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Montenegro-Quiñonez CA, Louis VR, Horstick O, Velayudhan R, Dambach P, Runge-Ranzinger S. Interventions against Aedes/dengue at the household level: a systematic review and meta-analysis. EBioMedicine 2023; 93:104660. [PMID: 37352828 PMCID: PMC10333437 DOI: 10.1016/j.ebiom.2023.104660] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 05/25/2023] [Accepted: 06/02/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Because the evidence for the role of structural housing and combinations of interventions (domestic or peri-domestic) against Aedes mosquitoes or dengue is still lacking, this systematic review and meta-analysis aimed to analyse and synthesize research focusing on the household as the unit of allocation. METHODS We searched MEDLINE, LILACS, and Web of Science databases until February 2023 using three general keyword categories: (1) "Aedes" or "dengue"; (2) structural housing interventions including "house", "water", or "drainage"; and (3) vector control interventions of potential relevance and their combinations. We performed a qualitative content analysis and a meta-analysis for 13 entries on dengue seroconversion data. FINDINGS 14,272 articles were screened by titles, 615 by abstracts, 79 by full-text. 61 were selected. Satisfactory data quality allowed for detailed content analysis. Interventions at the household level against the immature mosquito stages (21 studies, 34%) showed positive or mixed results in entomological and epidemiological outcomes (86% and 75% respectively). Combined interventions against immature and adult stages (11 studies, 18%) performed similarly (91% and 67%) while those against the adult mosquitoes (29 studies, 48%) performed less well (79%, 22%). A meta-analysis on seroconversion outcomes showed a not-statistically significant reduction for interventions (log odds-ratio: -0.18 [-0.51, 0.14 95% CI]). INTERPRETATION No basic research on housing structure or modification was eligible for this systematic review but many interventions with clear impact on vector indices and, to a lesser extent, on dengue were described. The small and not-statistically significant effect size of the meta-analysis highlights the difficulty of proving effectiveness against this highly-clustered disease and of overcoming practical implementation obstacles (e.g. efficacy loss, compliance). The long-term success of interventions depends on suitability, community commitment and official support and promotion. The choice of a specific vector control package needs to take all these context-specific aspects into consideration. FUNDING This work was funded by a grant from the World Health Organization (2021/1121668-0, PO 202678425, NTD/VVE).
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Affiliation(s)
- Carlos Alberto Montenegro-Quiñonez
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany; Instituto de Investigaciones, Centro Universitario de Zacapa, Universidad de San Carlos de Guatemala, Guatemala.
| | - Valérie R Louis
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany.
| | - Olaf Horstick
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany.
| | - Raman Velayudhan
- Department of Control of Neglected Tropical Diseases (NTD), World Health Organization, Switzerland.
| | - Peter Dambach
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany.
| | - Silvia Runge-Ranzinger
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany.
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Mulderij-Jansen V, Pundir P, Grillet ME, Lakiang T, Gerstenbluth I, Duits A, Tami A, Bailey A. Effectiveness of Aedes-borne infectious disease control in Latin America and the Caribbean region: A scoping review. PLoS One 2022; 17:e0277038. [PMID: 36322603 PMCID: PMC9629598 DOI: 10.1371/journal.pone.0277038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 10/18/2022] [Indexed: 11/05/2022] Open
Abstract
Background Aedes aegypti and Aedes albopictus are primary vectors of emerging or re-emerging arboviruses that threaten public health worldwide. Many efforts have been made to develop interventions to control these Aedes species populations. Still, countries in the Latin America and the Caribbean (LAC) region struggle to create/design/develop sustainable and effective control strategies. This scoping review synthesises evidence concerning the effectiveness of Ae. aegypti and Ae. albopictus prevention and control interventions performed in LAC (2000–2021). The findings can be used to evaluate, compare and develop more effective control strategies. Methodology The review is based on the methodology by Joanna Briggs Institute for conducting a scoping review. The MEDLINE (via PubMed and Web of Science), Cochrane Library, Scopus, EMBASE and ScienceDirect databases were used to search for articles. Grey literature was searched from governmental and non-governmental organisation websites. Four reviewers independently screened all titles and abstracts and full-text of the articles using the Rayyan web application, based on pre-defined eligibility criteria. Results A total of 122 publications were included in the review. Most studies focused on dengue virus infection and data on Ae. aegypti. Entomological data were mainly used to determine the intervention’s effectiveness. An integrated control intervention was the most commonly employed strategy in both regions. Biological control measures, environmental management, and health education campaigns on community participation achieved more sustainable results than an intervention where only a chemical control measure was used. Challenges to implementing interventions were insufficient financial support, resources, workforce, intersectoral collaboration and legislation. Conclusions Based on the synthesised data, an integrated vector (Aedes) management focused on community participation seems to be the most effective approach to mitigate Aedes-borne infectious diseases. Maintaining the approach’s effect remains challenging as it requires multisectoral and multi-disciplinary team engagement and active community participation. Future research needs to address the barriers to program implementation and maintenance as data on this topic is lacking.
