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Pérez D, Robert E, Pérez EJ, Vanlerberghe V, Lefèvre P, Ridde V. A Realist Synthesis of Community-Based Interventions in Vector-Borne Diseases. Am J Trop Med Hyg 2021; 104:1202-1210. [PMID: 33646975 PMCID: PMC8045614 DOI: 10.4269/ajtmh.20-0944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 12/30/2020] [Indexed: 11/17/2022] Open
Abstract
Randomized control trials have provided evidence that some community-based interventions (CBIs) work in vector-borne diseases (VBDs). Conversely, there is limited evidence on how well those CBIs succeed in producing specific outcomes in different contexts. To conduct a realist synthesis for knowledge translation on this topic, we examined the extent to which realist concepts (context, mechanisms, and outcomes) and their relationships are present in the existing literature on CBIs for VBDs. Articles on CBIs were identified from prior scoping reviews of health interventions for VBDs. Content of the articles was extracted verbatim if it referred either to realist concepts or CBI features. The number of articles and the average number of words extracted per category per CBI were quantified. Content of the articles was scrutinized to inductively gather qualitative evidence on the interactions between realist concepts. We reviewed 41 articles on 17 CBIs from 12 countries. The average number of words used for mechanisms was much lower than those used for outcomes and context (309,474, and 836, respectively). The average number of words used for mechanisms increased when a CBI was described in three or more articles. There were more extensive accounts on CBI features than on mechanisms. It was difficult to gather evidence on the interactions among realist concepts from the content of the articles. Scarce reporting on mechanisms in published articles limits conducting a realist synthesis of CBIs in VBDs. More transdisciplinary research that goes beyond the biomedical paradigm is needed to boost the development of intervention mechanisms in this field.
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Affiliation(s)
- Dennis Pérez
- 1Instituto de Medicina Tropical Pedro Kourí, Habana, Cuba
| | - Emilie Robert
- 2ICARES and Centre de Recherche SHERPA (Institut Universitaire Au Regard des Communautés Ethnoculturelles, CIUSSS du Centre-Ouest-del'Île-de-Montréal), Montreal, Canada
| | - Elsury J Pérez
- 3Public Health Research Institute (IRSPUM), University of Montreal School of Public Health (ESPUM), University of Montreal, Montreal, Canada
| | | | - Pierre Lefèvre
- 5Free-Lance Consultant in International Health, Brussels, Belgium
| | - Valéry Ridde
- 6CEPED, IRD (French Institute for Research on Sustainable Development), Université de Paris, ERL INSERM SAGESUD, Paris, France
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de Macêdo SF, Silva KA, de Vasconcelos RB, de Sousa IV, Mesquita LPS, Barakat RDM, Fernandes HMC, Queiroz ACM, Santos GPG, Filho VCB, Carrasquilla G, Caprara A, de Oliveira Lima JW. Scaling up of Eco-Bio-Social Strategy to Control Aedes aegypti in Highly Vulnerable Areas in Fortaleza, Brazil: A Cluster, Non-Randomized Controlled Trial Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031278. [PMID: 33572650 PMCID: PMC7908398 DOI: 10.3390/ijerph18031278] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 01/23/2021] [Accepted: 01/25/2021] [Indexed: 11/17/2022]
Abstract
Aedes aegypti is a cosmopolitan vector for arboviruses dengue, Zika and chikungunya, disseminated in all Brazilian states. The Eco-Bio-Social (EBS) strategy is vital in Aedes aegypti control as it mobilizes stakeholders (government, professionals, society, and academics) to promote healthy environments. This paper describes the rationale and methods of expanding the EBS strategy for Aedes aegypti control in Fortaleza, Northeast Brazil. A cluster, non-randomized controlled clinical trial was developed to analyze the strategy’s effectiveness in vulnerable territories (high incidence of dengue and violent deaths; low HDI; substandard urban infrastructure, high population density, and water scarcity). We selected two intervention and two control groups, resulting in a sample of approximately 16,000 properties. The intervention consisted of environmental management by sealing large elevated water tanks, introduction of beta fish in waterholes, elimination of potential breeding sites, and mobilization and training of schoolchildren, endemic disease workers, health workers, social mobilizers, and community leaders; community surveillance of arboviruses; construction and validation of a booklet for the prevention of arboviruses in pregnant women. We analyzed the costs of arboviruses to government and households, the intervention cost-effectiveness, chikungunya’s chronicity, and acceptance, sustainability, and governance of vector control actions. The primary outcome (infestation) was analyzed using the house, container, and Breteau indices. We hope that this study will help us understand how to scale up strategies to fight Aedes aegypti in vulnerable areas.
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Affiliation(s)
- Suyanne Freire de Macêdo
- Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil; (K.A.S.); (R.B.d.V.); (I.V.d.S.); (L.P.S.M.); (R.D.M.B.); (H.M.C.F.); (A.C.M.Q.); (G.P.G.S.); (V.C.B.F.); (A.C.); (J.W.d.O.L.)
