Intersectoral coordination in Aedes aegypti control. A pilot project in Havana City, Cuba

Abstract

Summarybackground The 55th World Health Assembly declared dengue prevention and control a priority and urged Member States to develop sustainable intersectoral strategies to this end. To provide evidence for the reorientation of the dengue prevention policy in Cuba, we launched an intervention study to document the effectiveness of a local-level intersectoral approach.methods We used a quasi-experimental design. Social scientists introduced participatory methods to facilitate dialogue in the biweekly meetings of the intersectoral Health Council of the intervention area. This council subsequently developed an intersectoral plan for dengue prevention, of which the core objective was to design and implement activities for communication and social mobilization. In the control area, routine dengue control activities continued without additional input. Knowledge, attitudes and perceptions of dengue, and entomological indices were compared inside and between the areas before and after the 1-year intervention period.

Effect of dengue vector control interventions on entomological parameters in developing countries: a systematic review and meta‐analysis

“…This supports the suggestion that combining interventions produces a higher overall effect. For malaria, there is growing evidence that integrated control approaches are highly effective ( Utzinger et al , 2002;Castro et al , 2004; Honduras, El Progreso, 1988 (Fernández et al, 1998) Mexico, Yucatan, 1990(Lloyd et al, 1992 Puerto Rico, NA, 1986 (Winch et al, 2002) Cuba, Havana, 1999 (Sanchez et al, 2005) Thailand, Kohn Kaen, 2001 (Phuanukoonnon et al, 2005) Philippines, Labangon, 1997 (Madarieta et al, 1999) Indonesia, Pekalongan, 1985(Suroso & Suroso, 1990 …”

“…Ideally, they should be accompanied by improvements in the provision of reliable safe drinking water. In the longterm, updating health legislation might give vector control Fiji, Lautoka, 2002(Raju, 2003 Venezuela, Trujillo, 2003 Mexico, Veracruz, 2002 Mexico, Yucatan, 1990(Lloyd et al, 1992 Puerto Rico, NA, 1986(Winch et al, 2002 Cuba, Havana, 1999 (Sanchez et al, 2005) Vietnam, Hai Hung province, 1994 (Igarashi, 1997) Philippines, Labangon, 1997 (Madarieta et al, 1999) Indonesia, Pekalongan, 1985(Suroso & Suroso, 1990 …”

The unbearable lightness of technocratic efforts at dengue control

“…The Cuban government has demonstrated strong political commitment to health development despite the limited financial resources available to the country and the economical blockade imposed by US (Kuntz 1994;DeVos 2005). The present trial, as well as other pilot initiatives in the country (Sanchez et al 2005;Spiegel et al 2007;Toledo Romani et al 2007) received all necessary financial and human support from the government, which has also been remarkably successful in dengue prevention (Gubler & Clark 1996). Global changes in dengue epidemiology and local environmental threats nevertheless constitute increasing challenges for Aedes control.…”

“…This study unequivocally demonstrates the need for community involvement. Notwithstanding, effective intersectoral coordination that guarantees, among others, reliable minimal water supply and adequate waste management, seems equally essential (Sanchez et al 2005;Toledo Romani et al 2007). Strengthening the delivery of essential public services while deploying specific vector control tools could leverage the much needed behavioural change at individual level.…”

Eficacia de la “metodología vivencial de aprendizaje” en el nivel de conocimiento sobre enfermedades transmitidas porAedes aegypti en un desastre natural

“…Sin embargo, en esta experiencia se tuvo la oportunidad de evaluar el desempeño de una intervención promovida por una entidad estatal que incluye un trabajo intersectorial (empresa-comunidad), lo cual, según Sánchez et al es uno de los requisitos para asegurar el cambio de conductas mediante un enfoque participativo (22) . Otra fortaleza de esta intervención es la adecuación al contexto cultural de la comunidad intervenida, asumiendo estrategias que sean fáciles de entender y propicien el involucramiento de las autoridades, es decir, asumir a la comunidad no como un blanco terapéutico sino como un agente, creando redes de soporte con lo cual se pueden crear unidades, naturalmente constituidas, de solución que puedan difundir e implementar estrategias preventivas contra la aparición de enfermedades transmitidas por Aedes aegypti (23,24) .…”