Abstract
BackgroundThe follow-up survey of a cluster-randomised controlled trial of evidence-based community mobilisation for dengue control in Nicaragua and Mexico included entomological information from the 2012 rainy and dry seasons. We used data from the Mexican arm of the trial to assess the impact of the community action on pupal production of the dengue vector Aedes aegypti in both rainy and dry seasons.MethodsTrained field workers inspected household water containers in 90 clusters and collected any pupae or larvae present for entomological examination. We calculated indices of pupae per person and pupae per household, and traditional entomological indices of container index, household index and Breteau index, and compared these between rainy and dry seasons and between intervention and control clusters, using a cluster t-test to test significance of differences.ResultsIn 11,933 houses in the rainy season, we inspected 40,323 containers and found 7070 Aedes aegypti pupae. In the dry season, we inspected 43,461 containers and counted 6552 pupae. All pupae and entomological indices were lower in the intervention clusters (IC) than in control clusters (CC) in both the rainy season (RS) and the dry season (DS): pupae per container 0.12 IC and 0.24 CC in RS, and 0.10 IC and 0.20 CC in DS; pupae per household 0.46 IC and 0.82 CC in RS, and 0.41 IC and 0.83 CC in DS; pupae per person 0.11 IC and 0.19 CC in RS, and 0.10 IC and 0.20 CC in DS; household index 16% IC and 21% CC in RS, and 12.1% IC and 17.9% CC in DS; container index 7.5% IC and 11.5% CC in RS, and 4.6% IC and 7.1% CC in DS; Breteau index 27% IC and 36% CC in RS, and 19% IC and 29% CC in DS. All differences between the intervention and control clusters were statistically significant, taking into account clustering.ConclusionsThe trial intervention led to significant decreases in pupal and conventional entomological indices in both rainy and dry seasons.Trial registrationISRCTN27581154.
Highlights
The follow-up survey of a cluster-randomised controlled trial of evidence-based community mobilisation for dengue control in Nicaragua and Mexico included entomological information from the 2012 rainy and dry seasons
In a cluster randomised controlled trial conducted in Mexico and Nicaragua, we showed that community participation based on socialising evidence for participatory action reduced rates of recent dengue infection, rates of self-reported dengue illness, and four entomological indices of the Aedes aegypti vector [19]
We tested the statistical significance of differences between groups using a cluster t-test [24] and we report the mean differences between groups and their cluster-adjusted 95% confidence intervals
Summary
The follow-up survey of a cluster-randomised controlled trial of evidence-based community mobilisation for dengue control in Nicaragua and Mexico included entomological information from the 2012 rainy and dry seasons. We used data from the Mexican arm of the trial to assess the impact of the community action on pupal production of the dengue vector Aedes aegypti in both rainy and dry seasons. Aedes aegypti is the vector for other infections of public health importance, including yellow fever, chikungunya, and zika [6,7,8]. The main strategy for controlling dengue (as well as chikungunya and zika) is to control the vector, and in particular to control its breeding sites in water containers in and around households. Trials of chemical and other interventions for dengue vector control have reported the impact on different pupae indices [11,12,13,14]
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