-ecological changes and this would advance projections of dengue risks associated with climate change.

Comparing Aedes vigilax Eggshell Densities in Saltmarsh and Mangrove Systems with Implications for Management.

Aedes vigilax (Skuse), a nuisance and disease vector, is prolific in intertidal wetlands in Australia. Aedine mosquitoes oviposit directly onto substrate. The eggshells are relatively stable spatially and temporally, providing an estimate of mosquito larval production. The aims of the research were to compare, at a general level, oviposition in mangroves and saltmarshes, and to compare oviposition between different habitats within mangroves and saltmarshes. The results indicated that there were no significant differences between production in mangrove and saltmarsh overall. However, within each system there were significant differences between habitat classes, with mangrove hummocks being the most productive. All classes, except for fringing mangrove forests, produced sufficient densities of eggshells (>0.05/cc) to warrant concern. While mosquito production in mangroves is known, the significantly higher production rates in the mangrove hummock habitats had not been demonstrated. This warrants improved management strategies that both specifically target these parts of mangrove systems and, secondly, addresses the longer-term potential for mangrove hummock habitats developing in the future; such as, in response to sea level rise and mangrove encroachment into saltmarsh. A strategy to increase tidal flushing within the systems would improve water quality and mitigate adverse impacts while providing a source reduction outcome.

The impact of encroachment of mangroves into saltmarshes on saltwater mosquito habitats.

Will mangrove encroachment into saltmarshes affect saltwater mosquito habitats? To address this, we synthesized information from two perspectives: 1) at a detailed level, the immature mosquito habitat within mangroves; 2) at a more general or regional level, changes due to mangrove expansion into saltmarshes. This is a synthesis of two research projects. One showed that mosquito larval habitats in mangroves are complex, related to the detailed interactions between topography and tidal patterns and that not all parts of a mangrove forest are suitable habitat. The other, based on remote sensing and analysis of rainfall data, showed that mangrove encroachment in eastern Australia is related to both climate and human land use over several decades (1972-2004). An important question emerged: when mangroves encroach into saltmarshes will they displace saltmarsh immature mosquito habitats or will they replace them with mangrove ones? There is no simple answer: it will vary with climate change and sea level scenario and how these affect the system. We conclude that mosquito management, which is locally implemented, needs to be integrated with land use planning systems, which often operate at a more general level.

Oviposition and larval habitat preferences of the saltwater mosquito, Aedes vigilax, in a subtropical mangrove forest in Queensland, Australia.

Our aim was to investigate the oviposition and larval habitats of the saltwater mosquito Aedes vigilax (Skuse) (Diptera: Culicidae) in a mangrove forest system in subtropical Queensland, Australia. Eggshells (indicators of oviposition) and larvae were sampled in three habitat classes that were depicted in a schematic model. Two classes were in depressions or basins, either with hummocks or dense pneumatophore substrates, both of which retained water after tidal flooding. The third class was in freely flushed mangroves that corresponded with more frequent tidal connections than the depression classes. ANOVA and Tukey-Kramer tests were used to analyze the data. The null hypotheses were rejected: the hummock class was a significant habitat based on both eggshell and larval data. The conclusion was that mosquito production in the mangrove system was distributed unevenly between habitat classes, and that the hummock class had conditions suited to the requirements of the immature stages of Ae. vigilax. This research has the potential to inform mosquito management strategies by focusing treatment on the problem habitats and underpinning habitat modifications including reducing water retention in the basins.

Dusk to dawn activity patterns of anopheline mosquitoes in West Timor and Java, Indonesia.

Malaria is a serious health issue in Indonesia. We investigated the dusk to dawn anopheline mosquito activity patterns, host-seeking and resting locations in coastal plain, hilly and highland areas in West Timor and Java. Adult mosquitoes were captured landing on humans or resting in houses or animal barns. Data analyzed were: mosquito night-time activities; period of peak activity; night-time activity in specific periods of time and for mosquito resting locations. Eleven species were recorded; data were sparse for some species therefore detailed analyses were performed for four species only. In Java Anopheles vagus was common, with a bimodal pattern of high activity. In West Timor, its activity peaked around midnight. Other species with peak activity around the middle of the night were An. barbirostris and An. subpictus. Most species showed no biting and resting preference for indoors or outdoors, although An. barbirostris preferred indoors in West Timor, but outdoors in Java. An. aconitus and An. annularis preferred resting in human dwellings; An. subpictus and An. vagus preferred resting in animal barns. An. barbirostris preferred resting in human dwellings in West Timor and in animal barns in Java. The information is useful for planning the mosquito control aspect of malaria management. For example, where mosquito species have peak activity at night indoors, bednets and indoor residual spraying should reduce malaria risk, but where mosquitoes are most active outdoors, other options may be more effective.

