SURVEILLANCE IN INSTITUTIONS

Prof. Dr. Waseem Akram, Head Research and Development Program on Dengue Punjab,

Chief Minister’s Secretariat

Synopsis of Module 2

Concept of Surveillance at institutional level

Mosquito trapsDesigning Traps (DT)Control Methods

Concept of Surveillance at Institutional Level

Larval surveys

• Larval surveys– Basic sampling unit is the house or premise, which is systematically

searched for water holding containers – Examination of containers for the presence of mosquito larvae and

pupae.

• Depending on the objective of the survey– Search may be terminated as soon as Aedes larvae are found– Continued until all containers have been examined.

• Collection of specimens for laboratory examination is necessary to confirm.

• Students must be taught to identify these mosquitoes

Basics to do VECTOR SURVEILLANCE

Four indices that are commonly used to monitor Aedes aegyptiinfection levels are:

• School index (Hl): percentage of school infected with larvae and/or pupaeHI = Number of schools infected/Number of schools inspected X100

• Container Index (Cl): percentage of water holding containers infected with larvae or pupae.

Cl = Number of positive containers/Number of containers inspected X100

• Breteau Index (Bl): number of positive containers per 100 schools inspectedBl: Number of positive containers/Number of schools inspected

X100

• Pupae Index (Pl): number of pupae per 100 schoolsPl = Number of pupae/Number of schools inspected X100

Designing various types of traps

Predicting population indices

Normal to Lethal economical traps

Designing the ovitraps and their installation

Preparing the Ovitraps

Pre

Step 1: Filling with Water

Step 2: Placing egg laying sheets

Step 3: Banding the strips

Making of Ovitrap

• Material Needed– A small container

– A ring mesh» 2

Making of Ovitrap

• Upper part of water bottle

• Lower part of water bottle with holes on both sides

• Inside water reservoir bottle

• Bottom hole

Making of Ovitrap

Assembling the Trap

Step A•Take the bowl and put the rounded mesh ring inside the bowl•Fill the bowl with water and observe the rounded mesh ring will rise in the bowl to the level of water.

Step B•Put the lower half of the bottle inside the bowl and press for short time till the lower half of bottle is filled with water.

Step CPut the inside water bottle filled with water inside the lower half of the bottle. This will help to supplement water incase its level drops down.

C

B

A

Assembling the Ovitrap

• Cover the lower half of the bottle with the upper half

• The trap is now ready for placement .

Traps Designed by

our Laboratory

Adult Surveys

Landing/biting collection: Landing/biting collection of humans is a sensitive means of detecting low level

infestations of Ae aegypti, but are very labour intensive. Because adult males have low dispersal rates, their presence can be a reliable

indicator of clear proximity to hidden larvae habitats. It is usually expressed in terms of landing/biting counts per man hour.

Resting collection: During periods of inactivity, adult mosquitoes typically rest indoors, especially in

classrooms and mostly in dark places, such as laboratories and other sheltered sites.

Resting collection requires systematic searching of these sites for adult mosquitoes with the aid of flashlight.

Following a standard timed collection routine in selected rooms of schools, densities are recorded as the number of adults per school or number of adults per man hour of human efforts.

Oviposition traps Ovitraps are devices used to

detect the presence of Ae aegypti where the population density is low and larval surveys are largely unproductive (when the Breteau index is less than 5) as well as normal conditions.

The ovitrap is used for Ae aegypti surveillance in urban areas to evaluate the impact of adulticidal space spraying on adult female population.

Control Methods Status of Mosquitoes during 2012

Research and Development

Current Status• Establishment of Office at

IPH

• Hiring of Entomologists

• Research trials on susceptibility being initiated

• Research collaborations and discussions with foreign delegates at IPH and UAF

Dengue and the commitment of Punjab government

The epidemic of 2011 brought strong commitment and over a period of one year following improvements were made

Phase I– Use of Insecticides

• Fogging• IRS

Phase 2– Provincial policy– Development of strategic policy on urgent basis– Social mobilization (COMBI) – Intra-sectoral collaboration – Environmental concerns– Mechanical tactics– Vector understanding

• Biology• Ecology• Behavior

– Indices – Biological options – Chemicals

Government Commitment

Phase 3• Continuity of Phase 2• Advancement in Environmental friendly

approaches– Physical Barriers (Polydimethylsiloxane PDMS)– Bio-technologies

• Bacteria– Bti– W. b

• Fungus

– Predators• DNA Based

Town Aedes Culex Remarks Total samples collected

Fogging requested

Measures Taken

Iqbal Town Negative INDOOR Positive OUTDOOR VH 0/400 No

Aziz Bhatti Positive INDOOR Positive OUTDOOR Low VH 6/300 One street fogged MC+IRS

