2010, Number 1
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MEDICC Review 2010; 12 (1)
Community involvement in dengue vector control: Cluster randomised trial
Vanlerberghe V, Toledo ME, Rodríguez M, Gómez D, Baly A, Benítez JR, Van der Stuyft P
Language: English
References: 34
Page: 41-47
PDF size: 161.53 Kb.
ABSTRACT
Objective To assess the effectiveness of an integrated community
based environmental management strategy to control
Aedes aegypti, the vector of dengue, compared with a routine strategy.
Design Cluster
randomised trial.
Setting Guantanamo, Cuba.
Participants 32 circumscriptions (around 2000 inhabitants each).
Interventions The circumscriptions were randomly allocated to control clusters (n=16)
comprising routine Aedes control programme (entomological surveillance, source reduction, selective adulticiding, and health education) and to intervention clusters (n=16) comprising the routine Aedes control programme combined with a community based environmental management approach.
Main Outcome Measures The primary outcome
was levels of Aedes infestation: house index (number of houses positive for at least one container with immature stages of
Ae aegypti per 100 inspected houses), Breteau index (number of containers positive
for immature stages of
Ae aegypti per 100 inspected houses), and the pupae per inhabitant statistic (number of
Ae aegypti pupae per inhabitant).
Results All clusters were subjected to the intended intervention; all completed the study protocol up to February 2006 and all were included in the analysis. At baseline the
Aedes infestation levels
were comparable between intervention and control clusters: house index 0.25%
v 0.20%, pupae per inhabitant 0.44×10
−3v 0.29×10
−3. At the end of the intervention these indices were significantly lower in the intervention clusters: rate ratio for house indices 0.49 (95% confidence interval 0.27 to 0.88) and rate ratio for pupae per inhabitant 0.27 (0.09 to 0.76).
Conclusion A community based environmental
management embedded in a routine control programme was effective at reducing levels of Aedes infestation.
Trial Registration Current Controlled Trials ISRCTN88405796.
REFERENCES
Farrar J, Focks D, Gubler D, Barrera R, Guzman MG, Simmons C, et al. Towards a global dengue research agenda. Trop Med Int Health 2007;12:695–9.
Deen JL, Harris E, Wills B, Balmaseda A, Hammond SN, Rocha C, et al. The WHO dengue classification and case definitions: time for a reassessment. Lancet 2006;368:170–3.
Gibbons RV, Vaughn DW. Dengue: an escalating problem. BMJ 2002;324:1563–6.
Shepard DS, Suaya JA, Halstead SB, Nathan MB, Gubler DJ, Mahoney RT, et al. Cost-effectiveness of a pediatric dengue vaccine. Vaccine 2004;22:1275–80.
TDR for research on diseases of poverty. Report of the Scientific Working Group meeting on Dengue, 1–5 Oct, 2006. Geneva: WHO. (TDR/ SWG/08 ed.)
World Health Organization. Dengue and dengue hemorrhagic fever. In: Kindhauser MK, ed. Communicable diseases 2002: global defense against the infectious disease threat. Geneva, WHO, 2003:140–3. (WHO/CDS/2003.15.)
Newton EA, Reiter P. A model of the transmission of dengue fever with an evaluation of the impact of ultra-low volume (ULV) insecticide applications on dengue epidemics. Am J Trop Med Hyg 1992;47:709–20.
Kroeger A, Lenhart A, Ochoa M, Villegas E, Levy M, Alexander N, et al. Effective control of dengue vectors with curtains and water container covers treated with insecticide in Mexico and Venezuela: cluster randomised trials. BMJ 2006;332:1247– 52.
Heintze C, Garrido MV, Kroeger A. What do community-based dengue control programmes achieve? A systematic review of published evaluations. Trans R Soc Trop Med Hyg 2007;101:317–25.
Perez D, Lefevre P, Sanchez L, Van der Stuyft P. Comment on: What do community-based dengue control programmes achieve? A systematic review of published evaluations. Trans R Soc Trop Med Hyg 2007;101:630–1.
Espinoza-Gomez F, Hernandez-Suarez CM, Coll-Cardenas R. Educational campaign versus malathion spraying for the control of Aedes aegypti in Colima, Mexico. J Epidemiol Community Health 2002;56:148–52.
Lloyd LS, Winch P, Ortega-Canto J, Kendall C. Results of a community-based Aedes aegypti control program in Merida, Yucatan, Mexico. Am J Trop Med Hyg 1992;46:635–42.