- Nursing Department, Federal University of Piauí, Picos 64607-670, Brazil
- Correspondence:
| | - Kellyanne Abreu Silva
- Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil; (K.A.S.); (R.B.d.V.); (I.V.d.S.); (L.P.S.M.); (R.D.M.B.); (H.M.C.F.); (A.C.M.Q.); (G.P.G.S.); (V.C.B.F.); (A.C.); (J.W.d.O.L.)
| | - Renata Borges de Vasconcelos
- Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil; (K.A.S.); (R.B.d.V.); (I.V.d.S.); (L.P.S.M.); (R.D.M.B.); (H.M.C.F.); (A.C.M.Q.); (G.P.G.S.); (V.C.B.F.); (A.C.); (J.W.d.O.L.)
| | - Izautina Vasconcelos de Sousa
- Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil; (K.A.S.); (R.B.d.V.); (I.V.d.S.); (L.P.S.M.); (R.D.M.B.); (H.M.C.F.); (A.C.M.Q.); (G.P.G.S.); (V.C.B.F.); (A.C.); (J.W.d.O.L.)
| | - Lyvia Patrícia Soares Mesquita
- Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil; (K.A.S.); (R.B.d.V.); (I.V.d.S.); (L.P.S.M.); (R.D.M.B.); (H.M.C.F.); (A.C.M.Q.); (G.P.G.S.); (V.C.B.F.); (A.C.); (J.W.d.O.L.)
| | - Roberta Duarte Maia Barakat
- Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil; (K.A.S.); (R.B.d.V.); (I.V.d.S.); (L.P.S.M.); (R.D.M.B.); (H.M.C.F.); (A.C.M.Q.); (G.P.G.S.); (V.C.B.F.); (A.C.); (J.W.d.O.L.)
| | - Hélida Melo Conrado Fernandes
- Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil; (K.A.S.); (R.B.d.V.); (I.V.d.S.); (L.P.S.M.); (R.D.M.B.); (H.M.C.F.); (A.C.M.Q.); (G.P.G.S.); (V.C.B.F.); (A.C.); (J.W.d.O.L.)
| | - Ana Carolina Melo Queiroz
- Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil; (K.A.S.); (R.B.d.V.); (I.V.d.S.); (L.P.S.M.); (R.D.M.B.); (H.M.C.F.); (A.C.M.Q.); (G.P.G.S.); (V.C.B.F.); (A.C.); (J.W.d.O.L.)
| | - Gerarlene Ponte Guimarães Santos
- Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil; (K.A.S.); (R.B.d.V.); (I.V.d.S.); (L.P.S.M.); (R.D.M.B.); (H.M.C.F.); (A.C.M.Q.); (G.P.G.S.); (V.C.B.F.); (A.C.); (J.W.d.O.L.)
| | - Valter Cordeiro Barbosa Filho
- Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil; (K.A.S.); (R.B.d.V.); (I.V.d.S.); (L.P.S.M.); (R.D.M.B.); (H.M.C.F.); (A.C.M.Q.); (G.P.G.S.); (V.C.B.F.); (A.C.); (J.W.d.O.L.)
- Federal Institute of Education, Science and Technology of Ceará, Aracati Campus, Aracati 62800-000, Brazil
| | | | - Andrea Caprara
- Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil; (K.A.S.); (R.B.d.V.); (I.V.d.S.); (L.P.S.M.); (R.D.M.B.); (H.M.C.F.); (A.C.M.Q.); (G.P.G.S.); (V.C.B.F.); (A.C.); (J.W.d.O.L.)
| | - José Wellington de Oliveira Lima
- Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil; (K.A.S.); (R.B.d.V.); (I.V.d.S.); (L.P.S.M.); (R.D.M.B.); (H.M.C.F.); (A.C.M.Q.); (G.P.G.S.); (V.C.B.F.); (A.C.); (J.W.d.O.L.)
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Quintero J, Ronderos Pulido N, Logan J, Ant T, Bruce J, Carrasquilla G. Effectiveness of an intervention for Aedes aegypti control scaled-up under an inter-sectoral approach in a Colombian city hyper-endemic for dengue virus. PLoS One 2020; 15:e0230486. [PMID: 32236142 PMCID: PMC7112230 DOI: 10.1371/journal.pone.0230486] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 03/03/2020] [Indexed: 11/18/2022] Open
Abstract
Aedes aegypti transmitted arboviral diseases are of significant importance in Colombia, particularly since the 2014/2015 introduction of chikungunya and Zika in the Americas and the increasing spread of dengue. In response, the Colombian government initiated the scaling-up of a community-based intervention under inter and multi-sector partnerships in two out of four sectors in Girardot, one of the most hyper-endemic dengue cities in the country. Using a quasi-experimental research design a scaled-up community-led Aedes control intervention was assessed for its capacity to reduce dengue from January 2010 to August 2017 in Girardot, Colombia. Reported dengue cases, and associated factors were analysed from available data sets from the Colombian disease surveillance systems. We estimated the reduction in dengue cases before and after the intervention using, Propensity Score Matching and an Autoregressive Moving Average model for robustness. In addition, the differences in dengue incidence among scaling-up phases (pre-implementation vs sustainability) and between treatment groups (intervention and control areas) were modelled. Evidence was found in favour of the intervention, although to maximise impact the scaling-up of the intervention should continue until it covers the remaining sectors. It is expected that a greater impact of the intervention can be documented in the next outbreak of dengue in Girardot.
