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Randomized Controlled Trial
. 2015 Feb;109(2):99-105.
doi: 10.1093/trstmh/tru187.

Entomological impact and social participation in dengue control: a cluster randomized trial in Fortaleza, Brazil

Andrea Caprara  1 , José Wellington De Oliveira Lima  2 , Ana Carolina Rocha Peixoto  2 , Cyntia Monteiro Vasconcelos Motta  2 , Joana Mary Soares Nobre  2 , Johannes Sommerfeld  3 , Axel Kroeger  4
Affiliations
Randomized Controlled Trial

Entomological impact and social participation in dengue control: a cluster randomized trial in Fortaleza, Brazil

Andrea Caprara et al. Trans R Soc Trop Med Hyg. 2015 Feb.

Abstract

Background: This study intended to implement a novel intervention strategy, in Brazil, using an ecohealth approach and analyse its effectiveness and costs in reducing Aedes aegypti vector density as well as its acceptance, feasibility and sustainability. The intervention was conducted from 2012 to 2013 in the municipality of Fortaleza, northeast Brazil.

Methodology: A cluster randomized controlled trial was designed by comparing ten intervention clusters with ten control clusters where routine vector control activities were conducted. The intervention included: community workshops; community involvement in clean-up campaigns; covering the elevated containers and in-house rubbish disposal without larviciding; mobilization of schoolchildren and senior inhabitants; and distribution of information, education and communication (IEC) materials in the community.

Results: Differences in terms of social participation, commitment and leadership were present in the clusters. The results showed the effectiveness of the intervention package in comparison with the routine control programme. Differences regarding the costs of the intervention were reasonable and could be adopted by public health services.

Conclusions: Embedding social participation and environmental management for improved dengue vector control was feasible and significantly reduced vector densities. Such a participatory ecohealth approach offers a promising alternative to routine vector control measures.

Keywords: Brazil; Cluster randomized trial; Dengue; Intervention study; Social participation; Vector management.

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Figures

Figure 1.
Figure 1.
Aedes aegypti infestation, before (dry season) and after (rainy season) the intervention. —— Control area; ––– Intervention area.
Figure 2.
Figure 2.
Spidergrams assessing five indicators of community participation. This figure is available in black and white in print and in color at Transactions online.
See this image and copyright information in PMC

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