Zika Mozzie Seeker (ZMS) transforms traditional presence/absence surveillance for invasive mosquito species by synchronizing citizen scientists set egg traps to provide 'early-warning' networks. Eggs from Do It Yourself ovitraps are aggregated and rapidly screened using a world-first method that can detect 'DNA' of one Aedes aegypti amongst 5,000 of the local species. Eggs from many (10-25) traps are batched into each polymerase chain (PCR) cohort, with results fed back to each participant.
Zika Mozzie Seeker (ZMS) is one of Australia’s first health-based citizen-science projects. The aim of ZMS is to enlist large numbers of citizen scientists to set mosquito egg traps as a means to efficiently expand 'early warning' networks for invasive species that can vector disease (Zika, dengue or chikungunya). In Queensland there are two invasive species of ‘Zika mosquitoes’ (Aedes aegypti and Aedes albopictus) - but both are absent in the most highly urbanised region of South East Queensland. Zika mosquitoes exploit water-bearing containers in urban environments and have very limited flight ranges (200-500m) – making it extremely difficult for health authorities to detect a localised invasion early. Evidence of Zika mosquito absence will increase confidence that our largest communities are not infested with ‘Zika mozzies’, as a preventative strategy against Zika outbreaks. Why is this important? The impacts of Zika infection can be profound for individuals, families, communities and health systems. In 2015-16 Zika outbreaks prompted World Health Organization (WHO) to declare a ‘Public Health Emergency of International Concern’ following recognition that infection can cause congenital defects due to microcephaly (small skull) and neurological complications (e.g. Guillain-Barre Syndrome) in adults.
Zika Mozzie Seeker aligns with WHO recommendations to develop novel community-based Zika risk management measures and Office of Chief Scientist Australia aim to promote citizen science. Traditional urban mosquito surveillance is transformed by linking citizen scientists to a world-first method of rapidly screening large amounts of mosquito 'DNA' for Zika mosquitoes by using highly sensitive polymerase chain reaction (PCR) tests. One Ae. aegypti can be detected amongst 5,000 of the local mosquito species. This allows eggs from many (10-25) traps to be combined into each PCR cohort; removing the need and time to individually examine many thousands of mosquito larvae by microscopy.
Education and partnership programs with health authorities can empower individuals and communities to adopt preventative behaviours (e.g. tipping out water-bearing containers each week) to mitigate risk of cryptic Zika outbreaks. Zika Mozzie Seeker is a powerful tool for countries and/or regions that are not yet affected by Zika outbreaks to engage communities and confirm the absence of Zika mosquito species. This information is critical to assist health authorities to both ascertain the risk of exotic mosquito-borne disease transmission, and to detect an invasion early enough to implement eradication programs. The contribution by each citizen scientist is important – a detection of Zika mosquitoes in SE Queensland will trigger a comprehensive, costly and protracted eradication protocol, as described in a recent economic analysis of Ae. albopictus invasion in Brisbane.
Since mid-2016 Metro South Health (MSH) has partnered with its community (1 million people across 3,856 km2) to monitor for invasions of Zika mosquito (Aedes aegypti). The project combines three innovative elements, namely:
- Synchronized citizen science to conduct biannual sampling of urban mosquitoes using Do-it-Yourself egg trapping in trapping ‘rounds’ – managed by MSH
- A ‘Decision Support System’ coordination hub. All participation, mailing and sampling result processes are managed for timely feed-back to individuals and community – created by MSH
- PCR diagnostic testing to screen large amounts of 'DNA' (genetic material) from local mosquitoes for Ae. aegypti DNA – by Queensland Health’s Forensic and Scientific Services.
Citizen scientists register on-line (MSH ZMS website). The ‘egg collection kit’, self-addressed envelope and PCR testing is provided free by Queensland Health. Twice a year, participants are invited to deploy an ovitrap in their backyards for a few weeks. A ‘green policy’ is promoted by directing participants to recycling bins to source mosquito trap buckets, and using electronic communications (email, SMS) to minimise paper use. Eggs are sent to MSH for counting (by automated software) and batching (up to 25 traps), prior to PCR testing for Ae. aegypti DNA. The process of mailing out ‘egg collection kits’ and batching the returned eggs into PCR cohorts enables ZMS to deliver an efficient, loosely synchronised trapping ‘Round’.
