Assessing Interventions to Manage West Nile Virus Using Multi-Criteria Decision Analysis with Risk Scenarios

Abstract

The recent emergence of West Nile virus (WNV) in North America highlights vulnerability to climate sensitive diseases and stresses the importance of preventive efforts to reduce their public health impact. Effective prevention involves reducing environmental risk of exposure and increasing adoption of preventive behaviours, both of which depend on knowledge and acceptance of such measures. When making operational decisions about disease prevention and control, public health must take into account a wide range of operational, environmental, social and economic considerations in addition to intervention effectiveness. The current study aimed to identify, assess and rank possible risk reduction measures taking into account a broad set of criteria and perspectives applicable to the management of WNV in Quebec under increasing transmission risk scenarios, some of which may be related to ongoing warming in higher-latitude regions. A participatory approach was used to collect information on categories of concern to relevant stakeholders with respect to WNV prevention and control. Multi-criteria decision analysis was applied to examine stakeholder perspectives and their effect on strategy rankings under increasing transmission risk scenarios. Twenty-three preventive interventions were retained for evaluation using eighteen criteria identified by stakeholders. Combined evaluations revealed that, at an individual-level, inspecting window screen integrity, wearing light colored, long clothing, eliminating peridomestic larval sites and reducing outdoor activities at peak times were top interventions under six WNV transmission scenarios. At a regional-level, the use of larvicides was a preferred strategy in five out of six scenarios, while use of adulticides and dissemination of sterile male mosquitoes were found to be among the least favoured interventions in almost all scenarios. Our findings suggest that continued public health efforts aimed at reinforcing individual-level preventive behaviours combined with the application of larvicides to manage the risk of WNV infection are the interventions most acceptable and effective at reaching current management objectives now and under future theoretical transmission risk.

Analysis Of Preventive Measures for West Nile Virus

“…But the potential costs required for these interventions such as measures such as retrofitting sewers can be very costly and may have certain negative effects of other situations. The researchers confirm that individual interventions are consistent across studies, but that regional-level measures need to be analyzed on a case-by-case basis in outbreak areas [13].…”

A Rapid Literature Review of Multi-Criteria Decision Support Methods in the Context of One Health for All-Hazards Threat Prioritization

“…Seven (20%) studies included all three elements of our definition (14, 17, 24-28). Fewer studies (n = 4; 11%) met all three elements of our definition and included criteria or stakeholders from all three domains (18,(29)(30)(31). Only 2 studies (6%) met our One Health definition, reflected on all three domains, and acknowledged One Health as a driver for the study design (21,22).…”

Mosquitopia

“…Controlling these other vector mosquitoes therefore presents difficult challenges. Personal protection and prevention measures such as topical repellents are recommended along with larval control; controlling adults or releasing sterile males are not recommended against West Nile virus (Hongoh et al 2016, Campagna, Trudel and INSPQ 2018, CDC 2019b. Reduction of West Nile vectors by larvicides or adulticides often depends on mass spraying, a decidedly old-fashioned technique.…”

“…To complicate matters, some of these species are already resistant to insecticides, leaving their efficacy unproven in both reducing mosquito numbers and transmitting diseases , Dunbar et al 2018. Novel control methods need to be developed but the knowledge of these species is scarce, leaving the first-line strategy one of heightening people's awareness of using personal protections and developing efficient surveillance tools (Kading et al 2020, Hongoh et al 2016, Lindsey et al 2020.…”