Ecobiosocial Community Intervention for Improved Aedes aegypti Control Using Water Container Covers to Prevent Dengue: Lessons Learned from Girardot Colombia

Abstract

NTRODUCTIONDengue is the most important mosquito-borne viral diseaseworldwide (WHO 2012). Its incidence has grown dramat-ically around the world in recent decades making it a majorpublic health concern (Badurdeen et al. 2013; BrathwaiteDick et al. 2012; Morens et al. 2013). Over 40% of theworld’s population is now at risk from dengue and thedisease is endemic in more than 100 countries. TheAmericas, South-east Asia and the Western Pacific regionsare the most seriously affected. Colombia in South Amer-ica, was classified as the eighth most highly endemiccountry between 2004 and 2010 (WHO 2012). In 2010, thecountry suffered the worst registered epidemic with157,203 cases, 147,426 dengue cases and 9,777 severe den-gue, with a lethality of 2.26% (230 deaths). The year 2013was an important epidemiological year with epidemicoutbreaks registered in Colombia and neighbouring LatinAmerican countries (OPS 2013).The predominant dengue vector is Aedes aegypti,adomestic mosquito species whose breeding sites are relatedto environmental factors linked and maintained by humanbehaviours—individual, collective and institutional—andtheir related social, economic and political contexts (Powelland Tabachnick 2013). Until a vaccine becomes availablefor public health use, primary prevention remains depen-dent upon institutional, social and dengue vector controlprogrammes, which include domestic environmentalmanagement such as source reduction, provision of safewater, covering and screening of water containers, andreduction of vector to human contact through the use ofinsecticide-treated nets in windows and doors (Erlangeret al. 2008).This study sits within the project entitled Ecobiosocialapproach for the design and implementation of a sustain-able strategy for dengue vector control in Girardot (Gi-rardot libre de dengue in Spanish), which is based on amulti-country effort developed following a TDR/IDRCproposal on Innovative Community-Based EcosystemManagement Interventions for Improved Chagas andDengue Disease Prevention in Latin America and theCaribbean. Girardot is located 120 km from Bogota, thecapital of the country and presents ecological (289 MASL)and climatic conditions [Mean temperature 28 C, rainfall821 mm and humidity 80% with a dry (December–April)and rainy season (May–October)] that make the city one ofthe most endemic municipalities of dengue in the country.Long-lasting insecticide-treated curtains on windowsand water containers were selected as suitable interventionsbased on the literature (Kroeger et al. 2006; Lenhart et al.2008; Seng et al. 2008; Vanlerberghe et al. 2010; TDR 2006)and the results of phase one of the project (Quintero et al.2014). First, natural populations of A. aegypti in Girardot