As members of the E4Warning consortium, Gina Tsarouchi, Quillon Harpham (HR Wallingford), Lyra Tyson (UPF), and Remy Hoek Spaans (BSC) traveled to Sri Lanka in November to participate in a workshop organized by Dr. Lahiru Kodithuwakku and Gina Tsarouchi. The event, in collaboration with the National Dengue Control Unit (NDCU) and the Ministry of Health, focused on enhancing innovative tools for dengue prediction and control.

The workshop aimed to train participants in using the D-MOSS platform, a live dengue forecasting system combining satellite earth observation data, climate models, and statistical tools to provide probabilistic forecasts of dengue outbreaks. It also served as a valuable opportunity to adapt the methods to Sri Lanka’s unique public health context, informed by input from local professionals.

Bringing Together Experts from Across Sri Lanka

The workshop attracted over 80 participants from districts across the country, including entomologists, regional epidemiologists, medical officers of health, academics, NGOs, and representatives from the NDCU. This diverse group ensured that the discussions were enriched with practical insights and multidisciplinary expertise.

Dr. Preshila Samaraweera kicked off the workshop with an informative presentation on Sri Lanka’s progress in dengue control, highlighting current research projects and interventions. This set the stage for the D-MOSS training sessions, where participants had hands-on opportunities to test the system and provide feedback.

Training, Feedback, and Collaboration

The D-MOSS platform was well-received, with participants exploring its ability to visualize past, current, and forecasted dengue trends. One participant noted:

“These elements collectively offer a comprehensive view of past, present, and predicted dengue trends, supporting proactive planning and response.”

Following a lunch break, attendees learned about the statistical modeling methods used in E4Warning, with a focus on interpreting probabilistic forecasts. A group discussion then explored ways to enhance the dengue early warning system, including the integration of new data sources such as mobility patterns and socio-economic data. The day concluded with a presentation on the Mosquito Alert platform, sparking a lively conversation about how citizen science could contribute to vector control in Sri Lanka.

Lessons Learned and Next Steps

Reflecting on two intensive days of learning, several valuable lessons emerged from the experience. As highlighted during the workshop discussions, effective dengue control—particularly larval source management—requires a multi-sectoral approach. For example, Aedes mosquitoes often breed in artificial containers that fall under the responsibility of different sectors, such as road maintenance crews for potholes or port authorities for harbor areas.

Another critical area for improvement is the integration of entomological data into a digital infrastructure. Currently, much of this data is collected on paper, limiting its accessibility and use for coordinated control efforts. Digitizing these records would enhance monitoring, analysis, and intervention strategies.

Additionally, dengue prediction models could be further refined by incorporating mobility patterns and socio-economic census data, offering a more comprehensive understanding of how the disease spreads and where interventions could be most effective.

By continuously enhancing the digital tools developed through the E4Warning project, we aim to support the Sri Lankan National Dengue Control Unit (NDCU) in achieving its ambitious goals for dengue control and prevention.

Our partner and WP leader, Rachel Lowe, ICREA Research Professor and Global Health Resilience (GHR) Group Leader at the Barcelona Supercomputing Center (BSC), was recently interviewed by HERA (Health Emergency Preparedness and Response Authority) and featured on their website: https://ec.europa.eu/newsroom/hera/items/852413/en

HERA is an EU body established to strengthen Europe’s ability to anticipate and respond to health emergencies, particularly in the wake of the COVID-19 pandemic. It aims to ensure the provision of critical medical countermeasures and enhance Europe’s readiness for future health threats.

In the interview, Rachel Lowe discusses the intricate connections between climate change and the outbreaks of climate-sensitive infectious diseases, exploring why these outbreaks are increasing and spreading to new regions, particularly in Europe. She also explains how shifting climate patterns could influence emergency preparedness and response strategies, highlighting the need for proactive, integrated approaches. She shared insights into specific climate-sensitive diseases that pose a potential threat to the EU, including dengue, chikungunya, and West Nile virus, and discussed ongoing efforts like the development of the EpiOutlook platform within the IDAlert project, which is part of the European Climate-Health Cluster. This platform aims to provide early warnings of climatic suitability for various infectious diseases in Europe. They also track the impact of climate change on these diseases in the Lancet Countdown in Europe collaboration.

As part of E4Warning, Professor Lowe also elaborated on her work in developing decision support tools like the D-MOSS (Dengue forecasting Model Satellite-based System) for dengue in endemic regions in collaboration with HR-Wallingford, as well the efforts on integrating different data sources such as citizen science initiatives like Mosquito Alert, which could enhance the monitoring and management of disease vectors across Europe, providing critical support for future public health interventions.

For more details, read the full interview on the HERA website and gain valuable insights into how E4Warning and its partners are addressing the growing challenges posed by climate-sensitive diseases in Europe.

E4Warning participated in the high-level conference “Research Perspectives on the Health Impacts of Climate Change,” organized by the Directorate-General for Research and Innovation (DG RTD) of the European Commission. This event, held in Brussels on February 19th and 20th, 2024, aimed to highlight the crucial nexus between climate change and global health issues.

Chloe Fletcher, a PhD candidate from the Global Health Resilience group at the Barcelona Supercomputing Center (BSC), attended the conference. Her research focuses on developing statistical models for predicting outbreaks of climate-sensitive infectious diseases, such as dengue and leptospirosis. Fletcher presented a poster titled “A Generalized Modelling Framework for Dengue Early Warning Systems in South and Southeast Asia,” a collaborative effort involving Ramy Hoek Spaans (BSC), Sophie Belman (BSC), Chloe Fletcher (BSC), Quillon Harpham (HRW), Gina Tsarouchi (HRW), and Rachel Lowe (BSC), all contributing to the E4Warning project.

This study aims to broaden the successful application of the Dengue Forecasting Model Satellite-based System (D-MOSS), originally implemented in Vietnam, to include Sri Lanka and Malaysia. By employing a Bayesian modeling approach and contrasting it with the conventional practices of dengue outbreak monitoring in each nation, the research seeks to identify which dengue predictors remain consistent or vary across these diverse regions.

The goal is to establish a universally applicable template for developing dengue early warning systems. The D-MOSS platform, which underpins this forecasting system, is managed by HR Wallingford. A key ambition of E4Warning is to collaborate intimately with local partners to deliver actionable data visualizations, thereby enabling an informed, data-driven approach to dengue management.

You can view the summaries of other posters presented during the conference at this link.