The role of surveillance in interventions directed against Vector-Borne disease

To analyze the contribution of epidemiological surveillance to the sustaina bility of public health interventions, programs designed to suppress preval ence of vector-borne infections are contrasted with those aiming to contain outbreaks of such agents of disease. Suppression programs apply insecticid es or drugs according to a predetermined plan, employing surveillance solel y for evaluating progress. Containment programs, in contrast, react to epid emiological indicators. Although efforts to suppress prevalence should be t ime-limited, reactive programs may be indefinitely sustainable. Alternative epidemiological bases for surveillance are described, including indicators for the basic reproduction number of infections, vectorial capacity, reser voir capacity, entomological inoculation rates (EIR), and transmission indi ces (TI) based on experience. Although risk of human infection is most reli ably estimated as a function of the EIR, interventions are most frequently guided by TI estimates. Because they invest in surveillance rather than app lication of insecticides or drugs, containment efforts are more sustainable and more conducive to ecosystem health than are programs designed to suppr ess transmission.