Arbovirus Prediction and Mitigation in the Indo-Pacific

Project Summary / Abstract Dengue, a potentially life-threatening disease, has increased 30-fold in the last 50 years. In Indonesia, 1 in 3 children have had a dengue infection by 5 years old. Islands in the Indo-Pacific are highly vulnerable to climate change and water insecurity, two key drivers of arbovirus spread. Predicting and mitigating arbovirus transmission in the Indo-Pacific is critical to addressing the increasing risk of arboviruses in the U.S. In the next several decades, half the U.S. may have habitat suitable for Aedes aegypti and Ae. albopictus, mosquitos which spread dengue, chikungunya, Zika, and yellow fever viruses. Revitalizing Informal Settlements and their Environments (RISE) is a cluster randomized control trial evaluating the benefits of upgrading local water infrastructure in urban slums in Indonesia and Fiji. The RISE intervention is a prototype for future slum upgrading to address climate change and water insecurity throughout the Indo- Pacific. Although the World Health Organization recommends permanent environmental modification as an arbovirus control strategy, this has never before been rigorously tested. RISE provides an important opportunity to evaluate whether this model decreases or inadvertently increases arbovirus transmission. In addition to evaluating a new paradigm for mitigating arbovirus transmission, RISE is an ideal platform to assess gaps in knowledge about environmental drivers of arbovirus transmission. My hypothesis is that modifiable environmental conditions drive arbovirus transmission in these communities. To test this hypothesis, I will leverage the RISE platform to study arbovirus risk factors in this region and evaluate the impact of permanent environmental modification on arbovirus transmission in urban slums. I will also create a mathematical model to simulate arbovirus transmission in this region under a range of climate change and intervention scenarios. I have developed a customized career development plan that aligns with my proposed research. It incorporates both formal and informal training under the mentorship of Drs. LaBeaud and Luby. This training plan draws upon my existing expertise in global health, tropical medicine, and epidemiology; it will enhance my expertise in laboratory diagnostics, geospatial analysis, and mathematical modeling. The planned didactics and technical training included here will provide the foundation necessary to achieve my goal of becoming an academic physician focused on mitigating the spread of infectious diseases in the era of climate change.