A novel entomological index, Aedes aegyptiBreeding Percentage, reveals the geographical spread of the dengue vector in Singapore and serves as a spatial risk indicator for dengue

Janet Ong,
Xu Liu,
Jayanthi Rajarethinam,
Grace Yap,
Derek Ho and
Lee Ching NgEmail author

Parasites & Vectors201912:17

https://doi.org/10.1186/s13071-018-3281-y

Received: 9 August 2018
Accepted: 27 December 2018
Published: 8 January 2019

Abstract

Background

Aedes aegypti is an efficient primary vector of dengue, and has a heterogeneous distribution in Singapore. Aedes albopictus, a poor vector of dengue, is native and ubiquitous on the island. Though dengue risk follows the dispersal of Ae. aegypti, the spatial distribution of the vector is often poorly characterized. Here, based on the ubiquitous presence of Ae. albopictus, we developed a novel entomological index, Ae. aegypti Breeding Percentage (BP), to demonstrate the expansion of Ae. aegypti into new territories that redefined the dengue burden map in Singapore. We also determined the thresholds of BP that render the specific area higher risk of dengue transmission.

Methods

We performed analysis of dengue fever incidence and Aedes mosquito breeding in Singapore by utilizing island-wide dengue cases and vector surveillance data from 2003 to 2013. The percentage of Ae. aegypti breeding among the total Aedesbreeding habitats (BP), and the reported number of dengue fever cases in each year were calculated for each residential grid.

Results

The BP of grids, for every year over the 11-year study period, had a consistent positive correlation with the annual case counts. Our findings suggest that the geographical expansion of Ae. aegypti to previously “non-dengue” areas have contributed substantially to the recent dengue fever incidence in Singapore. Our analysis further indicated that non-endemic areas in Singapore are likely to be at risk of dengue fever outbreaks beyond an Ae. aegypti BP of 20%.

Conclusions

Our analyses indicate areas with increasing Ae. aegypti BP are likely to become more vulnerable to dengue outbreaks. We propose the usage of Ae. aegypti BP as a factor for spatial risk stratification of dengue fever in endemic countries. The Ae. aegypti BP could be recommended as an indicator for decision making in vector control efforts, and also be used to monitor the geographical expansion of Ae. aegypti.