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Abstract Background The exotic invasive tiger mosquito, Aedes albopictus, appeared in southern Switzerland in 2003. The spread of the mosquito has been surveyed constantly since then, and an integrated vector management (IVM) has been implemented to control its numbers. The control measures focus on the aquatic phase of the mosquito with removal of breeding sites and applications of larvicides in public areas whereas private areas are reached through extensive public information campaigns. Here, we evaluated the efficacy of the IVM. Methods Since all the municipalities with Ae. albopictus in southern Switzerland are currently implementing the IVM, Italian municipalities just across the Swiss-Italian border, where Ae. albopictus is present but no coordinated intervention programme is in place, served as control. Ovitraps and adult female traps were used to measure mosquito abundance in 2019. Generalised mixed-effects models were used to model the numbers of Ae. albopictus eggs and adult females collected. These numbers of Ae. albopictus eggs were compared to the numbers of eggs collected in 2012 and 2013 in a previous assessment of the IVM, using a hurdle model. Results Mean numbers of Ae. albopictus eggs and adult females in 2019 were consistently higher in the municipalities not following an IVM programme. In these municipalities, there were about four times (3.8) more eggs than in the municipalities implementing an IVM programme. Also, the numbers of eggs and adult females increased steadily from the beginning of the Ae. albopictus reproductive season, reaching a peak in August. In contrast, the increase in numbers of Ae. albopictus was much more contained in the municipalities implementing an IVM programme, without reaching an evident peak. Comparison with data from 2012 and 2013 indicates that the gap between intervention and non-intervention areas may have almost doubled in the past 6 years. Conclusions The results of the survey strongly support the efficacy of the IVM programme implemented in southern Switzerland compared to municipalities without defined control measures. With the constant implementation of an IVM, it appears possible to contain the numbers of Ae. albopictus at a manageable level, reducing the nuisance for the human population and the risk of arbovirus epidemics. Graphical Abstract

Background: The exotic invasive tiger mosquito, Aedes albopictus, appeared in southern Switzerland in 2003. The spread of the mosquito has been surveyed constantly since then, and an integrated vector management (IVM) has been implemented to control its numbers. The control measures focus on the aquatic phase of the mosquito with removal of breeding sites and applications of larvicides in public areas whereas private areas are reached through extensive public information campaigns. Here, we evaluated the efficacy of the IVM. Methods: Since all the municipalities with Ae. albopictus in southern Switzerland are currently implementing the IVM, Italian municipalities just across the Swiss-Italian border, where Ae. albopictus is present but no coordinated intervention programme is in place, served as control. Ovitraps and adult female traps were used to measure mosquito abundance in 2019. Generalised mixed-effects models were used to model the numbers of Ae. albopictus eggs and adult females collected. These numbers of Ae. albopictus eggs were compared to the numbers of eggs collected in 2012 and 2013 in a previous assessment of the IVM, using a hurdle model. Results: Mean numbers of Ae. albopictus eggs and adult females in 2019 were consistently higher in the municipalities not following an IVM programme. In these municipalities, there were about four times (3.8) more eggs than in the municipalities implementing an IVM programme. Also, the numbers of eggs and adult females increased steadily from the beginning of the Ae. albopictus reproductive season, reaching a peak in August. In contrast, the increase in numbers of Ae. albopictus was much more contained in the municipalities implementing an IVM programme, without reaching an evident peak. Comparison with data from 2012 and 2013 indicates that the gap between intervention and non-intervention areas may have almost doubled in the past 6 years. Conclusions: The results of the survey strongly support the efficacy of the IVM programme implemented in southern Switzerland compared to municipalities without defined control measures. With the constant implementation of an IVM, it appears possible to contain the numbers of Ae. albopictus at a manageable level, reducing the nuisance for the human population and the risk of arbovirus epidemics. [ABSTRACT FROM AUTHOR]

