Medicine

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Advances in Aedes mosquito vector control strategies using CRISPR/Cas9
(Springer, 2021) Wickramasinghe, P.D.S.U.; Silva, G.N.; Gunawardene, Y.I.N.S.; Dassanayake, R.S.
Advancements in genetic engineering have resulted in the development of mosquitoes with impaired vector competence, thereby limiting acquisition and transmission of pathogens. The main dengue (DENV) vector, Aedes aegypti, is an invasive species that have spread unwittingly across the world as a result of human trade and travel. The Ae. aegypti mosquito species has spread across tropical and subtropical regions, with higher presence in urban regions where rapid breeding patterns have shown in artificial containers. Identification of and treating an adequate number of mosquito breeding sites as a control measure have been done for the past couple of years, and yet improvement is far from the expectations, even with well-funded and well-organized initiatives. In order to stop the pathogen transmission, genetically modified mosquitoes (GMM) needs to be created and released. Despite many Aedes-related achievements, GMM creation has been challenging. The spread of particular genetic elements that impair vector competence, trigger deleterious recessive mutations, or skew a population's sex ratio can be used to prevent the spread of vector disease, or eradicate invasive organisms in a species-specific and eco-friendly manner. In recent years, genome editing strategies have evolved to make use of a variety of nucleases, ranging from sequence-specific zinc finger nucleases to modular TALENs (transcription activator-like effector nucleases) and most recently, RNA-guided nucleases adapted from bacterial adaptive immune systems, dubbed CRISPR/Cas (clustered regularly interspaced palindromic repeats/CRISPR associated systems). By combining these methods, a new era in gene editing had emerged. Generally, both of these gene editing technologies utilize sequence-specific nucleases to generate double-stranded DNA breaks (or nicks) in the target sequence, resulting in desired DNA modifications using endogenous DNA repair mechanisms. Since cells with DNA lesions are unable to divide further, the nuclease-generated strand breaks must be rapidly repaired by the cell to maintain the viability. CRISPR/Cas has been widely accepted for use in a variety of organisms, including insect species, with only minor optimization steps needed thus far. CRISPR/Cas9 technology transformed the process of engineering nucleases capable of cleaving complex genomic sequences. A complementary guide RNA (gRNA) directs the Cas9 endonuclease's operation to the specific DNA target site, enabling the editing of virtually any DNA sequence without complex protein engineering and selection procedures. Apart from genome editing, the specificity and flexibility of the CRISPR/Cas9 method enables unprecedented rapid development of genetically modified organisms with mutation systems for disease vector insect control. The stability and expression of the gene construct generated by CRISPR/Cas9 or any other method must be addressed before GMM are released, in order to make sure that pathogen transmission and formulation are interrupted robustly and completely. Spreading foreign antipathogen genes through gene drive strategies among wild mosquito populations strengthens the case for a more streamlined approach. Major fields that must be adequately assessed include risk evaluation and management, conducting studies to ensure human and environmental protection, developing effective control strategies built on comprehensive gene-driving systems, and adequately addressing the ethical, legal, and social consequences of GMM release. Although GMM is theoretically feasible as a disease control method, field releases should be made only when strong scientific evidence of human and environmental protection and effectiveness are presented, and public acceptance is addressed appropriately. This chapter discusses the diverse technological advances in generating Ae. aegypti mosquitoes which are resistant to dengue virus (DENV) and other diseases, as well as the biosafety and risk assessment of these procedures. Additionally, the chapter outlines a convincing path forward for developing successful genetic-based DENV control strategies based on CRISPR/Cas9, which could be expanded to control other arboviruses while maintaining biosafety.
Water quality characteristics of breeding habitats in relation to the density of Aedes aegypti and Aedes albopictus in domestic settings in Gampaha district of Sri Lanka
(Elsevier, 2022) Dalpadado, R.; Amarasinghe, D.; Gunathilaka, N.
