Evaluation of Innovative Strategies for Aedes aegypti Control: Challenges for their Introduction and Impact Assessment

Abstract

[Introduction]. The Region of the Americas has a long history of vector-borne disease control. The evidence reveals the success of various programs in the past. The control of yellow fever and malaria in Cuba and Panama under the direction of William Gorgas (1901–1910), the elimination of Anopheles gambiae in Brazil (1940), the elimination of Aedes aegypti between 1950 and 1960 led by Fred Soper under the auspices of PAHO, the elimination of transmission of Chagas disease by Triatoma infestans in Brazil and Uruguay, and the recent elimination of onchocerciasis from 11 of the 13 endemic foci in Colombia, Ecuador, Mexico, and Guatemala (2013–2016) are recent examples of interventions that have combined the use of insecticides, sanitary engineering, and effective vaccines or medicines, supported by community participation and other control methods… It is estimated that nearly half the world’s current population lives in areas at risk for dengue. Transmission is occurring in more than 100 countries and between 300 and 500 million people are infected annually, 96 million of whom have clinical manifestations and 500,000 have severe cases, with around 25,000 deaths. The infection is endemic in the Americas and in the Southeast Asia, Western Pacific, Africa, and Eastern Mediterranean regions. In the last 50 years the incidence has increased thirtyfold, a trend that shows no sign of abating. The epidemiological scenario reveals that the number of cases is increasing, that outbreaks are larger and longer-lasting, and that the affected areas and populations are continually expanding. Achieving the WHO goal of reducing mortality by 50% and morbidity by 25% by 2020 will be a challenge, given the lack of good surveillance systems that can correctly quantify the burden of disease and the deficiencies of vector control programs in the endemic countries…