Abstract Background Schistosomiasis is a chronic disease linked to poverty and is widely endemic, particularly in sub-Saharan Africa. For decades, the World Health Organization has called for a larger role of the primary health care system in schistosomiasis control, and its integration within the routine activities of primary health care facilities. Here, we reviewed existing studies on the integration of schistosomiasis control measures within the primary health care system, more precisely at the health centre, and we analysed their outcomes. Methods An online search of studies published via PubMed and Embase databases was carried out until December 2017. Keywords were used to identify articles related to the integration of schistosomiasis control within the primary health care system, especially at the health centre level. Studies on integration of the following control measures were included: diagnosis and treatment, supplemented or not with (i) health education; (ii) snail control; and (iii) clean water supply and sanitation. A qualitative review was undertaken. To conclude on the effectiveness of an intervention, intermediate outcomes (knowledge, attitude and practice, coverage, access to health care) and distal outcomes (prevalence, incidence, mortality) were considered, and pre/post-intervention results were compared. Results Of 569 records found, 11 met the inclusion criteria. Studies were classified in three groups, according to the control measures they included. Integration of diagnosis and treatment, and health education in the first group resulted in an improvement of knowledge level of care providers, access to health care and health care seeking behaviour of the community. However, no positive effect was observed on the knowledge level of symptoms and modes of transmission at the community level. Most studies in the second group (with snail control as additional measure) and the third group (with clean water supply and sanitation as additional measure) showed a positive effect on schistosomiasis prevalence and incidence post-intervention, independent of the additional control measures implemented. Conclusions The results of this review suggest a positive impact of integration of schistosomiasis control within the primary health care system. However, more robust studies are needed, especially in resource-limited regions, for conclusive evidence on the effectiveness and the sustainability of this strategy.

Abstract Background In Ticino, a canton located south of the Alps in Switzerland, a surveillance programme on Aedes albopictus (Stegomyia albopicta) started in 2000 seeing that the region was considered at high risk of introduction based on the rapid spread of this mosquito in neighbouring Italy. Methods The surveillance programme, which is still ongoing, was adapted continuously to handle preventive measures of arrival, dispersal and establishment of this invasive species. The monitoring was based on ovitraps supported by reports from the population. The integrated control measures included removal of breeding sites, larvicide applications with Bacillus thuringiensis israelensis or diflubenzuron and, in some circumstances, adulticide applications with permethrin. These measures involved citizens, municipalities and Civil Protection Units. Results Ae. albopictus was first observed in 2003 in Ticino. We describe the strategies adopted and their adaptations to the evolving problem since year 2000. The approach used allowed keeping the mosquito densities at tolerable levels and below the threshold of autochthonous Ae. albopictus borne disease transmission. During the surveillance period, new typologies of breeding sites for Ae. albopictus have been discovered. Conclusions It was worth tackling the arrival of Ae. albopictus and adopting immediate control measures, followed by regular control measures after its establishment. Early intervention and prevention of the possible spread of the tiger mosquito over the territory avoided facing a crisis situation. This also reduced the difficulty of managing the situation and probably also reduced the overall cost if this had not been put in place.

Background: In Ticino, a canton located south of the Alps in Switzerland, a surveillance programme on Aedes albopictus (Stegomyia albopicta) started in 2000 seeing that the region was considered at high risk of introduction based on the rapid spread of this mosquito in neighbouring Italy. Methods: The surveillance programme, which is still ongoing, was adapted continuously to handle preventive measures of arrival, dispersal and establishment of this invasive species. The monitoring was based on ovitraps supported by reports from the population. The integrated control measures included removal of breeding sites, larvicide applications with Bacillus thuringiensis israelensis or diflubenzuron and, in some circumstances, adulticide applications with permethrin. These measures involved citizens, municipalities and Civil Protection Units. Results: Ae. albopictus was first observed in 2003 in Ticino. We describe the strategies adopted and their adaptations to the evolving problem since year 2000. The approach used allowed keeping the mosquito densities at tolerable levels and below the threshold of autochthonous Ae. albopictus borne disease transmission. During the surveillance period, new typologies of breeding sites for Ae. albopictus have been discovered. Conclusions: It was worth tackling the arrival of Ae. albopictus and adopting immediate control measures, followed by regular control measures after its establishment. Early intervention and prevention of the possible spread of the tiger mosquito over the territory avoided facing a crisis situation. This also reduced the difficulty of managing the situation and probably also reduced the overall cost if this had not been put in place. [ABSTRACT FROM AUTHOR]