Review of measures to control Chikungunya virus
A systematic review of individual and community mitigation measures for prevention and control of chikungunya virus. Hierlihy C*, Waddell L*, Young I, Greig J*, Corrin T*, Mascarenhas M*. PLoS One 2019 Feb 27; 14(2):e0212054. doi: https://doi.org/10.1371/journal.pone.0212054
This science story examines the collaborative work for a systematic review on Chikungunya virus (CHIKV). The research provides insight on the mitigation and prevention for a serious public health threat transmitted by mosquitos. Effective strategies to avoid these types of vector-borne diseases are becoming more important as the global public health community prepares for the potential range expansion of disease vectors due to the effects of climate change.
What was known about this area prior to your work, and why was the research done?
Chikungunya is a mosquito-borne virus causing human illness. Fever and joint pain are the most common symptoms but some cases can result in persistent joint pain lasting months, or even years. Often symptoms are mild and infections go unrecognized. CHIKV, endemic to parts of Asia and Africa, has caused several major epidemics globally over the last two decades. And in 2013 the virus spread to the Americas and islands in the Caribbean for the first time. As there is no vaccine available against CHIKV, the best protection against infection relies on personal protective measures and community level interventions, such as vector control. A systematic review was conducted to summarize which individual and community level prevention and control strategies have been investigated and which are most effective to prevent and control the transmission of CHIKV.
What are your most significant findings from this work?
The systematic review identified 81 relevant articles which examined individual and community mitigation measures and their effectiveness in the prevention of Chikungunya infections. Six mitigation categories were studied: behavioural protective measures (i.e. removal of stagnant water, wearing long clothes to avoid mosquito bites, using repellants, using bed nets and window screens in homes), insecticide use, public education, biological control of vectors, quarantine of infected individuals, and control of blood and blood products. Studies were highly variable and often did not measure outcomes that could be used to evaluate if the intervention studied was effective. Across all categories, only insecticide use in and around homes or affected areas had a consistent, protective effect. This is not to say that other mitigation measures are not effective, but they require additional research to improve our knowledge of what combination offers the most effective protection against exposure to CHIKV.
What are the implications or impact of the research?
The systematic review underlined the need for further research to assess the effectiveness of the various mitigation strategies presented. Evidence to support which mitigation measures, or combination of mitigation measures are the most effective at protecting against exposure to CHIKV will aid public health officials in designing effective education and vector control programs to reduce the risk of local CHIKV transmission. A reduction of local CHIKV transmission would also decrease the risk of importing CHIKV to new areas through infected travellers.
Additional References of Significance:
- Mascarenhas M*, Garasia S*, Berthiaume P*, Corrin T*, Greig J*, Ng V*, Young I, Waddell L*. A scoping review of published literature on chikungunya virus. PLoS ONE 2018 2018 Nov 29; 13(11):e0207554. doi: https://doi.org/10.1371/journal.pone.0207554
- Corrin T*, Waddell L*, Greig J*, Young I, Hierlihy C*, Mascarenhas M*. Risk perceptions, attitudes, and knowledge of chikungunya among the public and health professionals: a systematic review. Trop Med Health 2017 Sep 4; 45(21). doi: https://doi.org/10.1186/s41182-017-0061-x
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