What evidence exists on the impact of specific ecosystem components and functions on infectious diseases? A systematic map
The control and prevention of vector-borne and zoonotic diseases is often based on the reduction of host or vector populations, involving but not limited to preventative culling and use of insecticides. Yet, destructive interventions such as these have shown several limitations including ineffectiveness on arthropods and negative impacts on ecosystems. An alternative strategy would be to rely on the natural ecosystem functions and their careful management to regulate such diseases. The goal of our work was to evaluate existing scientific evidence on potential links between ecosystem components/functions and 14 vector-borne and zoonotic diseases impacting human health and answer the question: “What evidence exists on the impact of specific ecosystem components and functions on infectious diseases?”.
We searched for scientific articles published in English and French and screened them in a 3-round process (title, abstract and full-text). Articles were retained, without any geographical limitation, if they matched the following eligibility criteria: an exposure/intervention linked to changes in biological communities, habitats, or landscapes; an outcome consisting of any measure of infection in vector, animal or human hosts; and the presence of a comparator, in time and/or in space. The results are presented as a systematic map, followed by a narrative review where the amount of papers allowed for synthesis.
Searches in 5 scientific publication databases allowed to retrieve 9723 unique articles, among which 207 were retained after the screening process. The amount of relevant literature was highly variable depending on diseases, and the types of exposures also varied greatly among studies focusing on the same disease. A hundred articles presented in the map were unique in their “disease x exposure” combination and thus not eligible for further narrative description. The remaining 107 articles were organized in 34 “disease x exposure” groups, encompassing 9 out of the 14 initial diseases. The groups were composed of 2 to 16 articles and were examined to provide a description of the current state of knowledge for those diseases.
Studies investigating the interaction between infectious diseases and ecosystems components and functions are still very scarce, and certain diseases are much more studied than others. Out of 14 diseases, 8 generated less than 10 relevant articles, while 2 diseases (Lyme disease and West Nile disease) represented 44% of all relevant studies. Although several vector-borne diseases included in the review represent a major health issue in the world, such as malaria or dengue, they have been exclusively studied under the prism of land-use, and we were unable to find relevant studies that tested the regulatory role of animal biodiversity-related functions. The role of predation in the regulation of vector and host populations has rarely been studied, with the exception of schistosomiasis. The dilution and amplification effects were addressed in several studies focusing on the composition of ecological communities. This map is a first step and could be upgraded in order to guide future research projects with the aim to conduct meta-analysis and build a robust evidence base to inform decision-making.
Biodiversity, Ecosystem services, Landscape, Dilution effect, One Health, Ecological control
Many infectious pathogens can be transmitted from animals to humans and vice versa, or by animals (especially arthropods) to humans. Such diseases are called zoonotic and/or vector-borne diseases. To control or prevent them, it is often recommended to target population reduction of host or vector species, through preventive culling or insecticide use for example. But these types of destructive interventions have shown several limits altering their efficiency, including acquired resistance of arthropods to insecticides, unpredicted change in the ecology of host populations, unexpected negative functional consequences on ecosystems, as well as economic embrittlement when livestock is concerned. An alternative pathway of action would be to rely on the functioning of ecosystems, and on their careful management, to regulate diseases and thus reduce their impact on human health. In this perspective, a thorough evaluation of the conditions that can potentially promote such a positive regulation of infectious pathogens by ecosystems, and their efficiency, is needed. Here, we present the protocol of a systematic review that will evaluate the scientific evidence existing on potential links between ecosystem components or functions and 14 vector-borne and zoonotic diseases impacting human health.
We will search for studies that tested the effect of changes in (i) biological communities, and (ii) habitats and landscapes, on diseases. Scientific literature from 5 publication databases will be screened in a 3-rounds process: title, abstract and full-text screening. At each stage, articles will be either rejected or kept for the next round, depending on whether they fall in the exclusion or inclusion criteria. We will present results in two parts: a systematic map and a systematic review. The systematic map will present, for the 14 diseases, the number of publications, their geographical distribution, the type of ecosystem component/function they studied, as well as the host(s) in which epidemiological measurements have been performed. From this systematic map, we will identify groups of articles that allow for critical appraisal, i.e. groups of articles that studied the effect of the same ecosystem component/function on the same disease. Only those articles will be included in the systematic review. The validity of these articles will be assessed by critical appraisal and presented as a narrative synthesis with confidence levels.