Criteria for the prioritization of public health interventions for climate-sensitive vector-borne diseases in Quebec

PLoS One. 2017 Dec 27;12(12):e0190049. doi: 10.1371/journal.pone.0190049. eCollection 2017.

Abstract

Prioritizing resources for optimal responses to an ever growing list of existing and emerging infectious diseases represents an important challenge to public health. In the context of climate change, there is increasing anticipated variability in the occurrence of infectious diseases, notably climate-sensitive vector-borne diseases. An essential step in prioritizing efforts is to identify what considerations and concerns to take into account to guide decisions and thus set disease priorities. This study was designed to perform a comprehensive review of criteria for vector-borne disease prioritization, assess their applicability in a context of climate change with a diverse cross-section of stakeholders in order to produce a baseline list of considerations to use in this decision-making context. Differences in stakeholder choices were examined with regards to prioritization of these criteria for research, surveillance and disease prevention and control objectives. A preliminary list of criteria was identified following a review of the literature. Discussions with stakeholders were held to consolidate and validate this list of criteria and examine their effects on disease prioritization. After this validation phase, a total of 21 criteria were retained. A pilot vector-borne disease prioritization exercise was conducted using PROMETHEE to examine the effects of the retained criteria on prioritization in different intervention domains. Overall, concerns expressed by stakeholders for prioritization were well aligned with categories of criteria identified in previous prioritization studies. Weighting by category was consistent between stakeholders overall, though some significant differences were found between public health and non-public health stakeholders. From this exercise, a general model for climate-sensitive vector-borne disease prioritization has been developed that can be used as a starting point for further public health prioritization exercises relating to research, surveillance, and prevention and control interventions in a context of climate change. Multi-stakeholder engagement in prioritization can help broaden the range of criteria taken into account, offer opportunities for early identification of potential challenges and may facilitate acceptability of any resulting decisions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Climate*
  • Disease Vectors*
  • Focus Groups
  • Humans
  • Pilot Projects
  • Public Health Practice*
  • Quebec

Grants and funding

The Quebec institute for Public Health research provided facilities for stakeholder meetings. The Public Health Agency of Canada provided funding to cover meeting facility and travel cost of participants for focus group discussions in the context of a separate, concurrent study on West Nile virus. VH is funded by the Canadian Institutes of Health Research, Ouranos Consortium for research in climatology and adaptation to climate change and the Strategic Training Program in Global Health Research, a partnership of the Canadian Institutes of Health Research and the Quebec Population Health Research Network. This project is also nested within the Initiative de Recherche Internationale sur l'Adaptation aux Changements Climatiques - Faire-face Aux Changements Ensemble program funded by the International Development Research Centre, Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada and Social Sciences and Humanities Research Council from Canada. The funding sources had no involvement in the actual research or preparation of the paper.