In spite of the unavailability of measures to target dengue control in human populations, the promising way of combating the disease is by controlling vector mosquito larvae and their breeding habitats. Water quality characteristics of the breeding habitats of dengue vectors are among the crucial parameters that determine the female mosquito's oviposition and breeding. Therefore, a cross-sectional study was conducted to investigate the habitat characteristics of dengue vector mosquitoes by assessing the water quality of positive breeding habitats using the weighted arithmetic water quality index (WQI). The present study was conducted in domestic areas of the selected medical officer of health areas of the Gampaha district, Sri Lanka, from 2017 to 2019. Water quality characteristics of breeding habituations were measured and analyzed. The relationship between water quality parameters in breeding habitats with the occurrence of mosquito species was assessed using Kruskal-Wallis one-way analysis of variance, followed by pairwise comparison using Dunn's test and Mann-Whitney U test at a 5% level of significance. This study revealed that the temperature of Aedes mosquito breeding water ranged between 25.3 and 39.8 °C, and bred at temperatures as high as 39.8 °C in discarded receptacles. The results indicated that Ae. aegypti was prominent in alkaline water ranging between 7.5 and 8.5 pH, whereas Ae. albopictus was abundant in water with a pH range of 6.5-7.5. Both species of Aedes inhabited waters of low turbidity and TDS level. Ae. aegypti and Ae. albopictus immatures were prominent in water where TDS levels ranged between 250 and 350 ppm. The mean conductivity in the mosquito breeding water was recorded as 228.3 ± 63.9 µs/cm. The study revealed that Aedes mosquitoes could breed in water with a mean dissolved oxygen level of 6.9 ± 0.7 mg/L, ranging between 6.35 ± 1.09 mg/L and 7.28 ± 0.26 mg/L. The water quality indices were calculated for the eight previously identified breeding habitat categories of Aedes mosquitoes.
Breeding habitat distribution of medically important mosquitoes in Kurunegala, Gampaha, Kegalle, and Kandy districts of Sri Lanka and potential risk for disease transmission: A Cross-sectional study
(Hindawi Pub. Corp., 2020) Ranasinghe, K.; Gunathilaka, N.; Amarasinghe, D.; Udayanga, L.
ABSTRACT: Some arbovirus infections, especially dengue, have increased rapidly over the last few decades in Sri Lanka. Prevalence and distribution of different mosquito species have been limitedly documented, which remains grossly inadequate in providing evidence for potential health risks. In this study, the diversity and species composition of mosquitoes in four selected districts in Sri Lanka (Kurunegala, Gampaha, Kegalle, and Kandy) were investigated. Entomological surveys were conducted from a total of 160 temporary and permanent mosquito breeding habitats identified in the study area from June 2017 to October 2018. Mosquito immature stages were sampled using standard dipping, siphoning, or pipetting methods and identified up to the species level. Percentage relative abundance and habitat characteristics such as species richness, dominance, and Shannon-Weiner diversity were calculated for each surveyed habitat type. Associations between co-occurring species were estimated by Hulbert's coefficient of interspecific association (C8). A total of 4663 mosquito larvae belonging to seven genera and fifteen species of mosquitoes were collected. The relative distribution of mosquito species differed significantly among the four studied districts (X 2 = 143.248; df = 33; P < 0.001). According to Kruskal-Wallis statistics (P < 0.05 at 95% of significance), all diversity indices for immature stages of medically important mosquitoes varied significantly across different breeding sites. Paddy fields had the significantly highest species richness of 4.0 ± 2.82. The coefficients of interspecific association among all the recorded medically important vector mosquitoes were found negative during the present study. The findings of the current study would be useful to identify the entomological potential for disease transmission and facilitate the implementation of appropriate vector control interventions. This would ultimately provide an avenue to improve the personal skills of health staff rather than limiting their knowledge to specified disease vectors, under which the control program is concerned.
Aedes aegypti lines for combined sterile insect technique and incompatible insect technique applications: the importance of host genomic background
(Blackwell Publishing Ltd, 2020) Carvalho, D.O.; Torres-Monzon, J.A.; Koskinioti, P.; Wijegunawardana, N.D.A.D.; Liang, X.; Pillwax, G.; Xi, Z.; Bourtzis, K.