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Affiliation(s)
- Juliana Quintero
- Eje de Salud Poblacional, Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Universidad Santo Tomas, Bogotá, Colombia
| | | | - James Logan
- Eje de Salud Poblacional, Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Thomas Ant
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jane Bruce
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Castro-Bonilla L, Coronel-Ruiz C, Parra-Alvarez S, Castellanos JE, Porras-Ramírez A, Velandia-Romero ML. Factors Associated with Dengue Virus Infection and Reinfection in Asymptomatic Children in Two Colombian Municipalities. Am J Trop Med Hyg 2018; 99:1422-1429. [PMID: 30398143 PMCID: PMC6283502 DOI: 10.4269/ajtmh.17-0617] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 06/02/2018] [Indexed: 12/21/2022] Open
Abstract
Dengue is the most important arbovirosis in the world. In this study, we assessed the knowledge, attitudes, and practices (KAP) regarding dengue in parents from two small Colombian municipalities in the Cundinamarca Province. Parents and their healthy children from 4 to 14 years of age were included in some public elementary schools. After a medical examination, blood samples were taken for diagnosis of dengue using enzyme-linked immunosorbent assays (capture immunoglobulin M and capture immunoglobulin G [IgG], indirect IgG and detection non-structural viral protein 1) and detection of viral RNA by reverse transcription polymerase chain reaction. In addition, a KAP survey was applied to the children's parents or tutors. The indirect IgG test determined that of the 347 examined children, 87.9% had a previous infection with the dengue virus (DENV), 12.7% of them were positive for viral RNA (asymptomatic infection), and 32.0% presented reinfections. Risk factors evaluation showed that children aged 8 years and older living in the municipalities for more than 7 years were more likely to be infected or reinfected by DENV. In the same way, poor nutrition, lack of water supply, sewer service, or waste disposal services could raise the likelihood of dengue infections. The surveys indicated that parents have unhealthy practices and a low knowledge about the transmission of the disease, which could result in an increase of mosquito breeding sites, allowing sustained dengue transmission.
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Quintero J, García-Betancourt T, Cortés S, García D, Alcalá L, González-Uribe C, Brochero H, Carrasquilla G. Effectiveness and feasibility of long-lasting insecticide-treated curtains and water container covers for dengue vector control in Colombia: a cluster randomised trial. Trans R Soc Trop Med Hyg 2015; 109:116-25. [PMID: 25604762 PMCID: PMC4299530 DOI: 10.1093/trstmh/tru208] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Long-lasting insecticide-treated net (LLIN) window and door curtains alone or in combination with LLIN water container covers were analysed regarding effectiveness in reducing dengue vector density, and feasibility of the intervention. Methods A cluster randomised trial was conducted in an urban area of Colombia comparing 10 randomly selected control and 10 intervention clusters. In control clusters, routine vector control activities were performed. The intervention delivered first, LLIN curtains (from July to August 2013) and secondly, water container covers (from October to March 2014). Cross-sectional entomological surveys were carried out at baseline (February 2013 to June 2013), 9 weeks after the first intervention (August to October 2013), and 4–6 weeks after the second intervention (March to April 2014). Results Curtains were installed in 922 households and water container covers in 303 households. The Breteau index (BI) fell from 14 to 6 in the intervention group and from 8 to 5 in the control group. The additional intervention with LLIN covers for water containers showed a significant reduction in pupae per person index (PPI) (p=0.01). In the intervention group, the PPI index showed a clear decline of 71% compared with 25% in the control group. Costs were high but options for cost savings were identified. Conclusions Short term impact evaluation indicates that the intervention package can reduce dengue vector density but sustained effect will depend on multiple factors.
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Affiliation(s)
- Juliana Quintero
- Centro de Estudios e Investigación en Salud, CEIS-Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | | | - Sebastian Cortés
- Centro de Estudios e Investigación en Salud, CEIS-Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Diana García
- Centro de Estudios e Investigación en Salud, CEIS-Fundación Santa Fe de Bogotá, Bogotá, Colombia Universidad Nacional de Colombia, Bogotá, Colombia
| | - Lucas Alcalá
- Centro de Estudios e Investigación en Salud, CEIS-Fundación Santa Fe de Bogotá, Bogotá, Colombia Universidad Nacional de Colombia, Bogotá, Colombia
| | - Catalina González-Uribe
- Centro de Estudios e Investigación en Salud, CEIS-Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | | | - Gabriel Carrasquilla
- Centro de Estudios e Investigación en Salud, CEIS-Fundación Santa Fe de Bogotá, Bogotá, Colombia
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