Social, behavioral and environmental determinants of vector-borne diseases: A narrative review of evidence and implications for integrated control approaches.

Abstract

Vector-borne diseases exert immense health burdens worldwide. Malaria alone causes over 200 million cases and 600,000 deaths annually. Transmission involves complex drivers requiring examination beyond entomological factors. A systematic literature search across databases identified relevant studies on vector-borne disease determinants published in the last two decades, with priority given to rigorous designs like longitudinal analyses, reviews, and meta-analyses from diverse epidemic regions, allowing narrative synthesis of key determinants, relationships, and gaps. This narrative review synthesizes evidence on social, behavioral, and environmental determinants of major vector-borne disease risks over the past decade. Lower education, poverty, unplanned urbanization, gender inequities, inadequate water and waste management, climate variations, and land-use changes stood out as key determinants. However, significant knowledge gaps remain around quantifying precise threshold effects and impacts of tailored interventions across contexts. A social-ecological perspective recognizing interdependencies between determinants should frame integrated control programs. Multicomponent strategies addressing environmental modifications, protective measures, behavioral motivators, and infrastructure alongside governance and community engagement require implementation research and impact evaluation. Overall, this review highlights priority areas for advancing evidence-based vector control through contextualized, determinant-targeted policies and interventions. Further research incorporating modeling, trials, and cost-effectiveness analyses is critical to validate approaches that address influential drivers, leverage motivators, and reduce the global burden.