ABSTRACT: Aedes aegypti L. (Diptera: Culicidae), being the primary vector of pathogenic arboviruses, is a target for the development of novel genetic approaches to complement current conventional vector control strategies such as the combined sterile insect and incompatible insect technique (SIT/IIT). A transinfected line of Ae. aegypti carrying the wAlbB Wolbachia strain (WB2) was introgressed into two genomic backgrounds, Brazil and Mexico, producing two new Ae. aegypti strains (WB2-BRA and WB2-MEX). These strains were evaluated with respect to several life-history traits such as fecundity, fertility, longevity, pupa size, pupation curve, and male mating competitiveness, as well as their response to irradiation. Our results show that the impact of Wolbachia infection depends on the genomic background and that the Brazilian one had no significant effect, whereas the Mexican one negatively affected fertility, longevity, and pupal size. Interestingly, Wolbachia-infected Ae. aegypti lines required a lower irradiation dose to achieve complete female sterility than the uninfected ones. The present findings are discussed given the potential use of Wolbachia-infected Ae. aegypti lines in combined SIT/IIT population suppression programs.
Larval indices of vector mosquitoes as predictors of dengue epidemics: An approach to manage dengue outbreaks based on entomological parameters in the districts of Colombo and Kandy, Sri Lanka
(Hindawi Pub. Co., 2020) Udayanga, L.; Aryaprema, S.; Gunathilaka, N.; Iqbal, M. C. M.; Fernando, T.; Abeyewickreme, W.
BACKGROUND: Early detection of dengue epidemics is a vital aspect in control programmes. Predictions based on larval indices of disease vectors are widely used in dengue control, with defined threshold values. However, there is no set threshold in Sri Lanka at the national or regional levels for Aedes larval indices. Therefore, the current study aimed at developing threshold values for vector indices in two dengue high-risk districts in Sri Lanka. METHODS: Monthly vector indices (House Index [HI], Container Index [CI], Breteau Index for Aedes aegypti [BIagp], and Ae. albopictus [BIalb]), of ten selected dengue high-risk Medical Officer of Health (MOH) areas located in Colombo and Kandy districts, were collected from January 2010 to June 2019, along with monthly reported dengue cases. Receiver Operating Characteristic (ROC) curve analysis in SPSS (version 23) was used to assess the discriminative power of the larval indices in identifying dengue epidemics and to develop thresholds for the dengue epidemic management. RESULTS: Only HI and BIagp denoted significant associations with dengue epidemics at lag periods of one and two months. Based on Ae. aegypti, average threshold values were defined for Colombo as Low Risk (2.4 ≤ BIagp < 3.8), Moderate Risk (3.8 ≤ BIagp < 5), High Risk (BIagp ≥ 5), along with BIagp 2.9 ≤ BIagp < 4.2 (Low Risk), 4.2 ≤ BIagp < 5.3 (Moderate Risk), and BIagp ≥ 5.3 (High Risk) for Kandy. Further, 5.5 ≤ HI < 8.9, 8.9 ≤ HI < 11.9, and HI ≥ 11.9 were defined as Low Risk, Moderate Risk, and High Risk average thresholds for HI in Colombo, while 6.9 ≤ HI < 9.1 (Low Risk), 8.9 ≥ HI < 11.8 (Moderate Risk), and HI ≥ 11.8 (High Risk) were defined for Kandy. CONCLUSIONS: The defined threshold values for Ae. aegypti and HI could be recommended as indicators for early detection of dengue epidemics and to drive vector management activities, with the objective of managing dengue epidemics with optimal usage of financial, technical, and human resources in Sri Lanka.
Gene flow patterns among Aedes aegypti (Diptera: Culicidae) populations in Sri Lanka
(MDPI AG, 2020) Fernando, H.S.D.; Hapugoda, M.; Perera, R.; Black Iv, W.C.; de Silva, B.G.D.N.K.
ABSTRACT:In Sri Lanka, dengue is the most serious arboviral disease. Recent increases in dengue cases suggest a higher infection rate and spread of the disease to new areas. The present study explores gene flow patterns of Ae. aegypti, the main vector of dengue disease, among 10 collection sites including major ports and inland cities using variations at 11 microsatellite loci. Discriminant analysis of principal components (DAPC) and k-means clustering estimated eight genetic clusters. Analysis of Molecular Variance (AMOVA) estimated equal variances among cities and among collections in Colombo, Sri Lanka. Significant evidence, although weak, was detected for isolation by distance. Analysis of gene flow rates and directions using MIGRATE-n indicated that populations throughout the island served as a source of immigrants for Colombo with abundant gene flow among major commercial cities in Sri Lanka, which appear to receive migrant mosquitoes from throughout Sri Lanka. The observed patterns probably arise through human movement of Ae. aegypti during commerce from throughout Sri Lanka into Colombo increasing the risk of spread. The patterns uncovered in this study are significant for global health as Sri Lanka is situated along a key international shipping route. KEYWORDS: Aedes aegypti; Sri Lanka; gene flow patterns; population structure.