NamVS, Nguyen TY, Tran VP, Truong UN, LeQM, Le VL, et al. Elimination of dengue by community programs using Mesocyclops (Copepoda) against Aedes aegypti in central Vietnam. Am J Trop Med Hyg 2005;72:67–73.
Parks W, Lloyd L, Nathan MB, Hosein E, Odugleh A, Clark GG, et al. International experiences in social mobilization and communication for dengue prevention and control. Dengue Bull 2005;28(special suppl):1–7.
Ukoumunne OC, Gulliford MC, Chinn S, Sterne JA, Burney PG, Donner A. Methods in health service research. Evaluation of health interventions at area and organisation level. BMJ 1999;319:376–9.
Nathan MB, Focks DA, Kroeger A. Pupal/ demographic surveys to inform denguevector control. Ann Trop Med Parasitol 2006;100(suppl 1):S1–3.
Kouri GP, Guzman MG, Bravo JR, Triana C. Dengue haemorrhagic fever/dengue shock syndrome: lessons from the Cuban epidemic, 1981. Bull World Health Organ 1989;67:375–80.
Guzman MG, Pelaez O, Kouri G, Quintana I, Vazquez S, Penton M, et al. [Final characterization of and lessons learned from the dengue 3 epidemic in Cuba, 2001-2002]. Rev Panam Salud Publica 2006;19:282–9.
Hayes RJ, Bennett S. Simple sample size calculation for cluster-randomized trials. Int J Epidemiol 1999;28:319–26.
Baly A, Toledo ME, Boelaert M, Reyes A, Vanlerberghe V, Ceballos E, et al. Cost effectiveness of Aedes aegypti control programmes: participatory versus vertical. Trans R Soc Trop Med Hyg 2007;101:578–86.
Perez D, Lefevre P, Sanchez L, Sanchez LM, Boelaert M, Kouri G, et al. Community participation in Aedes aegypti control: a sociological perspective on five years of research in the health area “26 de Julio”, Havana, Cuba. Trop Med Int Health 2007;12:664–72.
Sanchez L, Perez D, Perez T, Sosa T, Cruz G, Kouri G, et al. Intersectoral coordination in Aedes aegypti control. A pilot project in Havana City, Cuba. Trop Med Int Health 2005;10:82–91.
Toledo ME, Vanlerberghe V, Baly A, Ceballos E, Valdes L, Searret M, et al. Towards active community participation in dengue vector control: results from action research in Santiago de Cuba, Cuba. Trans R Soc Trop Med Hyg 2007;101:56–63.
Rifkin SB, Muller F, Bichmann W. Primary health care: on measuring participation. Soc Sci Med 1988;26:931–40.
Focks DA, Chadee DD. Pupal survey: an epidemiologically significant surveillance method for Aedes aegypti: an example using data from Trinidad. Am J Trop Med Hyg 1997;56:159–67.
Kay B, Nam VS. New strategy against Aedes aegypti in Vietnam. Lancet 2005;365:613–7.
Leontsini E, Gil E, Kendall C, Clark GG. Effect of a community-based Aedes aegypti control programme on mosquito larval production sites in El Progreso, Honduras. Trans R Soc Trop Med Hyg 1993;87:267–71.
Winch PJ, Leontsini E, Rigau-Perez JG, Ruiz- Perez M, Clark GG, Gubler DJ. Communitybased dengue prevention programs in Puerto Rico: impact on knowledge, behavior, and residential mosquito infestation. Am J Trop Med Hyg 2002;67:363–70.
Kay BH, Nam VS, Tien TV, Yen NT, Phong TV, Diep VT, et al. Control of aedes vectors of dengue in three provinces of Vietnam by use of Mesocyclops (Copepoda) and community-based methods validated by entomologic, clinical, and serological surveillance. Am J Trop Med Hyg 2002;66:40–8.
Vordam V, Kuno G. Laboratory diagnosis of dengue virus infections. In: Guber DJ, Kuno G, eds. Dengue and dengue hemorrhagic fever. London: CAB International, 1997:313–34.
Zakus JD, Lysack CL. Revisiting community participation. Health Policy Plan 1998;13:1–12.
Toledo Romani ME, Vanlerberghe V, Perez D, Lefevre P, Ceballos E, Bandera D, et al. Achieving sustainability of community-based dengue control in Santiago de Cuba. Soc Sci Med 2007;64:976–88.
Gubler DJ, Clark GG. Community involvement in the control of Aedes aegypti. Acta Trop 1996;61:169–79.
Simmons R, Brown J, Diaz M. Facilitating largescale transitions to quality of care: an idea whose time has come. Stud Fam Plann 2002;33:61–75.
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