Data Gunj Positive INDOOR Positive OUTDOOR VH VH 5/275 One fogging on 6/3/2012

MC+IRS+Fogging

Gulberg Positive INDOOR Positive OUTDOOR Low VH Target fogging MC+IRS

Samanabad Positive INDOOR Positive OUTDOOR Low VH 7/200 No fogging MC+IRS

Shalamar Positive INDOOR Positive OUTDOOR Medium VH 8/320 No fogging MC+IRS

Wahga Positive INDOOR Positive OUTDOOR Low VH 5/320 No fogging MC+IRS

Ravi Positive INDOOR Positive OUTDOOR Low 4/300 No fogging MC+IRS

Nister Positive INDOOR L-M-H 15/300 Two fogging MC+IRS+ 1 Fogging on 3-3-2012+ Fogging

Status and Measures taken to prevent the spread of mosquitoes during the 2012

Population status of Aedes till May, 2012

Town Aedes Site Total samples collected

Sample Measures Taken

Water tank Remarks

E 1st 2nd 3rd 4th P A

Iqbal Town

Aziz Bhatti √ √ √ Indoor MC+IRS Plastic blue + fridge tray

Fogging in street

Data Gunj √ √ √ Indoor MC+IRS Plastic blue

Gulberg √ √ √ Indoor MC+IRS Plastic blue + cement tank

All drained

Samanabad 25 34 14 30 25 Indoor 2 dips IPH MC+IRS Plastic blue + money plant + fridge tray

Cleared

Shalamar √ √ √ Indoor + outdoor

MC+IRS Plastic blue +fridge tray + pitcher in Nan shop

Wahga √ √ √ Indoor MC+IRS Plastic + cemented

Ravi √ √ Indoor MC+IRS Plastic blue

Nister √ √ √ √ √ √ Indoor+ outdoor

MC+IRS Plastic blue + Bird drinking pot

Adults seen fogging in huts

Point of Concern

• Breeding sites detected indoor• Most may go undetected• Public showing negligence in clearing the

breeding spots• Plastic buckets most potential breeding spots

of Aedes aegypti

Impact of over night Rain• Indoor surveillance specially in areas where vector

breeding has been reported should be monitored and standing water must be removed from roof tops, water coolers and other sites

• Out door surveillance should closely monitor – tire shops– room cooler shops – bird feeding pots– Grave yards

Research lines and the developing

world

Future of vaccines

Biological lines

COMBI

Future of vaccines

• Stage one• Stage two• Stage 3• Stage 4

Biological Lines

• Larvivorous fish are recommended for control of Ae. aegypti in large water bodies or large water containers.

• Endotoxin-producing bacteria, Bacillus thuringiensis serotype H-14 (Bt H-14) has been found an effective mosquito control agent.

• Copepods• Stable Isotopes

Products and their status

Sr. # Product Name

Group Nature Physical nature

Action Company Price

1 Sumilarv Pyriproxyfen IGR Granular Molting inhibitor

Sumitomo $48/kg

2 Aquatain AMF Silicone based polymer

Polymer Liquid Physical barrier

Australian ????

3 Mousticide Mosquito protein +bacteria

TMOF-Bti Powder Starvation HIMONT ????

4 Bactivec Bacteria Bti Liquid Starvation Cuban Government

????

5 Dunk Bacteria Bti Solid Starvation Summit $2.8/dunk

6 Soil Conditioner Bacteria B. laterosporous

Granular Starvation Local ????

The following products from different companies were taken for laboratory studies and field evaluations

A WAY FORWARD

Test Results with Alternatesto Chemicals

Mosquito Dunks

Experiment at UAF

Application of DUNKS

Experiment at UAF

Application of DUNKS

A WAY FORWARD

Bactivec

• Bti and effective against Aedes and other mosquitoes

• Can be applied as aerial• Price not quoted • Sample under going

testing

Field Trials with Aquatain AMF

Sites • Classified both as Indoor and Out door

– Disposal tanks (1), – Tires (2), – Open garbage (3), – Hospital outlet (4), – Disposal areas of hospital’s (5) where most of

the hospitals used items were dumped are effective breeding sites of day time biting mosquitoes.

– Hedges around the homes (6), – kitchen nursery (7), – bins (8), – garage (9)

Parks and Temples

• This site generally included the mosquitoes from – old temples, – pools, – small dark caves – Vegetation– water reservoirs with

standing to flowing water.

Collection places

Bamboo stumps in houses

Automobile tyres kept inside the houses

Adult Trapping

• CDC miniature, bio-sentinal and magnetic light traps

• Traps with human clothing odors to attract the mosquitoes to the vicinity of the trap.

• Traps were placed 5-6 ft. off the ground on a tree branch in protected area.