A sophisticated ‘ZMS Decision Support System’ has been developed by MSH that is efficient, flexible and scalable to coordinate the data and information streams between each citizen scientist and MSH (e.g. registration details, egg data, email and SMS texting for reminders and the provision of individualised results for egg abundance, PCR diagnostics and thematic mapping outputs). The project places an emphasis on two-way communication (e.g. by responding to all SMS/email enquiries), providing forums to accommodate volunteers, and enabling face-to face feedback to improve 'user' experience.
What Makes Your Project Innovative?
Innovative synchronised citizen science, IT solutions and rapid 'DNA' testing;
- Participants sign up on a ZMS website to set Do-It-Yourself mosquito egg traps and mail eggs in for analyses. The carbon footprint is minimised by;
- suggesting recycled containers (from rubbish bin) as the bucket for egg traps
- minimal paper use by using ZMS website instructions for trap assembly, electronic communications (emails and SMSs) and maps.A novel Decision Support System coordinated data flows to and from each participant. Features include mass mail-out, barcoding functionality, automated egg counting software, email and SMS texting for reminders, individualised results for egg abundance and 'no Zika mozzies', diagnostics management and thematic map outputs.
- World-first method of using Polymerase Chain Reaction (PCR) diagnostics to rapidly screen mosquito genetic material for two target species. High sensitivity enables eggs from multiple traps to be pooled into cohorts.
What is the current status of your innovation?
Zika Mozzie Seeker to date has;
1. Completed four rounds of synchronised trapping in the jurisdiction of Metro South Health.
2. Commenced the exploration of alternative strategies that enable focal implementation (school project and depot trial) with the objective to minimise costs in a scaled-up program, and
3. Protected IP around the Decision Support System. Functionality is being reviewed to improve reporting, outputs and user experience.
We are preparing for an assessment of potential roll-out into SE Queensland in 2019. Staff costs and quantitative data has been compiled to describe key performance indicators for future rounds of trapping. A manual to guide future subscribers to deliver ZMS and to navigate the Decision Support System is under review to assist to successfully replicate the process with a high degree of confidence.
Collaborations & Partnerships
Citizens: Set mosquito egg traps, sent eggs to MSPHU
Metro South Public Health Unit: Created and managed project, engagement, decision support system, egg counting and packaging for PCR
Metro South Health: ZMS website
Queensland Health Forensic and Scientific Services: Developed & delivered PCR tests
Communicable Diseases Branch, Department of Health: Seed funding for project & subsidised PCR tests
Toohey Forest Environmental Education Centre - developed high school resources
Users, Stakeholders & Beneficiaries
Citizens - empowered to minimise Zika outbreak risk at home and in their community through knowledge (mosquito vector and disease) and practice (DIY traps). Egg abundance 'heat maps' published on the ZMS website may motivate behavioural changes to regularly check rainwater tank screens or empty containers.
Metro South Health - evidence-base of species absence and a blueprint that is scalable, flexible and transferable to regions that are vulnerable to Ae. aegypti and/or Ae. albopictus.
Results, Outcomes & Impacts
Four synchronized 'rounds' of trapping was conducted over 18 months (Feb 2017 - May 2018). Each round attracted on average 694 registrants on the ZMS website (total 2,778). Participation (return of eggs in a self-addressed envelope) in each round exceeded 50%, with an average 59% (all rounds). Half (47.9%), of the participants collected eggs, with an average of 216 eggs in those envelopes containing eggs Automated egg counting software, developed in-house within the DSS, is very accurate when samples are clean with less than 1,000 eggs. Thematic maps are generated automatically. High diagnostic efficiency was demonstrated by processing of 169,000 eggs (all four rounds) by 81 PCRS (20 per round).