Use of mechanical and behavioural methods to eliminate female Aedes aegypti and Aedes albopictus for sterile insect technique and incompatible insect technique applications.
(BioMed Central, 2019) Gunathilaka, N.; Ranathunge, T.; Udayanga, L.; Wijegunawardana, A.; Gilles, J. R. L.; Abeyewickreme, W.
BACKGROUND:Sex separation of mosquitoes at different stages is currently being attempted to ensure the successful release of male mosquitoes in novel vector control approaches. Mechanical and behavioral techniques have been tried most frequently. METHODS: Batches of (n = 300) Aedes aegypti and Ae. albopictus pupae were used for standard sieving (using sieves with 1.12, 1.25, 1.40 and 1.60 mm mesh sizes) and the Fay-Morlan glass plate separation methods. Male and female separation by each method was calculated. For behavioral separation, a spiked blood meal with different concentrations (0, 2, 4, 6, 8 and 10 ppm) of ivermectin and spinosad (spinosyn, 12% w/v), were provided to a batch (n = 300) of adult Ae. aegypti and Ae. albopictus (1:1 sex ratio) followed by observation of mortality. An additional "double feeding method" involved provision of a further blood meal after 24 h, with the same concentrations of ivermectin and spinosad as the initial feeding, followed by a 48-h observation of mortality. All experiments were repeated five times. RESULTS: In the standard sieving method, the percentage of males and females separated at different pore sizes differed significantly (P < 0.05). The majority of the male pupae were collected in the 1.12 mm pore sized sieve for both Ae. aegypti (73%) and Ae. albopictus (69%) while females were retained mainly in the sieve with the pore size of 1.25 mm. In the Fay-Morlan glass plate separation, 99.0% of the Ae. aegypti and 99.2% of the Ae. albopictus introduced male pupae could be separated, but with female contaminations of 16 and 12%, respectively. Provision of a blood meal spiked with 8 ppm of ivermectin under the "double feeding" was identified as the most effective way of achieving 100% female elimination for both Aedes species. CONCLUSIONS: With 100% separation, use of a spiked blood meal is a more effective method of sex separation than the mechanical methods. Application of the spiked blood meal approach as a second separation level for sexes, after applying the Fay-Morlan glass plate method, could achieve 100% sex separation of sexes whilst allowing a reduction in the amount of toxicants required.
First report of V1016G and S989P knockdown resistant (kdr) mutations in pyrethroid-resistant Sri Lankan Aedes aegypti mosquitoes
(BioMed Central, 2018) Fernando, S.D.; Hapugoda, M.; Perera, R.; Saavedra-Rodriguez, K.; Black WC 4th; de Silva, N.K.; ; ;
BACKGROUND: Dengue is a serious arboviral disease in Sri Lanka with a large number of dengue fever (DF) cases every year. Control of the primary vector Aedes aegypti depends upon larval habitat source reduction and insecticide application. However, increases in the number of reported cases suggest the inefficiency of current control strategies and the possibility of resistance to currently used insecticides. Early detection of mutations in the voltage-gated sodium channel (vgsc) gene that confer knockdown resistance (kdr) to pyrethroid insecticides is important in resistance management in vector populations. RESULTS: Resistance to pyrethroid insecticides was detected in the three populations studied. Polymerase chain reaction was used to detect the presence of two kdr mutations F1534C and V1016G. During this process a S989P mutation was also detected in pyrethroid-resistant Ae. aegypti populations. These mutations were found to be widespread and frequent in the collections studied. CONCLUSIONS: To our knowledge, this study reveals for the first time the presence of V1016G and S989P mutant alleles in the vgsc of Sri Lankan Ae. aegypti populations. The spread of the mutant alleles throughout the country poses a threat of increased resistance to pyrethroids. Long-term insecticide applications and indiscriminate use of pyrethroids has led to the evolution of resistance. More strategic and diverse strategies, including novel insecticides with new modes of action and community participation, should be engaged for Ae. aegypti control.
