Vector-borne disease surveillance and control resource needs in Colorado public health organizations.

Since 2002, Colorado has experienced a high vector-borne disease (VBD) burden from diseases like West Nile fever, plague, and tularemia. Recent evidence underscores a lack of vector-borne surveillance and control program capacity across public health organizations, prompting our evaluation of funding and resource needs for such programs in Colorado. We assessed the needs, organizational capacity, and mitigation strategies of Colorado public health organizations' VBD programs using a convergent mixed methods study design. Between January and May 2024, we surveyed and interviewed key public health organizations leaders. Findings were determined through mixed methods integration of survey data, thematic analysis on interviews, and content analysis on financial and policy documents. Overall, 28 public health practitioners (35% response rate) at 24 Colorado public health organizations (63% urban, 25% rural, 13% frontier counties) were surveyed and 18 were interviewed. We found only 37.5% of Colorado's public health organizations conducted vector surveillance for any vector species. Smaller rural and frontier communities (<100K people) were particularly vulnerable to inadequate VBD organizational capacity and resource availability, and public health organizations in areas with populations < 10K or between 51-100K did not conduct vector surveillance. Interviewees perceived their VBD surveillance and program capacity as inadequate and reported significant limitations in their ability to carry out vector control activities. Moreover, they reported that competing priorities for emerging diseases resulted in reactionary rather than proactive responses to VBDs, highlighting the lack of sustainable funding for vector programs. As VBDs continue to increase in Colorado, outbreaks of diseases like West Nile fever or plague will likely go undetected without improved surveillance. The findings from our study have implications for where surveillance and control are lacking and highlight opportunities to continue improving and supporting surveillance and controls programs for VBDs.