The prevalence of diseases borne by mosquitoes, particularly in the genus Aedes, is rising worldwide. This has been attributed, in part, to the dramatic rates of contemporary urbanization. While Aedes-borne disease risk varies within and between cities, few investigations use urban science-based approaches to examine how city structure and function contribute to vector or pathogen introduction and maintenance. Here, we integrate theories from complex adaptive systems, landscape ecology and urban geography to develop an urban systems framework for understanding Aedes-borne diseases. The framework establishes that cities comprise hierarchically structured patches of different land uses and characteristics. Properties of the patches (that is, composition) determine localized disease risk, while configuration and connectivity drive emergent patterns of pathogen spread. Complexity is added by incorporating individual and collective human social structures, considering how feedbacks among social actors and with the landscape drive risk and transmission. We discuss how these concepts apply to case studies of Aedes-borne disease from around the world. Ultimately, the framework strengthens existing theoretical and mixed qualitative-quantitative approaches, and advances considerations of how interventions including urban planning (for example, piped water provisioning) and emerging vector control strategies (for example, Wolbachia-infected mosquitoes) can be implemented to prevent and control the rising threat of Aedes-borne diseases.
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