A Statistical Approach to Define Thresholds for Dengue Epidemic Management in Akurana Medical Officer of Health Area, Kandy District of Sri Lanka
(19th Conference on Postgraduate Research, International Postgraduate Research Conference 2018, Faculty of Graduate Studies,University of Kelaniya, Sri Lanka, 2018) Udayanga, N.W.B.A.L.; Gunathilaka, P.A.D.H.N.; Iqbal, M.C.M.; Fernando, M.A.S.T.; Abeyewickreme, W.
Stegomyia indices, namely; Premise Index (PI), Breteau Index (BI) and Container Index (CI) are used forvector management approaches in Sri Lanka. Properly defined threshold values for larval indices are of higher importance to provide forecasts on dengue epidemics and also for effective larval management of dengue vectors. However, such critical thresholds are poorly defined for Sri Lanka. The present study aimed to define threshold values forabove larval indices for dengue epidemic management in the Akurana Medical Officer of Health (MOH) in the Kandy District. Larval surveys were conducted on a monthly basis from January, 2016 to June, 2018. Four larval indices, namely BI for Aedesaegypti (BIA) and Aedesalbopictus (BIB), PI and CI were calculated. Further, monthly larval indices of AkuranaMOH area from January, 2012 to December, 2015, were obtained from the MOH office, along with monthly reported dengue cases for the entire study period. Receiver Operating Characteristic (ROC) curves in SPSS (version 23) were used to assess the discriminative power of the larval indices in determiningdengue epidemics and thresholds based on larval indices. As indicated by the area of ROC curve (AUC), the BIA (0.661) and PI (0.637) were having a notable discriminative power to forecast dengue epidemics at a two-month lag period. Both BIB (0.397) and CI (0.526) were non-informative influencers at one and two-month lag periods. The BIA and PI were better predictors of dengue incidence than BIB and CI. Based on the ROC curve, three risk thresholds were defined for BIA as Low Risk (BIA≤2.1), Moderate Risk (3.9≤BIA<4.85), and High Risk (BIA≥4.85), with respect to Ae. aegypti. According to the PI, thresholds were defined as Low Risk (PI≤6.2), Moderate Risk (7.7≤ PI<9.9), and High Risk (PI≥ 9.9). Threshold values defined for BI of Ae. aegypti and PI, could be recommended to be considered in implementing vector control efforts in the above study area for effective dengue epidemic management, through pre planned entomological management of dengue vectors.
Empirical optimization of risk thresholds for dengue: an approach towards entomological management of Aedes mosquitoes based on larval indices in the Kandy District of Sri Lanka
(BioMed Central, 2018) Udayanga, L.; Gunathilaka, N.; Iqbal, M.C.M.; Najim, M.M.M.; Pahalagedara, K.; Abeyewickreme, W.
BACKGROUND: Larval indices such as Premise Index (PI), Breteau Index (BI) and Container Index (CI) are widely used to interpret the density of dengue vectors in surveillance programmes. These indices may be useful for forecasting disease outbreaks in an area. However, use of the values of these indices as alarm signals is rarely considered in control programmes. Therefore, the current study aims to propose threshold values for vector indices based on an empirical modeling approach for the Kandy District of Sri Lanka. METHODS: Monthly vector indices, viz PI, BI and CI, for Aedes aegypti and Aedes albopictus, of four selected dengue high risk Medical Officer of Health (MOH) areas in the Kandy District from January 2010 to August 2017, were used in the study. Gumbel frequency analysis was used to calculate the exceedance probability of quantitative values for each individual larval index within the relevant MOH area, individually and to set up the threshold values for the entomological management of dengue vectors. RESULTS: Among the study MOH areas, Akurana indicated a relatively high density of both Ae. aegypti and Ae. albopictus, while Gangawata Korale MOH area had the lowest. Based on Ae. aegypti, threshold values were defined for Kandy as low risk (BIagp > 1.77), risk (BIagp > 3.23), moderate risk (BIagp > 4.47) and high risk (BIagp > 6.23). In addition, PI > 6.75 was defined as low risk, while PI > 9.43 and PI>12.82 were defined as moderate and high risk, respectively as an average. CONCLUSIONS: Threshold values recommended for Ae. aegypti (primary vector for dengue) along with cut-off values for PI (for Ae. aegypti and Ae. albopictus), could be suggested as indicators for decision making in vector control efforts. This may also facilitate the rational use of financial allocations, technical and human resources for vector control approaches in Sri Lanka in a fruitful manner.

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