Innovative Surveillance and Control Strategy Training for Vector-borne Diseases in Bhutan

People around the world are susceptible to bacteria and viruses transmitted by ticks, fleas, mosquitos, and other insects, or “vectors.” Bhutan’s Department of Public Health has made substantial progress toward reducing malaria transmission. However, vector-borne diseases remain a threat in Bhutan.

Currently, vector-borne diseases prevalent in the country are malaria, dengue, leishmaniasis, and scrub typhus with few isolated cases of Japanese encephalitis reported since 2014. Bhutan has also seen one episode of Chikungunya outbreak in the past. In addition, with climate change and more people traveling in and out of the country, Bhutan remains under constant threat of importing exotic emerging vector-borne diseases, such as Zika virus, lymphatic filariasis, and more. This calls for a concerted effort from all relevant sectors, including communities, to prevent and control vector-borne disease outbreaks in the country.

As part of a global attempt to eradicate malaria, Bhutan’s Health Ministry established the Vector-borne Disease Control Program (VDCP) in Gelephug in Southern Bhutan under the Department of Public Health. Although the malaria technicians at VDCP conduct routine entomological surveillance, the quality and uniformity of the entomological data is a concern due to lack of technical capacity and other resources.

To address these issues, the Bhutan Foundation is bringing in expertise from the Yale School of Public Health (YSPH) and the US Department of Agriculture (USDA) to collaborate with the Khesar Gyalpo University of Medical Sciences of Bhutan (KGUMSB) and the VDCP to lead a 10-day hands-on training in Gelephug and Tsirang. The training will develop malaria technicians’ skills and equip them with resources that will lead to accurate and qualitative data.

In addition, the training will use a citizen-science program, in which the technicians and entomologists can supplement the existing public health infrastructure by using the community to help monitor for insect-transmitted pathogens and insect pests. The participants will learn about the risks of insect-transmitted pathogens and the best ways to involve the community to take preventive measures. The project will use an innovative surveillance and control strategy, which involves community participation and ownership of the disease for effective control. In the long run, we hope that the citizen-science program will strengthen the monitoring effort and community response in the event of an outbreak.