Abstract
BackgroundDengue is an increasingly important public health problem in most Latin American countries and more cost-effective ways of reducing dengue vector densities to prevent transmission are in demand by vector control programs. This multi-centre study attempted to identify key factors associated with vector breeding and development as a basis for improving targeted intervention strategies.MethodsIn each of 5 participant cities in Mexico, Colombia, Ecuador, Brazil and Uruguay, 20 clusters were randomly selected by grid sampling to incorporate 100 contiguous households, non-residential private buildings (businesses) and public spaces. Standardized household surveys, cluster background surveys and entomological surveys specifically targeted to obtain pupal indices for Aedes aegypti, were conducted in the dry and wet seasons.ResultsThe study clusters included mainly urban low-middle class populations with satisfactory infrastructure and –except for Uruguay- favourable climatic conditions for dengue vector development. Household knowledge about dengue and “dengue mosquitoes” was widespread, mainly through mass media, but there was less awareness around interventions to reduce vector densities. Vector production (measured through pupal indices) was favoured when water containers were outdoor, uncovered, unused (even in Colombia and Ecuador where the large tanks used for household water storage and washing were predominantly productive) and –particularly during the dry season- rainwater filled. Larval infestation did not reflect productive container types. All productive container types, including those important in the dry season, were identified by pupal surveys executed during the rainy season.ConclusionsA number of findings are relevant for improving vector control: 1) there is a need for complementing larval surveys with occasional pupal surveys (to be conducted during the wet season) for identifying and subsequently targeting productive container types; 2) the need to raise public awareness about useful and effective interventions in productive container types specific to their area; and 3) the motivation for control services that-according to this and similar studies in Asia- dedicated, targeted vector management can make a difference in terms of reducing vector abundance.
Highlights
Dengue is an increasingly important public health problem in most Latin American countries and more cost-effective ways of reducing dengue vector densities to prevent transmission are in demand by vector control programs
According to World Health Organization (WHO), dengue transmission is currently reported in all Latin American countries, except for Uruguay [2,3,4]
Vector breeding sites are most commonly found in the intra- and peri-domestic environment, pre-imago stages have been found in public spaces, cemeteries, schools, hospitals, health centres and hotels [6,7]
Summary
Dengue is an increasingly important public health problem in most Latin American countries and more cost-effective ways of reducing dengue vector densities to prevent transmission are in demand by vector control programs. Social factors incorporate a series of variables relating to health systems, including vector control and health services, and their political context (e.g. health sector reforms), public and private services such as sanitation and sewage, garbage collection and water supply as well as “macro-social” events such as demographic growth and urbanization, as well as community and household-based practices, knowledge and attitudes and how these are shaped by large-scale forces such as poverty, social inequality and community dynamics [11] This broad eco-bio-social conceptual framework informed the present investigation of the ecosystem–specific (i.e. ecohealth) context in participant research sites. The study reported here is a multi-country research effort with a universal core protocol developed following a TDR/IDRC proposal development/study design/methods workshop on Innovative Community Based Ecosystem Management Interventions for Improved Chagas and Dengue Disease Prevention in Latin America and the Caribbean, held in Antigua, Guatemala in July 2009, and a Third Community of practice workshop held in Merida, Mexico, in August 2011
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