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Overgaard HJ, Linn NYY, Kyaw AMM, Braack L, Win Tin M, Bastien S, Vande Velde F, Echaubard P, Zaw W, Mukaka M, Maude R. School and community driven dengue vector control and monitoring in Myanmar: Study protocol for a cluster randomized controlled trial. Wellcome Open Res 2023; 7:206. [PMID: 38313099 PMCID: PMC10837613 DOI: 10.12688/wellcomeopenres.18027.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/06/2024] Open
Abstract
Background Dengue is the most common and widespread mosquito-borne arboviral disease globally estimated to cause >390 million infections and >20,000 deaths annually. There are no effective preventive drugs and the newly introduced vaccines are not yet available. Control of dengue transmission still relies primarily on mosquito vector control. Although most vector control methods currently used by national dengue control programs may temporarily reduce mosquito populations, there is little evidence that they affect transmission. There is an urgent need for innovative, participatory, effective, and locally adapted approaches for sustainable vector control and monitoring in which students can be particularly relevant contributors and to demonstrate a clear link between vector reduction and dengue transmission reduction, using tools that are inexpensive and easy to use by local communities in a sustainable manner. Methods Here we describe a cluster randomized controlled trial to be conducted in 46 school catchment areas in two townships in Yangon, Myanmar. The outcome measures are dengue cases confirmed by rapid diagnostic test in the townships, dengue incidence in schools, entomological indices, knowledge, attitudes and practice, behavior, and engagement. Conclusions The trial involves middle school students that positions them to become actors in dengue knowledge transfer to their communities and take a leadership role in the delivery of vector control interventions and monitoring methods. Following this rationale, we believe that students can become change agents of decentralized vector surveillance and sustainable disease control in line with recent new paradigms in integrated and participatory vector surveillance and control. This provides an opportunity to operationalize transdisciplinary research towards sustainable health development. Due to the COVID-19 pandemic and political instability in Myanmar the project has been terminated by the donor, but the protocol will be helpful for potential future implementation of the project in Myanmar and/or elsewhere.Registration: This trial was registered in the ISRCTN Registry on 31 May 2022 ( https://doi.org/10.1186/ISRCTN78254298).
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Affiliation(s)
- Hans J. Overgaard
- Faculty of Science and Technology, Norwegian University of Life Sciences, As, 1432, Norway
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, KHON KAEN, 40002, Thailand
| | - Nay Yi Yi Linn
- Central Vector Borne Disease Control Unit, Ministry of Health and Sports, Nay Pyi Taw, Myanmar
| | - Aye Mon Mon Kyaw
- Yangon Regional Health Department, Ministry of Health and Sports, Yangon, Myanmar
| | - Leo Braack
- Malaria Consortium, Bangkok 10400, Thailand
- Institute for Sustainable Malaria Control, University of Pretoria, Pretoria 0028, South Africa
| | | | - Sheri Bastien
- Faculty of Landscape and Society, Norwegian University of Life Sciences, 1432 Ås, Norway
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 1N4, Canada
| | - Fiona Vande Velde
- Faculty of Landscape and Society, Norwegian University of Life Sciences, 1432 Ås, Norway
| | - Pierre Echaubard
- School of Oriental and African Studies (SOAS), University of London, London, WC1H 0XG, UK
- Faculty of Environment and Resource Studies, Mahidol University, Salaya, 73170, Thailand
| | - Win Zaw
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Mavuto Mukaka
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7LG, UK
| | - Richard Maude
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7LG, UK
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, 02115, USA
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Aung SH, Phuanukoonnon S, Mon Kyaw AM, Lawpoolsri S, Sriwichai P, Soonthornworasiri N, Jittamala P. Effectiveness of dengue training programmes on prevention and control among high school students in the Yangon region, Myanmar. Heliyon 2023; 9:e16759. [PMID: 37292340 PMCID: PMC10245065 DOI: 10.1016/j.heliyon.2023.e16759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/22/2023] [Accepted: 05/25/2023] [Indexed: 06/10/2023] Open
Abstract
Background Dengue is one of the health problems in Myanmar. Thus, health promotion in schools is considered a key approach for reducing risk-taking behaviours related to dengue. Objectives The study aimed to evaluate a dengue training programme for high school students to measure changes in knowledge, attitude and practices (KAP) towards dengue; evaluate the effectiveness of the programme in improving prevention and control practices among families and determining changes in larval indices in their dwelling places. Methodology The dengue school training programme was conducted for Grades 9 and 10 students in Yangon. In total, 300 students in the intervention school received training and were compared with 300 students as control. KAP was assessed using a self-administered questionnaire, whereas larval and control practice surveys were conducted at the homes of both groups 3 months before and after the programme. Results The KAP scores of the intervention group increased after the programme. Moreover, the programme improved prevention and control practices and decreased the larval indices in the intervention group. Students from the same group with high scores in knowledge and self-reported practices were less likely to exhibit Aedes larval positivity in their residential areas. Conclusion This study demonstrated the impact of the dengue training programme on the KAP of students and short-term family larval control practices, which influenced household larval indices.
