Evaluación de un módulo escolar sobre dengue y Aedes aegypti dirigido a escolares en Honduras

Montes, Gustavo Adolfo Ávila; Martínez, Mercedes; Sherman, Catalina; Cerna, Eduardo Fernández

doi:10.1590/s1020-49892004000800003

Cited by 34 publications

(23 citation statements)

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“…Finally, only relatively few studies have investigated the effect of health interventions in schools in developing countries (for example, [56,57]). Further, school children may act as mediators of health messages to their parents and the community [58]. With the interventions being implemented at the school level, it follows that the school should also be the unit of randomization, resulting in a cluster-randomized design.…”

Section: Discussionmentioning

confidence: 99%

Diarrhea and dengue control in rural primary schools in Colombia: study protocol for a randomized controlled trial

Overgaard

Alexander

Mátiz

et al. 2012

Trials

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BackgroundDiarrheal diseases and dengue fever are major global health problems. Where provision of clean water is inadequate, water storage is crucial. Fecal contamination of stored water is a common source of diarrheal illness, but stored water also provides breeding sites for dengue vector mosquitoes. Poor household water management and sanitation are therefore potential determinants of both diseases. Little is known of the role of stored water for the combined risk of diarrhea and dengue, yet a joint role would be important for developing integrated control and management efforts. Even less is known of the effect of integrating control of these diseases in school settings. The objective of this trial was to investigate whether interventions against diarrhea and dengue will significantly reduce diarrheal disease and dengue entomological risk factors in rural primary schools.Methods/designThis is a 2×2 factorial cluster randomized controlled trial. Eligible schools were rural primary schools in La Mesa and Anapoima municipalities, Cundinamarca, Colombia. Eligible pupils were school children in grades 0 to 5. Schools were randomized to one of four study arms: diarrhea interventions (DIA); dengue interventions (DEN); combined diarrhea and dengue interventions (DIADEN); and control (C). Schools were allocated publicly in each municipality (strata) at the start of the trial, obviating the need for allocation concealment. The primary outcome for diarrhea is incidence rate of diarrhea in school children and for dengue it is density of adult female Aedes aegypti per school. Approximately 800 pupils from 34 schools were enrolled in the trial with eight schools in the DIA arm, nine in the DEN, eight in the DIADEN, and nine in the control arms. The trial status as of June 2012 was: completed baseline data collections; enrollment, randomization, and allocation of schools. The trial was funded by the Research Council of Norway and the Lazos de Calandaima Foundation.DiscussionThis is the first trial investigating the effect of a set of integrated interventions to control both dengue and diarrhea. This is also the first trial to study the combination of diarrhea-dengue disease control in school settings.Trial registrationCurrent Controlled Trials ISRCTN40195031

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Section: Discussionmentioning

confidence: 99%

Diarrhea and dengue control in rural primary schools in Colombia: study protocol for a randomized controlled trial

Overgaard

Alexander

Mátiz

et al. 2012

Trials

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“…80, 88]. School children participating in school-based interventions may bring health messages back home to their parents and diffuse them through the wider community [48]. We will report on the effect of the educational components on knowledge, attitudes and practices in students and their parents, as well as teachers, in a subsequent publication.…”

Section: Discussionmentioning

confidence: 99%

“…Educational interventions targeting schools to promulgate public health messages and engage students in practical control efforts are receiving increasing attention [47–49]. School children are responsive to public health education and may act as messengers of behavioral change to their households and communities [48, 50, 51]. …”

Section: Introductionmentioning

confidence: 99%

A Cluster-Randomized Controlled Trial to Reduce Diarrheal Disease and Dengue Entomological Risk Factors in Rural Primary Schools in Colombia

et al. 2016

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BackgroundAs many neglected tropical diseases are co-endemic and have common risk factors, integrated control can efficiently reduce disease burden and relieve resource-strained public health budgets. Diarrheal diseases and dengue fever are major global health problems sharing common risk factors in water storage containers. Where provision of clean water is inadequate, water storage is crucial. Fecal contamination of stored water is a common source of diarrheal illness, but stored water also provides breeding sites for dengue vector mosquitoes. Integrating improved water management and educational strategies for both diseases in the school environment can potentially improve the health situation for students and the larger community. The objective of this trial was to investigate whether interventions targeting diarrhea and dengue risk factors would significantly reduce absence due to diarrheal disease and dengue entomological risk factors in schools.Methodology/Principal FindingsA factorial cluster randomized controlled trial was carried out in 34 rural primary schools (1,301 pupils) in La Mesa and Anapoima municipalities, Cundinamarca, Colombia. Schools were randomized to one of four study arms: diarrhea interventions (DIA), dengue interventions (DEN), combined diarrhea and dengue interventions (DIADEN), and control (CON). Interventions had no apparent effect on pupil school absence due to diarrheal disease (p = 0.45) or on adult female Aedes aegypti density (p = 0.32) (primary outcomes). However, the dengue interventions reduced the Breteau Index on average by 78% (p = 0.029), with Breteau indices of 10.8 and 6.2 in the DEN and DIADEN arms, respectively compared to 37.5 and 46.9 in the DIA and CON arms, respectively. The diarrhea interventions improved water quality as assessed by the amount of Escherichia coli colony forming units (CFU); the ratio of Williams mean E. coli CFU being 0.22, or 78% reduction (p = 0.008).Conclusions/SignificanceIntegrated control of dengue and diarrhea has never been conducted before. This trial presents an example for application of control strategies that may affect both diseases and the first study to apply such an approach in school settings. The interventions were well received and highly appreciated by students and teachers. An apparent absence of effect in primary outcome indicators could be the result of pupils being exposed to risk factors outside the school area and mosquitoes flying in from nearby uncontrolled breeding sites. Integrated interventions targeting these diseases in a school context remain promising because of the reduced mosquito breeding and improved water quality, as well as educational benefits. However, to improve outcomes in future integrated approaches, simultaneous interventions in communities, in addition to schools, should be considered; using appropriate combinations of site-specific, effective, acceptable, and affordable interventions.Trial RegistrationClinicalTrials.gov no. ISRCTN40195031

