Evidence based community mobilization for dengue prevention in Nicaragua and Mexico (Camino Verde,the Green Way): cluster randomized controlled trial

Abstract

Objective To test whether community mobilization adds effectiveness to conventional dengue control. Design Pragmatic open label parallel group cluster randomized controlled trial. Those assessing the outcomes and analyzing the data were blinded to group assignment. Centralized computerized randomization after the baseline study allocated half the sites to intervention, stratified by country, evidence of recent dengue virus infection in children aged 3-9, and vector indices. Setting Random sample of communities in Managua, capital of Nicaragua, and three coastal regions in Guerrero State in the south of Mexico. Participants Residents in a random sample of census enumeration areas across both countries: 75 intervention and 75 control clusters (about 140 households each) were randomized and analyzed (60 clusters in Nicaragua and 90 in Mexico), including 85 182 residents in 18 838 households. Interventions A community mobilization protocol began with community discussion of baseline results. Each intervention cluster adapted the basic intervention—chemical-free prevention of mosquito reproduction—to its own circumstances. All clusters continued the government run dengue control program. Main outcome measures Primary outcomes per protocol were self reported cases of dengue, serological evidence of recent dengue virus infection, and conventional entomological indices (house index: households with larvae or pupae/households examined; container index: containers with larvae or pupae/containers examined; Breteau index: containers with larvae or pupae/households examined; and pupae per person: pupae found/number of residents). Per protocol secondary analysis examined the effect of Camino Verde in the context of temephos use. Results With cluster as the unit of analysis, serological evidence from intervention sites showed a lower risk of infection with dengue virus in children (relative risk reduction 29.5%, 95% confidence interval 3.8% to 55.3%), fewer reports of dengue illness (24.7%, 1.8% to 51.2%), fewer houses with larvae or pupae among houses visited (house index) (44.1%, 13.6% to 74.7%), fewer containers with larvae or pupae among containers examined (container index) (36.7%, 24.5% to 44.8%), fewer containers with larvae or pupae among houses visited (Breteau index) (35.1%, 16.7% to 55.5%), and fewer pupae per person (51.7%, 36.2% to 76.1%). The numbers needed to treat were 30 (95% confidence interval 20 to 59) for a lower risk of infection in children, 71 (48 to 143) for fewer reports of dengue illness, 17 (14 to 20) for the house index, 37 (35 to 67) for the container index, 10 (6 to 29) for the Breteau index, and 12 (7 to 31) for fewer pupae per person. Secondary per protocol analysis showed no serological evidence of a protective effect of temephos. Conclusions Evidence based community mobilization can add ...

Coexistence of Aedes aegypti and Aedes albopictus in Jinghong City, Yunnan Province: A Survey of Aedes aegypti Invasion

“…For dengue, a disease without drugs or vaccines, the main approach used in prevention and control is reducing the population of Aedes mosquito [4,21]. During the dengue epidemic in China, we had an intervention strategy to suppress the dengue mosquito vectors [4,22].…”

Eficacia de la “metodología vivencial de aprendizaje” en el nivel de conocimiento sobre enfermedades transmitidas porAedes aegypti en un desastre natural

“…Esto se puede explicar debido a que las mujeres jóvenes suelen tener un mejor conocimiento sobre medidas preventivas en estas enfermedades, así como tienen una decisión más rápida sobre la implementación de estas medidas (17)(18)(19) .…”

Pemanfaatan Kalender 4M Sebagai Alat Bantu Meningkatkan Peran Serta Masyarakat dalam Pemberantasan dan Pencegahan Demam Berdarah

“…5,6 Selain itu, terdapat faktor-faktor risiko lain yang disebabkan oleh perubahan demografis suatu wilayah, yaitu pemukiman di daerah perkotaan yang semakin padat, juga sistem transportasi yang semakin baik yang menyebabkan mobilitas penduduk semakin tinggi, serta tingkat urbanisasi yang sulit dikontrol. 7,8 Secara umum upaya pemberantasan sarang nyamuk (PSN) di Indonesia merupakan aktivitas utama upaya pencegahan DBD yang melibatkan peran serta masyarakat. Program ini mulai dijalankan sejak tahun 1992 dengan gerakan 3M, yaitu Menguras-Menutup-Mengubur.…”