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Affiliation(s)
- Soe Htet Aung
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Thailand
| | - Suparat Phuanukoonnon
- Department of Social and Environmental Science, Faculty of Tropical Medicine, Mahidol University, Thailand
| | - Aye Mon Mon Kyaw
- Central Epidemiology Unit, Department of Public Health, Ministry of Health, Myanmar
| | - Saranath Lawpoolsri
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Thailand
| | - Patchara Sriwichai
- Department of Medical Entomology, Faculty of Tropical Medicine, Mahidol University, Thailand
| | | | - Podjanee Jittamala
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Thailand
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Scorpion envenomation in Brazil: Current scenario and perspectives for containing an increasing health problem. PLoS Negl Trop Dis 2023; 17:e0011069. [PMID: 36757916 PMCID: PMC9910716 DOI: 10.1371/journal.pntd.0011069] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
Opportunistic scorpion species can colonize urban environments, establishing high-density communities that enhance the chances of human accidents. This scenario has been taking place in Brazil, in which some Tityus species have taken city centers, causing an explosion in the number of scorpion envenoming cases. The characteristics of this scorpionism epidemic in Brazil is discussed in the present work. The number of Brazilian scorpion stings has surpassed 120,000 cases in 2017, and has been maintained above this number ever since, representing a more than 3-fold increase in 10 years, which was higher than the number of cases for most of the neglected tropical diseases in the country. The escalation in scorpionism cases is even higher in some regions of Brazil. Fortunately, the proportion of mild cases has also increased in the analyzed period, as well as the number of victims seeking for medical attention within the first hour after the accident. The species Tityus serrulatus, Tityus stigmurus, Tityus bahiensis, and Tityus obscurus are traditionally accountable for most of the scorpion accidents in different regions of Brazil, but other species deserve to be closely watched. Despite scorpionism being a notable health problem in Brazil, accident prevention and pest control regarding this venomous animal have not been properly addressed by the scientific community nor by policy makers. Therefore, this review also aims to point possible fields of research that could help to contain the aggravation of the current scorpionism landscape in Brazil.
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Sarmiento-Senior D, Matiz MI, Vargas-Cruz S, Jaramillo JF, Olano VA, Lenhart A, Stenström TA, Alexander N, Overgaard HJ. Improving knowledge, attitudes, and practices on dengue and diarrhea in rural primary school students, their parents, and teachers in Colombia: A cluster-randomized controlled trial. PLoS Negl Trop Dis 2022; 16:e0010985. [PMID: 36574453 PMCID: PMC9829171 DOI: 10.1371/journal.pntd.0010985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 01/09/2023] [Accepted: 11/26/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Improved education on water-related diseases in schools could help to reduce disease burden. This paper presents specific results on knowledge, attitudes and practices (KAP) of a cluster-randomized controlled trial to reduce diarrheal disease and dengue entomological risk factors in rural primary schools in Colombia. The aim was to investigate whether enhanced educational interventions on dengue and diarrheal disease in schools could improve KAP scores related to these diseases in students and teachers in rural primary schools, as well as the students' parents. METHODOLOGY/PRINCIPAL FINDINGS A factorial cluster-randomized controlled trial was carried out in 35 rural primary schools in two municipalities in Cundinamarca, central Colombia. Schools were randomized into four arms: interventions related to diarrheal disease (DIA), dengue (DEN), both (DIADEN), or no interventions (control, CON). Both educational and physical interventions to reduce risk factors of dengue and diarrhea were implemented. Comprehensive teachers' manuals were developed and deployed to guide the learning activities. The intervention was carried out over two school years. The knowledge scores of students receiving dengue interventions (DEN, DIADEN) increased by 1.16 point score (0.75-1.56, p<0.001) and those receiving diarrhea interventions (DIA, DIADEN) increased by 1.15 point score (0.67-1.63, p<0.001). The attitude and practice scores of students receiving the diarrhea interventions increased (Attitudes: 0.41 [0.11-0.71, p = 0.01]; Practices: 0.33 [0.01-0.65, p = 0.042]), but not for those receiving the dengue interventions (p = 0.31 and p = 0.08, respectively). CONCLUSIONS/SIGNIFICANCE There were increases in knowledge scores among students, their teachers and their parents for both diseases. However, the attitudes and practices components were not affected to the same extent. The hypothesis that the students would disseminate knowledge acquired from the educational interventions to their parents was confirmed for dengue, but not for diarrhea. TRIAL REGISTRATION ISRCTN40195031 The trial is registered in the Current Controlled Trials under Infections and Infestations category.
