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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Reducing costs and operational constraints of dengue vector control by targeting productive breeding places: A multi-country non-inferiority cluster randomized trial
Tropical Medicine and International Health, Volume 14, No. 9, Year 2009
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Description
SummaryObjectives To test the non-inferiority hypothesis that a vector control approach targeting only the most productive water container types gives the same or greater reduction of the vector population as a non-targeted approach in different ecological settings and to analyse whether the targeted intervention is less costly. Methods Cluster randomized trial in eight study sites (Venezuela, Mexico, Peru, Kenya, Thailand, Myanmar, Vietnam, Philippines), with each study area divided into 18-20 clusters (sectors or neighbourhoods) of approximately 50-100 households each. Using a baseline pupal-demographic survey, the most productive container types were identified which produced ≥55% of all Ae. aegypti pupae. Clusters were then paired based on similar pupae per person indices. One cluster from each pair was randomly allocated to receive the targeted vector control intervention; the other received the 'blanket' (non-targeted) intervention attempting to reach all water holding containers. Results The pupal-demographic baseline survey showed a large variation of productive container types across all study sites. In four sites the vector control interventions in both study arms were insecticidal and in the other four sites, non-insecticidal (environmental management and\or biological control methods). Both approaches were associated with a reduction of outcome indicators in the targeted and non-targeted intervention arm of the six study sites where the follow up study was conducted (PPI, Pupae per Person Index and BI, Breteau Index). Targeted interventions were as effective as non-targeted ones in terms of PPI. The direct costs per house reached were lower in targeted intervention clusters than in non-targeted intervention clusters with only one exception, where the targeted intervention was delivered through staff-intensive social mobilization. Conclusions Targeting only the most productive water container types (roughly half of all water holding container types) was as effective in lowering entomological indices as targeting all water holding containers at lower implementation costs. Further research is required to establish the most efficacious method or combination of methods for targeted dengue vector interventions. © 2009 Blackwell Publishing Ltd.
Authors & Co-Authors
Tun-Lin, Willoughby
Unknown Affiliation
Lenhart, Audrey E.
United Kingdom, Liverpool
Liverpool School of Tropical Medicine
Nam, Vu Sinh
Viet Nam, Hanoi
Ministry of Health Vitenam
Rebollar-Téllez, E.
Mexico, San Nicolas de Los Garza
Universidad Autónoma de Nuevo León
Morrison, Amy C.
United States, Davis
University of California, Davis
Barbazan, Philippe
Thailand, Nakhon Pathom
Mahidol University
Cote, M.
Venezuela, Merida
Universidad de Los Andes, Merida
Midega, Janet T.
Kenya, Nairobi
Kenya Medical Research Institute
Sanchez, F.
Philippines, Quezon City
University of East
Manrique-Saide, Pablo
Mexico, Merida
Universidad Autónoma de Yucatán
Kroeger, Axel
United Kingdom, Liverpool
Liverpool School of Tropical Medicine
Switzerland, Geneva
Organisation Mondiale de la Santé
Nathan, Michael B.
Switzerland, Geneva
Organisation Mondiale de la Santé
Meheus, Filip
Belgium, Antwerpen
Prins Leopold Instituut Voor Tropische Geneeskunde
Petzold, Max Gustav
Sweden, Gothenburg
Nordiska Högskolan För Folkhälsovetenskap
Statistics
Citations: 14
Authors: 14
Affiliations: 12
Identifiers
Doi:
10.1111/j.1365-3156.2009.02341.x
ISSN:
13602276
e-ISSN:
13653156
Research Areas
Environmental
Infectious Diseases
Study Design
Randomised Control Trial
Cross Sectional Study
Study Approach
Quantitative
Study Locations
Kenya