Turnaround time 36 hours.
Website views 20,000, Facebook impressions 24,000, SMSs 18,000, emails 1,200.
We hope to develop system efficiencies and have partners deliver school-based modules as an alternative/complementary strategy to address spatial holes in community participation.
Challenges and Failures
The exploratory nature of the project made it difficult to forecast specific outcomes and end points at the planning stage. Therefore timelines were indicative and require adjustment as the project progressed.
A defined pathway to guide the project through to commercialisation would have been helpful. Most project staff were part-time and competing priorities from outside the project disrupted and delayed timelines and some communications.
The major challenge was the uncertainty in attrition rates over successive trapping rounds. How many registrants would stay or leave and translate to participants? How many eggs would be collected? How many PCR tests would be required? Delivering iterative rounds clarified and identified the trends to these uncertainties in the local context. Alternative delivery strategies in focal areas were explored to mitigate participant 'burn-out' but require more work.
Inability to access the cloud meant that some IT functionalities were not tested.
Conditions for Success
New resourcing models that support partnerships between community and health authorities are necessary to build effective invasive mosquito 'early warning' across broad highly urbanised geographies. Access to innovation funding process to employ project staff was provided by existing committees within Metro South Health and Queensland Health. Provision of a ZMS website was a key tool to coordinate information to the public. Clarity of vision in a project plan enabled a small team of inspired individuals to focus on solving emerging issues, with minimal red tape, to provide innovative outcomes.
A hub created by co-location of Metro South Public Health Unit and the diagnostic laboratory (Queensland Health Forensic & Scientific Services) facilitated the initial development of the novel diagnostic method, project management networking and access to lab space. Governance by a project management team that represented the various organizational stakeholders was key to success.
The objective of the ZMS project was to develop a blue-print to deliver a citizen-science platform for invasive mosquito surveillance, and prepare for market-readiness. It has yet to be replicated in other health districts in Queensland. The focus of the project is to use low-cost consummables (egg collection kit and recycled containers) to promote scalability and sustainability across larger future programs. The intent by the Department of Health in early 2019 is to ascertain the feasibility of the ZMS system for roll-out throughout the remainder of the South-east Queensland region, which shares vulnerability to re-invasion by Ae. aegypti.
The blue-print can be adapted to Ae. albopictus across the remainder of Queensland, Australia or overseas in regions where presence-absence of target species is critical to ascertain risk of invasion in large urban geographies. The PCR can be readily adapted to accommodate other target invasive container-breeding species (e.g. Ae. koreicus).
Do not be afraid to challenge the norm; look for opportunities to promote innovation within your organization. Understand and align project proposals with the strategic directions of your own and other organizations (national, international) to strengthen the project sponsors understanding of the merit and relevance of the work.
Be prepared to collaborate with partners that have different areas of expertise, recognizing that their availability may be constrained. Ask lots of questions from different stakeholders early in the project to gain the clarity required to identify and navigate past any hurdles (financial, legal, organizational) that may impede progress to project completion.
Be prepared to advocate and commit to specialised community engagement staff into any project that is required to engage with the community and a range of organizational stakeholders. The engagement process needs to be structured and measured to provide opportunities for partners to be consulted adequately, provide feed-back and adjust accordingly. Construct a dissemination plan to ensure that new ideas are spread to external stakeholders over time. Allow enough time for those processes to be completed and keep all stakeholder appraised of progress in open, honest and transparent way.
Identify pathways to innovation both within your organization or accessible through partnerships with other institutions. Nominate your project for relevant awards to increase awareness of the project at an executive level.
Consult with specialists in IT solutions early to increase efficiency in the data management and reporting process.
Repeatability of results is important to demonstrating a projects success, so build iterative components into a project plan and articulate the quantitative and qualitative measurables.
- Identifying or Discovering Problems or Opportunities - learning where and how an innovative response is needed
- Evaluation - understanding whether the innovative initiative has delivered what was needed
28 November 2017