A Realist Synthesis of Community-Based Interventions in Vector-Borne Diseases

Abstract

Randomized control trials have provided evidence that some community-based interventions (CBIs) work in vector-borne diseases (VBDs). Conversely, there is limited evidence on how well those CBIs succeed in producing specific outcomes in different contexts. To conduct a realist synthesis for knowledge translation on this topic, we examined the extent to which realist concepts (context, mechanisms, and outcomes) and their relationships are present in the existing literature on CBIs for VBDs. Articles on CBIs were identified from prior scoping reviews of health interventions for VBDs. Content of the articles was extracted verbatim if it referred either to realist concepts or CBI features. The number of articles and the average number of words extracted per category per CBI were quantified. Content of the articles was scrutinized to inductively gather qualitative evidence on the interactions between realist concepts. We reviewed 41 articles on 17 CBIs from 12 countries. The average number of words used for mechanisms was much lower than those used for outcomes and context (309,474, and 836, respectively). The average number of words used for mechanisms increased when a CBI was described in three or more articles. There were more extensive accounts on CBI features than on mechanisms. It was difficult to gather evidence on the interactions among realist concepts from the content of the articles. Scarce reporting on mechanisms in published articles limits conducting a realist synthesis of CBIs in VBDs. More transdisciplinary research that goes beyond the biomedical paradigm is needed to boost the development of intervention mechanisms in this field.

Advisory groups in realist reviews: Systematically mapping current research and recommendations for practice

“…40% ( n = 37) of the realist reviews cited use of an advisory group at some stage (as per the working definition for this study, notably other terminology was often reported) [14–17, 25–61]. 60% ( n = 56) did not mention the use of an advisory group [62–117]. Of those that did not mention an advisory group, seven reviews [62–64] did report participant involvement that did not fulfill the criteria of an advisory group, i.e., participants were used as data sources but did not advise on the review.…”

Vector Control Strategies

“…aegypti, studies conducted mainly in the 2000s in several countries suggest that integrated community-based control of Ae. aegypti under different approaches reduced vector density and had an impact on dengue transmission [84][85][86][87][88]. These approaches, such as Socialisation of Evidence for Participatory Action [SEPA], have been used in mobilising communities for vector control in Nicaragua and Mexico, known as The Green Way, which is based on cluster randomised controlled trial added community engagement in dengue prevention.…”