Biology subjects

Perkins, T. A.

Publications and source records attributed to Perkins, T. A..

3 recordsLinked to original sources

bioRxiv2018

Mapping malaria by combining parasite genomic and epidemiologic data

Recent global progress in scaling up malaria control interventions has revived the goal of complete elimination in many countries. Decreasing transmission intensity generally leads to increasingly patchy spatial patterns of malaria transmission, however, and control programs must accurately identify remaining foci in order to target interventions efficiently. In particular, mosquito control interventions like bed nets and insecticide spraying are best targeted to transmission hotspots, and the role of connectivity between different pockets of local transmission becomes increasingly important since humans are able to move parasites beyond the limits of mosquito dispersal and re-introduce parasites to previously malaria-free regions. Quantifying the connectivity between regions due to human travel, measuring malaria transmission intensity in different areas, and monitoring parasite spatial spread are therefore key issues for policy-makers because they underpin the feasibility of elimination and inform the path to its attainment. To this end, recent efforts have been made to develop new approaches to incorporating human mobility into spatial epidemiological models, for example using mobile phone data, and there has been a surge of interest in collecting spatially informative parasite samples to measure the genomic signatures of parasite connectivity. Due to their complicated life-cycles, Plasmodium parasites pose unique challenges to researchers in this respect and new methods that move beyond traditional phylogenetic and population genetic tools must be developed to harness genetic information effectively. Here, we discuss the spatial epidemiology of malaria in the context of transmission-reduction interventions, and the challenges and promising directions for the development of integrated mapping, modeling, and genomic approaches that leverage disparate data sets to measure both connectivity and transmission.

epidemiology↗

bioRxiv2018

Estimating the impact of city-wide Aedes aegypti population control: An observational study in Iquitos, Peru

During the last 50 years, the geographic range of the mosquito Aedes aegypti has increased dramatically, in parallel with a sharp increase in the disease burden from the viruses it transmits, including Zika, chikungunya, and dengue. There is a growing consensus that vector control is essential to prevent Aedes-borne diseases, even as effective vaccines become available. What remains unclear is how effective vector control is across broad operational scales because the data and the analytical tools necessary to isolate the effect of vector-oriented interventions have not been available. We developed a statistical framework to model Ae. aegypti abundance over space and time and applied it to explore the impact of citywide vector control conducted by the Ministry of Health (MoH) in Iquitos, Peru, over a 12-year period. Citywide interventions involved multiple rounds of intradomicile insecticide space spray over large portions of urban Iquitos (up to 40% of all residences) in response to dengue outbreaks. Our model captured significant levels of spatial, temporal, and spatio-temporal variation in Ae. aegypti abundance within and between years and across the city. We estimated the shape of the relationship between the coverage of neighborhood-level vector control and reductions in female Ae. aegypti abundance; i.e., the dose-response curve. The dose-response curve, with its associated uncertainties, can be used to gauge the necessary spraying effort required to achieve a desired effect and is a critical tool currently absent from vector control programs. We found that with complete neighborhood coverage MoH intra-domicile space spray would decrease Ae. aegypti abundance on average by 67% in the treated neighborhood. Our framework can be directly translated to other interventions in other locations with geolocated mosquito abundance data. Results from our analysis can be used to inform future vector-control applications in Ae. aegypti endemic areas globally.\n\nAuthor SummaryDespite the growing threat of arboviruses, there is a dearth of best practices for the primary vector control tools used in the field. In the absence of cluster randomized control trials, evidence on the utility (or lack thereof) of vector control interventions must be gleaned from ongoing control programs. Motivated by 12 years of household-level Ae. aegypti abundance surveys and neighborhood-level space-spray campaign data from Iquitos, Peru, we developed a new framework to model mosquito abundance. In spite of significant spatial and temporal heterogeneity, we identified a statistically significant and practically important impact of the local Ministry of Health space-spray campaign, specifically, a reduction of mosquito abundance of 67% when coverage was optimal. Our framework can be directly applied to other locations with geolocated mosquito abundance data and our findings can be used to both optimize resources within Iquitos as well as inform future vector-control interventions in Ae. aegypti endemic areas globally.

ecology↗

bioRxiv2018

Downgrading disease transmission risk estimates using terminal importations

As emerging and re-emerging infectious diseases like dengue, Ebola, chikungunya, and Zika threaten new populations worldwide, officials scramble to assess local severity and transmissibility, with little to no epidemiological history to draw upon. Standard methods for assessing autochthonous (local) transmission risk make either indirect estimates based on ecological suitability or direct estimates only after local cases accumulate. However, an overlooked source of epidemiological data that can meaningfully inform risk assessments prior to outbreak emergence is the absence of transmission by imported cases. Here, we present a method for updating a priori ecological estimates of transmission risk using real-time importation data. We demonstrate our method using Zika importation and transmission data from Texas in 2016, a high-risk region in the southern United States. Our updated risk estimates are lower than previously reported, with only six counties in Texas likely to sustain a Zika epidemic, and consistent with the number of autochthonous cases detected in 2017. Importation events can thereby provide critical, early insight into local transmission risks as infectious diseases expand their global reach.

epidemiology↗