Overview

The health security of the Caribbean Region is threatened by the burden of Vector Borne Diseases (VBDs). The tropical environment, migration of both human and animals and climate change have influenced the spread and distribution of disease carrying vectors. Due to the interaction of various ecological, biological and social factors, prevention and control measures are extremely complicated and involve multisectoral approaches to produced desired outcomes. The challenge of limited resources has curtailed VBD diagnosis, surveillance, control and research.

Mosquito borne diseases such as Dengue, have spread throughout the Americas, resulting in high levels of morbidity, creating an added burden on health systems in the Region. Dengue epidemics cycle between 3 – 10 years in the Caribbean.

In December 2013, Chikungunya was first detected on the island of Saint-Martin and within one year expanded to all countries in the Caribbean region, with thousands of cases and chronic arthritic sequelae. The main initial epidemic is largely over, but the long-term impact on disability levels in the population is unknown. The Zika outbreak of 2016 was associated with reported cases of unexpected neurological complications, such as microcephaly in newborns and Guillain-Barré Syndrome (GBS). Some countries do not have the health system capacity in place to adequately respond to outbreaks such as these and address the possible long-term effects of the associated neurological sequelae.

Small Island Developing States (SIDS) within the Caribbean are particularly susceptible to the effects of climate change. Storms of greater frequency and severity have occurred over the last several years within the region with devastating effects. The aftermath of such storms result in flooding, which contributes both to an increase in mosquito borne diseases, as well as, leptospirosis.

Vector Borne Disease Strategy

AIM: To reduce the morbidity and mortality associated with VBDs by strengthening regional and national capacity for disease detection, prevention and control of key vectors.

CARPHA’s strategic approach to the prevention and control of VDBs is based primarily on the foundations for Integrated Vector Management (IVM), which involves multi-sectoral approaches geared towards improving human health. The strategy centres on six main areas including:

• Intersectoral coordination and collaboration (e.g. Health, Tourism, Agriculture, Education); advocacy, social mobilisation, and empowerment of communities
• Integration of chemical and non-chemical methods of vector control
• Evidence based decision making using data gathered from epidemiological and entomological surveillance
• Building of workforce development capacity in IVM
• Integration of climate change into disease surveillance outbreak prevention and control

Integrated surveillance within CARPHA

VBD surveillance cross cuts three other main areas within CARPHA: Laboratory; Communicable Diseases/Emergency response and Environmental Health (St. Lucia CARPHA Campus). These areas work in conjunction to execute a holistic, integrated strategy for gathering the relevant data for action that speaks to prevention and control measures and policy. The work of the VBD Unit falls primarily under the CARPHA strategic Priority Area 2 (Safe and Health Environments), but spreads across all remaining 5 priority areas.

VBD Integrated Surveillance Approach

Vector Borne Disease Unit – Staff Structure