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Affiliation(s)
- Vaitiare Mulderij-Jansen
- Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Faculty of Geosciences, Department of Human Geography and Spatial Planning, International Development Studies, Utrecht University, Utrecht, Netherlands
- Department of Epidemiology, Curaçao Biomedical & Health Research Institute, Willemstad, Curaçao
- * E-mail:
| | - Prachi Pundir
- George Institute for Global Health, New Delhi, India
| | - Maria E. Grillet
- Facultad de Ciencias, Instituto de Zoología y Ecología Tropical, Universidad Central de Venezuela, Caracas, Venezuela
| | | | - Izzy Gerstenbluth
- Department of Epidemiology, Curaçao Biomedical & Health Research Institute, Willemstad, Curaçao
- Epidemiology and Research Unit, Ministry of Health Environment and Nature of Curaçao, Willemstad, Curaçao
| | - Ashley Duits
- Red Cross Blood Bank Foundation, Willemstad, Curaҫao
- Department of Immunology, Curaçao Biomedical & Health Research Institute, Willemstad, Curaçao
- Institute for Medical Education, University Medical Center Groningen, Groningen, The Netherlands
| | - Adriana Tami
- Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ajay Bailey
- Faculty of Geosciences, Department of Human Geography and Spatial Planning, International Development Studies, Utrecht University, Utrecht, Netherlands
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Lenhart A, Castillo CE, Villegas E, Alexander N, Vanlerberghe V, van der Stuyft P, McCall PJ. Evaluation of insecticide treated window curtains and water container covers for dengue vector control in a large-scale cluster-randomized trial in Venezuela. PLoS Negl Trop Dis 2022; 16:e0010135. [PMID: 35245284 PMCID: PMC8926262 DOI: 10.1371/journal.pntd.0010135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 03/16/2022] [Accepted: 12/30/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Following earlier trials indicating that their potential in dengue vector control was constrained by housing structure, a large-scale cluster-randomized trial of insecticide treated curtains (ITCs) and water jar covers (ITJCs) was undertaken in Venezuela. METHODS In Trujillo, Venezuela, 60 clusters (6223 houses total) were randomized so that 15 clusters each received either PermaNet insecticide-treated window curtains (ITCs), permanent insecticide-treated water storage jar covers (ITJCs), a combination of both ITCs and ITJCs, or no insecticide treated materials (ITMs). A further 15 clusters located at least 5km from the edge of the study site were selected to act as an external control. Entomological surveys were carried out immediately before and after intervention, and then at 6-month intervals over the following 27 months. The Breteau and House indices were used as primary outcome measures and ovitrap indices as secondary. Negative binomial regression models were used to compare cluster-level values of these indices between the trial arms. RESULTS Reductions in entomological indices followed deployment of all ITMs and throughout the trial, indices in the external control arm remained substantially higher than in the ITM study arms including the internal control. Comparing the ratios of between-arm means to summarise the entomological indices throughout the study, the combined ITC+ITJC intervention had the greatest impact on the indices, with a 63% difference in the pupae per person indices between the ITC+ITJC arm and the internal control. However, coverage had fallen below 60% by 14-months post-intervention and remained below 40% for most of the remaining study period. CONCLUSIONS ITMs can impact dengue vector populations in the long term, particularly when ITCs and ITJCs are deployed in combination. TRIAL REGISTRATION ClinicalTrials.gov ISRCTN08474420; www.isrctn.com.