Does mosquito control have an effect on mosquito-borne disease? The case of Ross River virus disease and mosquito management in Queensland, Australia.

We examined the relationship between types of mosquito control programs and the mosquito-borne Ross River virus (RRV) disease in Queensland, Australia. Mosquito control information was collected through a survey of the responsible agencies (local governments), and RRV disease notification data were provided by the Queensland state health authority. The study developed a typology of mosquito control programs, based on the approaches used. Based on the analysis of data on RRV disease rates between mosquito control types within 4 climatic regions, each region had different combinations of mosquito control strategies in their programs; there were also general similarities in the relationship between program types and RRV rates between the regions. The long-term RRV disease rates were lower in areas where the mosquito control program included pre-emptive (rather than reactive) surveillance based on an extensive (rather than incomplete) knowledge of mosquito habitats, and where treatment of both saltwater and freshwater habitats (compared to only saltwater habitats, in coastal areas) occurred. The data indicate that mosquito control is an effective public health intervention to reduce mosquito-borne disease; hence, climate change adaptation strategies should ensure that adequate resources are available for effective vector control so as to manage the risk of mosquito-borne diseases.

Relationships between anopheline mosquitoes and topography in West Timor and Java, Indonesia.

BACKGROUND: Malaria is a serious health issue in Indonesia. Mosquito control is one aspect of an integrated malaria management programme. To focus resources on priority areas, information is needed about the vectors and their habitats. This research aimed to identify the relationship between anopheline mosquitoes and topography in West Timor and Java. METHODS: Study areas were selected in three topographic types in West Timor and Java. These were: coastal plain, hilly (rice field) and highland. Adult mosquitoes were captured landing on humans identified to species level and counted. RESULTS: Eleven species were recorded, four of which were significant for malaria transmission: Anopheles aconitus, Anopheles barbirostris, Anopheles subpictus and Anopheles sundaicus. Each species occupied different topographies, but only five were significantly associated: Anopheles annularis, Anopheles vagus and Anopheles subpictus (Java only) with hilly rice fields; Anopheles barbirostris, Anopheles maculatus and Anopheles subpictus (West Timor only) with coastal areas. CONCLUSION: Information on significant malaria vectors associated with specific topography is useful for planning the mosquito control aspect of malaria management.

Socio-environmental predictors of Barmah forest virus transmission in coastal areas, Queensland, Australia.

OBJECTIVE: To assess the socio-environmental predictors of Barmah forest virus (BFV) transmission in coastal areas, Queensland, Australia. METHODS: Data on BFV notified cases, climate, tidal levels and socioeconomic index for area (SEIFA) in six coastal cities, Queensland, for the period 1992-2001 were obtained from the relevant government agencies. Negative binomial regression models were used to assess the socio-environmental predictors of BFV transmission. RESULTS: The results show that maximum and minimum temperature, rainfall, relative humidity, high and low tide were statistically significantly associated with BFV incidence at lags 0-2 months. The fitted negative binomial regression models indicate a significant independent association of each of maximum temperature (beta = 0.139, P = 0.000), high tide (beta = 0.005, P = 0.000) and SEIFA index (beta = -0.010, P = 0.000) with BFV transmission after adjustment for confounding variables. CONCLUSIONS: The transmission of BFV disease in Queensland coastal areas seemed to be determined by a combination of local social and environmental factors. The model developed in this study may have applications in the control and prevention of BFV disease in these areas.

Climate variability, social and environmental factors, and ross river virus transmission: research development and future research needs.

BACKGROUND: Arbovirus diseases have emerged as a global public health concern. However, the impact of climatic, social, and environmental variability on the transmission of arbovirus diseases remains to be determined. OBJECTIVE: Our goal for this study was to provide an overview of research development and future research directions about the interrelationship between climate variability, social and environmental factors, and the transmission of Ross River virus (RRV), the most common and widespread arbovirus disease in Australia. METHODS: We conducted a systematic literature search on climatic, social, and environmental factors and RRV disease. Potentially relevant studies were identified from a series of electronic searches. RESULTS: The body of evidence revealed that the transmission cycles of RRV disease appear to be sensitive to climate and tidal variability. Rainfall, temperature, and high tides were among major determinants of the transmission of RRV disease at the macro level. However, the nature and magnitude of the interrelationship between climate variability, mosquito density, and the transmission of RRV disease varied with geographic area and socioenvironmental condition. Projected anthropogenic global climatic change may result in an increase in RRV infections, and the key determinants of RRV transmission we have identified here may be useful in the development of an early warning system. CONCLUSIONS: The analysis indicates that there is a complex relationship between climate variability, social and environmental factors, and RRV transmission. Different strategies may be needed for the control and prevention of RRV disease at different levels. These research findings could be used as an additional tool to support decision making in disease control/surveillance and risk management.

