Whose Job Is It Anyway? An Analysis of Views on Responsibility of Vector Control and Hotspots of Acceptance of Wolbachia Suppression Among Communities Organized to Prevent Arboviruses (COPA) Study Participants in Ponce, Puerto Rico Open Access

Abstract

Background: Dengue is one of the world’s most widespread arthropod-borne viral (arboviral) diseases, endemic in more than 100 countries. An estimated 390 million dengue infections occur every year. In the search for a sustainable vector control mechanism, scientists identified a way to reduce Aedes mosquito populations by introducing Wolbachia, a naturally occurring endosymbiotic bacterium. Community engagement for novel vector control methods is crucial to gain support for long term success of the intervention.

Methods: Communities Organized to Prevent Arboviruses (COPA) is a community-based cohort study being conducted by the CDC Dengue Branch, the Puerto Rico Vector Control Unit and Ponce Health Sciences University to evaluate acceptability, feasibility and impact of a novel vector control method while conducting disease and vector surveillance in Ponce, Puerto Rico. The COPA knowledge, attitudes, and practices (KAP) survey asked about perceived risk and burden of arboviral disease, personal investment, and vector control practices. A subset of participants was provided an explanation of novel vector control methods including Wolbachia suppression and surveyed on their acceptance of the techniques. In this report, these factors will be assessed for association with acceptance of the Wolbachia suppression. Additionally, the thirty-eight community clusters will be analyzed to identify different levels of acceptance.

Results: With an overall baseline participant response rate of 74%, a total of 1,357 eligible COPA participants between 21-50 years of age provided responses to the KAP and novel vector control method acceptance surveys. Of the participants, 36.9% were male and 63.1% were female. A total of 922 (67.9%) respondents expressed acceptance of the Wolbachia suppression program. Of the thirteen variables tested, annual income and repellant use were found to have a statistically significant association with acceptance. Those with an income of $40,000 or above were 1.13 times as likely [95% CI: 1.03, 1.23] to accept Wolbachia suppression than those who earned less than $40,000 annually.  Those who reported repellant use were 1.09 times as likely to be accepting of Wolbachia suppression [95% CI: 1.01, 1.18]. No significant hot or cold spots for acceptance of this intervention were detected in the cluster analysis.

Table of Contents

Introduction ………………………………………………………………………. 1

Dengue as a Global Problem ................................................................................ 1

Aedes Mosquitoes ................................................................................................  1

Climate Change and Mosquitoes ………………………………………………. 3

Vector Control Methods: Past, Present and Future ……………………………. 4

Puerto Rico’s Arbovirus History and Controversy Over Vector Control …….... 5                                            

Communities Organized to Prevent Arboviruses …………………………….... 6

  Methods ...…………………………………………………………………………. 9

           Demographic/ KAP Variables…………………………………………………… 9

           Acceptance of Wolbachia Suppression by Community Cluster…………………13

Results ….…….…………………………………………………………………... 14

 Discussion .……………………………….……………………………………….. 20

Table 1 …………………………….……………………………………………… 23

Table 2 …………………………….……………………………………………… 24

Figure 1 ……………………………..…………………………………………….. 25

Appendix A ..……………………….…………………………………………….. 26

       References ……...…...……………………………………………………………..29

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School	Rollins School of Public Health
Department	Epidemiology
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology
Keyword	Vector Control Puerto Rico
Committee Chair / Thesis Advisor	Kenneth Castro, MD, Emory University
Committee Members	Laura Adams, DVM, CDC
Partnering Agencies	CDC

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