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Affiliation(s)
- Audrey Lenhart
- Vector Biology Department, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Carmen Elena Castillo
- Vector Biology Department, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- Universidad de los Andes, Núcleo Rafael Rangel, Instituto Experimental Jose Witremundo Torrealba, Trujillo, Venezuela
| | - Elci Villegas
- Universidad de los Andes, Núcleo Rafael Rangel, Instituto Experimental Jose Witremundo Torrealba, Trujillo, Venezuela
| | - Neal Alexander
- MRC International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Veerle Vanlerberghe
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Patrick van der Stuyft
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Philip J. McCall
- Vector Biology Department, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Zinszer K, Caprara A, Lima A, Degroote S, Zahreddine M, Abreu K, Carabali M, Charland K, Dantas MA, Wellington J, Parra B, Fournet F, Bonnet E, Pérez D, Robert E, Dagenais C, Benmarhnia T, Andersson N, Ridde V. Sustainable, healthy cities: protocol of a mixed methods evaluation of a cluster randomized controlled trial for Aedes control in Brazil using a community mobilization approach. Trials 2020; 21:182. [PMID: 32059693 PMCID: PMC7023806 DOI: 10.1186/s13063-019-3714-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 09/09/2019] [Indexed: 12/22/2022] Open
Abstract
Background Dengue is increasing in its global presence with an estimated 4 billion people at-risk of infection in at least 128 countries. Despite the promising results of EcoHealth and community mobilization approaches to Aedes reduction, more evidence of their efficacy on reducing dengue risk is needed. The principal research question is to determine if interventions based upon community mobilization reduce the risk of dengue virus infection among children 3 to 9 years old compared to usual dengue control practice in Fortaleza, Brazil. Methods The present study will follow a pragmatic cluster randomized controlled trial (cRCT) design with randomization at the census tract level with equal allocation to the two arms. In each arm, there will be 34 clusters of 86 children between 3 to 9 years old for an expected total of 5848 children enrolled in the study, assuming a risk reduction of 29.5% based upon findings from a previous multi-site cRCT. The primary outcomes are rates of anti-dengue Immunoglobulin G (IgG) seroconversion and adult female Aedes density. The intervention is based upon a participatory health research approach, Socializing Evidence for Participatory Action (SEPA), where the research evidence is used to foster community engagement and ownership of the health issue and solution. Following allocation, intervention communities will develop and implement their own solutions that will likely include a wide variety of collective events and media approaches. Data collection activities over a period of 3 years include household visits for blood collection, household surveys, and entomological surveys; and qualitative activities including focus groups, in-depth interviews, and document analysis to evaluate the process, acceptability, fidelity, and sustainability of the intervention. Study participants will be aware of their assignment and all research staff will be blinded although the intervention assignment will likely be revealed to field staff through interaction with participants. Discussion The results of our study will provide evidence on community mobilization as an intervention for dengue control. We anticipate that if community mobilization is effective in Fortaleza, the results of this study will help develop evidence-based vector control programs in Brazil, and also in other countries struggling with Aedes-transmitted diseases. Trial registration ISRCTN66131315, registration date: 1 October 2018.
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Affiliation(s)
- Kate Zinszer
- School of Public Health, University of Montreal, Montréal, Québec, Canada. .,Québec Public Health Research Centre, Montréal, Canada. .,Québec Population Health Research Network, Montréal, Canada.
| | - Andrea Caprara
- Québec Population Health Research Network, Montréal, Canada
| | - Antonio Lima
- Fortaleza Municipal Health Secretariat, Fortaleza, Brazil.,University of Fortaleza, Fortaleza, Brazil
| | | | - Monica Zahreddine
- School of Public Health, University of Montreal, Montréal, Québec, Canada
| | | | | | - Katia Charland
- School of Public Health, University of Montreal, Montréal, Québec, Canada
| | | | | | | | - Florence Fournet
- French Institute for Research on Sustainable Development, Paris, France
| | - Emmanuel Bonnet
- French Institute for Research on Sustainable Development, Paris, France
| | - Denis Pérez
- School of Public Health, University of Montreal, Montréal, Québec, Canada.,Pedro Kourí Tropical Medicine Institute, