Cost-effectiveness of community mobilization (Camino Verde) for dengue prevention in Nicaragua and Mexico: A cluster randomized controlled trial

Tschampl, Cynthia A.; Undurraga, Eduardo A.; Ledogar, Robert J.; Coloma, Joséfina; Legorreta-Soberanis, José; Paredes-Solís, Sergio; Arosteguí, Jorge; Hernández-Álvarez, Carlos; Harris, Eva; Andersson, Neil; Shepard, Donald S.

doi:10.1016/j.ijid.2020.03.026

“…Suppressing vector populations typically employs sustainable appropriate methods targeting the immature stage habitats. Diligent sustained action by community groups can have major impacts, PLOS NEGLECTED TROPICAL DISEASES and be effective in both outbreak prevention and response, even in the absence of insecticides [60][61][62][63]. This requires regular waste disposal for elimination of discarded materials, containers with no function and general garbage.…”

Section: Typology Of Breeding Sitesmentioning

confidence: 99%

First comprehensive analysis of Aedes aegypti bionomics during an arbovirus outbreak in west Africa: Dengue in Ouagadougou, Burkina Faso, 2016–2017

Badolo

¹

,

Sombié

²

,

Yameogo

³

et al. 2022

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Background Dengue’s emergence in West Africa was typified by the Burkina Faso outbreaks in 2016 and 2017, the nation’s largest to date. In both years, we undertook three-month surveys of Aedes populations in or near the capital city Ouagadougou, where the outbreaks were centered. Methodology In 1200LG (urban), Tabtenga (peri-urban) and Goundry (rural) localities, we collected indoor and outdoor resting mosquito adults, characterized larval habitats and containers producing pupae and reared immature stages to adulthood in the laboratory for identification. All mosquito adults were identified morphologically. Host species (from which bloodmeals were taken) were identified by PCR. Generalized mixed models were used to investigate relationships between adult or larval densities and multiple explanatory variables. Results From samples in 1,780 houses, adult Ae. aegypti was significantly more abundant in the two urban localities (Tabtenga and 1200 LG) in both years than in the rural site (Goundry), where Anopheles spp. were far more common. Results from adult collections indicated a highly exophilic and anthropophilic (>90% bloodmeals of human origin) vector population, but with a relatively high proportion of bloodfed females caught inside houses. Habitats producing most pupae were waste tires (37% of total pupae), animal troughs (44%) and large water barrels (30%). While Stegomyia indices were not reliable indicators of adult mosquito abundance, shared influences on adult and immature stage densities included rainfall and container water level, collection month and container type/purpose. Spatial analysis showed autocorrelation of densities, with a partial overlap in adult and immature stage hotspots. Conclusion Results provide an evidence base for the selection of appropriate vector control methods to minimize the risk, frequency and magnitude of future outbreaks in Ouagadougou. An integrated strategy combining community-driven practices, waste disposal and insecticide-based interventions is proposed. The prospects for developing a regional approach to arbovirus control in West Africa or across Africa are discussed.

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“…For instance, in the case of dengue fever, an emerging pandemic, a study from Vietnam showed a dengue control efficacy rate of 99.7% following a rural CHW intervention [ 56 ]. Furthermore, in a Nicaraguan and Mexican randomised controlled trial, there was a 29.5% reduction in dengue infections in CHW intervention clusters [ 57 ].…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of rural community health workers in improving health outcomes during the COVID-19 pandemic: a systematic review

Kaseje,

Ranganathan,

Magadi

et al. 2024

Global Health Action

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Background Rural community health workers [CHWs] play a critical role in improving health outcomes during non-pandemic times, but evidence on their effectiveness during the COVID-19 pandemic is limited. There is a need to focus on rural CHWs and rural health systems as they have limited material and human resources rendering them more vulnerable than urban health systems to severe disruptions during pandemics. Objectives This systematic review aims to describe and appraise the current evidence on the effectiveness of rural CHWs in improving access to health services and health outcomes during the COVID-19 pandemic in low-and middle-income countries [LMICs]. Methods We searched electronic databases for articles published from 2020 to 2023 describing rural CHW interventions during the COVID-19 pandemic in LMICs. We extracted data on study characteristics, interventions, outcome measures, and main results. We conducted a narrative synthesis of key results. Results Fifteen studies from 10 countries met our inclusion criteria. Most of the studies were from Asia [10 of 15 studies]. Study designs varied and included descriptive and analytical studies. The evidence suggested that rural CHW interventions led to increased household access to health services and may be effective in improving COVID-19 and non-COVID-19 health outcomes. Overall, however, the quality of evidence was poor due to methodological limitations; 14 of 15 studies had a high risk of bias. Conclusion Rural CHWs may have improved access to health services and health outcomes during the COVID-19 pandemic in LMICs but more rigorous studies are needed during future pandemics to evaluate their effectiveness in improving health outcomes in different settings and to assess appropriate support required to ensure their impact at scale.