Four degrees of latitude: mosquito control on the "right" coasts of Australia and Florida, USA.

This study compares mosquito control within similar environments between 26 and 30 degrees of latitude on the east central coasts of Florida and of Australia. It describes and compares the relevant mosquito-producing environments, the development of mosquito control, legislative framework, funding arrangements, and organizational differences between the areas, including the international interactions that have facilitated good practices. The article identifies some strengths and weaknesses of the programs in each area. Significant strengths include some aspects of funding and administration; collaborations with other organizations; the roles of national and state organizations, including research agencies; and commitment of individuals. Potential weaknesses in programs that are part of larger organizations include their relatively low position in the organizational hierarchy and the need to compete for resources. Programs that are independent districts may lack opportunity to interact with other land management units. Other weaknesses include the relatively high turnover of staff in state environmental resource agencies and the potential loss of institutional memory when long-term mosquito control staff members leave. The case comparison highlights similarities in product use at the individual program level (Indian River Mosquito Control District and Gold Coast Pest Management Unit) and differences in practices including aerial adulticiding being used in Florida but not in Australia.

Habitat characteristics and eggshell distribution of the salt marsh mosquito, Aedes vigilax, in marshes in subtropical Eastern Australia.

Research at 10 locations in coastal subtropical Queensland, Australia, has shown that salt marshes contained heterogeneous distributions of eggshells of the pest and vector mosquito Aedes vigilax (Skuse) (Diptera:Culicidae). The eggshell distribution was related to specific vegetation assemblages, with a mix of the grass, Sporobolus virginicus (L.) Kunth (Poales: Poaceae), and the beaded glasswort, Sarcocornia quinqueflora (Bunge ex (Ung.-Stern) A.J. Scott (Caryophyllales: Chenopodiaceae), as significantly higher in eggshells than any other vegetation. There were also high numbers in the mix of S. virginicus with the arrowgrass, Triglochin striata Ruiz & Pavón (Alismatales: Juncaginaceae). Both mixed types are found in relatively wetter areas, despite very few eggshells being found generally in the low marsh. Most sites contained S. virginicus and eggshell locations were variable for this species alone. This was probably related to its life form variability in response to salinity and location on the marsh. Location on the marsh was important for eggshell distribution with most eggshells around the edges of pools and depressions, followed by, but to a significantly lesser extent, the marsh surface. Eggshells were fewest in the low marsh. Partition analysis resulted in a tree that simplified and summarised the factors important for eggshell distribution confirming the individual analyses. The potential effects of climate, sea level and other change are also briefly discussed in the context of likely changes to land cover and relative location on the marsh. For example, increased sea level may lead to low marsh conditions extending into higher marsh area with implications for oviposition and numbers of eggshells.

Constructed wetlands for sewage effluent treatment and mosquito larvae at two sites in subtropical Australia.

This study of 2 wetlands in subtropical Australia, constructed to treat sewage effluent, examined the relationships between dips positive for mosquito larvae and water quality, operational status of the system, vegetation, and nontarget macroinvertebrates. One site is inland and the other is close to the coast. Larvae of disease vector mosquitoes were present at various times in the wetlands, especially in summer and autumn. The proportion of early instars (1st and 2nd) was greater than that of later ones (3rd and 4th). Dissolved oxygen was negatively, and temperature was positively, associated with the proportion of dips containing larvae. For the coastal site we noted that larvae were more common during draw-down of water for maintenance and also as the system started to come online. Vegetation associated with larvae included dense Typha orientalis and algae. Where there were several types of plants, such as at the coastal site, plant density and water depth were not significantly related to larval presence. Where there were several types of macroinvertebrates there were fewer dips positive for larvae. To provide water treatment capacity and minimal mosquito production we concluded that design should include a variety of plant types, discouraging low dissolved oxygen (for example, by aeration) and ongoing maintenance should be carried out in winter or spring, when mosquitoes are fewer than in summer.