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“…Por el contrario, en Indonesia (27) y México (28) se ha documentado el papel de los estudiantes en la multiplicación del conocimiento y la implementación de las medidas de control en las viviendas (26,29). Ello también se corrobora en la implementación de estrategias educativas como módulos escolares en Honduras y como educación popular en Cuba, donde se han demostrado buenos resultados en la reducción de los índices de infestación a partir de dichas iniciativas (29,30).…”

Section: Discussionunclassified

Difusión masiva de reportes situacionales sobre dengue: efectos de la intervención en Guadalajara de Buga, Colombia

et al. 2012

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Contribución de los autores:Todos los autores participaron en el diseño del estudio del estudio, en el análisis de la información y en la escritura del manuscrito. ARTÍCULO ORIGINAL Biomédica 2013;33(Supl. Introducción. La retroalimentación a las comunidades de la situación de dengue en su localidad, podría ser útil para mantener la motivación para su participación en el control del dengue y disminuir los índices entomológicos de Aedes. Objetivos. Evaluar la cobertura y el alcance de una intervención basada en la difusión masiva de reportes situacionales sobre el dengue y su efecto en la presencia de criaderos intradomiciliarios de Aedes spp. en Guadalajara de Buga, Colombia. Materiales y métodos. Se llevó a cabo un estudio observacional de corte transversal en 1.426 viviendas, para establecer la presencia de criaderos intradomiciliarios y caracterizar la exposición a la intervención. El efecto de la intervención se evaluó en un estudio de casos y controles. Los casos obedecieron al total de viviendas con criaderos positivos y, entre las viviendas sin criaderos positivos ubicadas en la misma manzana del caso, se seleccionaron aleatoriamente cuatro controles por caso.Resultados. El índice de viviendas positivas fue de 2,5 %. La cobertura fue del 59,4 % y el alcance del 22,3 %. El contacto con la intervención no se asoció con la ausencia de criaderos intradomiciliarios positivos. La presencia de matas con agua o floreros se asoció con criaderos positivos (p=0,01) y el uso de anjeos se consideró como factor protector (p=0,02). Conclusiones. Aunque la cobertura de la intervención fue adecuada, no se observó que tuviera efecto sobre la ausencia de criaderos intradomiciliarios positivos. Por lo tanto, se requiere la evaluación de la intervención en términos de su fidelidad, diseño y proceso de implementación. Introduction: Maintaining communities abreast of their local dengue situation could help to keep them motivated to participate in dengue control and to decrease Aedes entomological indexes. Objectives: To evaluate the coverage and reach of an intervention based on mass-media communication of dengue surveillance reports and its effect on the presence of intra-domiciliary breeding sites for Aedes in Guadalajara de Buga, Colombia. Materials and methods: An observational cross-sectional study was conducted in 1,426 households to identify the intra-domiciliary breeding sites and to characterize the intervention exposure. To evaluate the effect of the intervention, a case-control study was performed. All households with positive breeding sites were considered as cases. Four controls per case were randomly selected among the non-positive breeding site households located on the same block of the case. Results: The positive house index was 2.5%; coverage was 59.4% and reach was 22.3%. There was no association between the intervention and the presence of intra-domiciliary breeding sites. The presence of water plants and flower pots were associated to positive breeding sites (p=0.01) and the use of screens was associated ...

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Evaluación de un módulo escolar sobre dengue y Aedes aegypti dirigido a escolares en Honduras

Cited by 34 publications

References 12 publications

Diarrhea and dengue control in rural primary schools in Colombia: study protocol for a randomized controlled trial

Diarrhea and dengue control in rural primary schools in Colombia: study protocol for a randomized controlled trial

A Cluster-Randomized Controlled Trial to Reduce Diarrheal Disease and Dengue Entomological Risk Factors in Rural Primary Schools in Colombia

Difusión masiva de reportes situacionales sobre dengue: efectos de la intervención en Guadalajara de Buga, Colombia

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