Int J Health Geogr - Spatially explicit multi-criteria decision analysis for managing vector-borne diseases.


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The complex epidemiology of vector-borne diseases creates significant challenges in the design and delivery of prevention and control strategies, especially in light of rapid social and environmental changes. Spatial models for predicting disease risk based on environmental factors such as climate and landscape have been developed for a number of important vector-borne diseases. The resulting risk maps have proven value for highlighting areas for targeting public health programs. However, these methods generally only offer technical information on the spatial distribution of disease risk itself, which may be incomplete for making decisions in a complex situation. In prioritizing surveillance and intervention strategies, decision-makers often also need to consider spatially explicit information on other important dimensions, such as the regional specificity of public acceptance, population vulnerability, resource availability, intervention effectiveness, and land use. There is a need for a unified strategy for supporting public health decision making that integrates available data for assessing spatially explicit disease risk, with other criteria, to implement effective prevention and control strategies. Multi-criteria decision analysis (MCDA) is a decision support tool that allows for the consideration of diverse quantitative and qualitative criteria using both data-driven and qualitative indicators for evaluating alternative strategies with transparency and stakeholder participation. Here we propose a MCDA-based approach to the development of geospatial models and spatially explicit decision support tools for the management of vector-borne diseases. We describe the conceptual framework that MCDA offers as well as technical considerations, approaches to implementation and expected outcomes. We conclude that MCDA is a powerful tool that offers tremendous potential for use in public health decision-making in general and vector-borne disease management in particular.

Resumo Limpo

complex epidemiolog vectorborn diseas creat signific challeng design deliveri prevent control strategi especi light rapid social environment chang spatial model predict diseas risk base environment factor climat landscap develop number import vectorborn diseas result risk map proven valu highlight area target public health program howev method general offer technic inform spatial distribut diseas risk may incomplet make decis complex situat priorit surveil intervent strategi decisionmak often also need consid spatial explicit inform import dimens region specif public accept popul vulner resourc avail intervent effect land use need unifi strategi support public health decis make integr avail data assess spatial explicit diseas risk criteria implement effect prevent control strategi multicriteria decis analysi mcda decis support tool allow consider divers quantit qualit criteria use datadriven qualit indic evalu altern strategi transpar stakehold particip propos mcdabas approach develop geospati model spatial explicit decis support tool manag vectorborn diseas describ conceptu framework mcda offer well technic consider approach implement expect outcom conclud mcda power tool offer tremend potenti use public health decisionmak general vectorborn diseas manag particular

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