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“…Suppressing vector populations typically employs sustainable appropriate methods targeting the immature stage habitats. Diligent sustained action by community groups can have major impacts, and be effective in both outbreak prevention and response, even in the absence of insecticides [59][60][61][62]. This requires regular waste disposal for elimination of discarded materials, containers with no function and general garbage.…”

Section: Discussionmentioning

confidence: 99%

Bionomics of Aedes aegypti during the 2016-2017 dengue outbreaks in Ouagadougou, Burkina Faso

Badolo¹,

Sombié²,

Yameogo³

et al. 2021

Preprint

0

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BackgroundDengue’s emergence in West Africa was typified by the Burkina Faso outbreaks in 2016 and 2017, the nation’s largest to date. In both years, we undertook three-month surveys of Aedes populations in or near the capital city Ouagadougou, where the outbreak was centered.MethodologyIn urban, peri-urban and rural localities we collected indoor and outdoor resting mosquito adults, characterized larval habitats and containers producing pupae and reared immature stages to adulthood in the laboratory for identification. All mosquito adults were identified morphologically. Host species from which bloodmeals were taken were identified by PCR Generalized mixed models were used to investigate relationships between adult or larval densities and multiple explanatory variables.ResultsFrom samples in 1,791 houses, Ae. aegypti was the most abundant mosquito in the two urban localities where it occurred in 46% of containers sampled and comprised over 85% of collections. Results indicated a highly exophilic and anthropophilic (>90% bloodmeals of human origin) vector population, but with a relatively high proportion of bloodfed females caught inside houses. Habitats producing most pupae were waste tires (37% of total pupae), animal troughs (44%) and large water barrels (30%).While Stegomyia indices were not reliable indicators of adult mosquito abundance, shared influences on adult and immature stage densities included rainfall and container water level, collection month and container type/ purpose. Spatial analysis showed autocorrelation of densities, with partial overlap in adult and immature stage hotspots.ConclusionResults provide an evidence base for the selection of appropriate vector control methods to minimize the risk, frequency and magnitude of future outbreaks in Ouagadougou. An integrated strategy combining community-driven practices, waste disposal and insecticide-based interventions is indicated. The prospects of developing a regional approach to arbovirus control in west Africa or across Africa was discussedAuthor SummaryAedes aegypti is the most efficient vector of human diseases including yellow fever, dengue chikungunya and Zika. West Africa is an emerging hotspot for dengue, as illustrated by Burkina Faso’s outbreaks in 2016 and 2017. Coincidentally, this study investigated the bionomics and behavior of Ae. aegypti in urban, peri-urban and rural localities of Ouagadougou, from August to October in each year. The results from over 1700 homes showed that Ae. aegypti preferentially fed on humans and rested primarily outdoors. The most common pupal productive habitats were discarded vehicle tires, animal water troughs and large water barrels. Infestation rates were higher in the urban and peri-urban localities. A range of community-based control measures are suitable for consideration in a vector control program to prevent outbreaks. Further work is required but the study provides the most complete contemporary description of an Ae. aegypti population in West Africa and provides sufficient evidence to develop programs for prevention and control of outbreaks. The potential of a regional based vector control program for west Africa is discussed briefly.

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Cost-effectiveness of community mobilization (Camino Verde) for dengue prevention in Nicaragua and Mexico: A cluster randomized controlled trial

Cited by 7 publications

References 25 publications

First comprehensive analysis of Aedes aegypti bionomics during an arbovirus outbreak in west Africa: Dengue in Ouagadougou, Burkina Faso, 2016–2017

First comprehensive analysis of Aedes aegypti bionomics during an arbovirus outbreak in west Africa: Dengue in Ouagadougou, Burkina Faso, 2016–2017

The effectiveness of rural community health workers in improving health outcomes during the COVID-19 pandemic: a systematic review

Bionomics of Aedes aegypti during the 2016-2017 dengue outbreaks in Ouagadougou, Burkina Faso

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