摘要：We were very interested to read the discussion of Felipe Dzul-Manzanilla and colleagues 1 on the importance of identifying hotspots of Aedes mosquito-borne virus transmission for establishing efficient disease control. Identification of high risk transmission areas is based on the spatiotemporal epidemiology of patients with confirmed dengue virus, chikungunya virus, and Zika virus infection over a substantial period of time. However, much of the global rural population live in areas beyond surveillance, with hotspots of data focused around research institutions and urban areas and vast areas of the world that are surveillance terra incognita. With the enormous infrastructural and financial challenges for building appropriate formal laboratory systems in rural Africa, Asia, and the Americas, innovation is needed to build ASSURED (Affordable, Sensitive, Specific, User-friendly, Rapid and robust, Equipment-free and Deliverable to end-users) surveillance systems to collect reliable data on Aedes-borne disease transmission. Effective widespread planetary expansion of formal laboratory systems will take decades and, in the meantime, one potential method would be to add diagnostic value to rapid diagnostic tests (RDTs) as substrates for detection of pathogens presenting with similar clinical syndromes and epidemiology.