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Affiliation(s)
- Diana Sarmiento-Senior
- Instituto de Salud y Ambiente, Universidad El Bosque, Bogotá, Colombia
- * E-mail: (DSS); (NA); (HJO)
| | - Maria Ines Matiz
- Instituto de Salud y Ambiente, Universidad El Bosque, Bogotá, Colombia
| | | | | | | | - Audrey Lenhart
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Thor Axel Stenström
- Institute for Water and Waste Water Technology, Durban University of Technology, Durban, South Africa
| | - Neal Alexander
- MRC International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
- * E-mail: (DSS); (NA); (HJO)
| | - Hans J. Overgaard
- Faculty of Science and Technology, Norwegian University of Life Sciences, Ås, Norway
- Department of Microbiology & Tropical Disease Research Center, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
- * E-mail: (DSS); (NA); (HJO)
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Overgaard HJ, Linn NYY, Kyaw AMM, Braack L, Win Tin M, Bastien S, Vande Velde F, Echaubard P, Zaw W, Mukaka M, Maude R. School and community driven dengue vector control and monitoring in Myanmar: Study protocol for a cluster randomized controlled trial. Wellcome Open Res 2022. [DOI: 10.12688/wellcomeopenres.18027.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background. Dengue is the most common and widespread mosquito-borne arboviral disease globally estimated to cause >390 million infections and >20,000 deaths annually. There are no effective vaccines or preventive drugs. Control of dengue transmission relies primarily on mosquito vector control. Although most vector control methods currently used by national dengue control programs may temporarily reduce mosquito populations, there is little evidence that they affect transmission. There is an urgent need for innovative, participatory, effective, and locally adapted approaches for sustainable vector control and monitoring in which students can be particularly relevant contributors and to demonstrate a clear link between vector reduction and dengue transmission reduction, using tools that are inexpensive and easy to use by local communities in a sustainable manner. Methods. Here we describe a cluster randomized controlled trial to be conducted in 46 school catchment areas in two townships in Yangon, Myanmar. The outcome measures are dengue cases confirmed by rapid diagnostic test in the townships, dengue incidence in schools, entomological indices, knowledge, attitudes and practice, behavior, and engagement. Conclusions. The trial involves middle school students that positions them to become actors in dengue knowledge transfer to their communities and take a leadership role in the delivery of vector control interventions and monitoring methods. Following this rationale, we believe that students can become change agents of decentralized vector surveillance and sustainable disease control in line with recent new paradigms in integrated and participatory vector surveillance and control. This provides an opportunity to operationalize transdisciplinary research towards sustainable health development. Due to the COVID-19 pandemic and political instability in Myanmar the project has been terminated by the donor, but the protocol will be helpful for potential future implementation of the project in Myanmar and/or elsewhere. Registration: This trial was registered in the ISRCTN Registry on 31 May 2022 (https://doi.org/10.1186/ISRCTN78254298).
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Overgaard HJ, Dada N, Lenhart A, Stenström TAB, Alexander N. Integrated disease management: arboviral infections and waterborne diarrhoea. Bull World Health Organ 2021; 99:583-592. [PMID: 34354313 PMCID: PMC8319858 DOI: 10.2471/blt.20.269985] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 02/15/2021] [Accepted: 03/08/2021] [Indexed: 11/27/2022] Open
Abstract
Water-related diseases such as diarrhoeal diseases from viral, bacterial and parasitic organisms and Aedes-borne arboviral diseases are major global health problems. We believe that these two disease groups share common risk factors, namely inadequate household water management, poor sanitation and solid waste management. Where water provision is inadequate, water storage is essential. Aedes mosquitoes commonly breed in household water storage containers, which can hold water contaminated with enteric disease-causing organisms. Microbiological contamination of water between source and point-of-use is a major cause of reduced drinking-water quality. Inadequate sanitation and solid waste management increase not only risk of water contamination, but also the availability of mosquito larval habitats. In this article we discuss integrated interventions that interrupt mosquito breeding while also providing sanitary environments and clean water. Specific interventions include improving storage container design, placement and maintenance and scaling up access to piped water. Vector control can be integrated into sanitation projects that target sewers and drains to avoid accumulation of stagnant water. Better management of garbage and solid waste can reduce the availability of mosquito habitats while improving human living conditions. Our proposed integration of disease interventions is consistent with strategies promoted in several global health frameworks, such as the sustainable development goals, the global vector control response, behavioural change, and water, sanitation and hygiene initiatives. Future research should address how interventions targeting water, sanitation, hygiene and community waste disposal also benefit Aedes-borne disease control. The projected effects of climate change mean that integrated management and control strategies will become increasingly important.
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Affiliation(s)
- Hans J Overgaard
- Faculty of Science and Technology, Drøbakveien 31, Norwegian University of Life Sciences, NO – 1432 Ås, Norway
| | - Nsa Dada
- Faculty of Science and Technology, Drøbakveien 31, Norwegian University of Life Sciences, NO – 1432 Ås, Norway
| | - Audrey Lenhart
- Center for Global Health, United States Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Thor Axel B Stenström
- Institute for Water and Wastewater Technology, Durban University of Technology, Durban, South Africa
| | - Neal Alexander
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, England
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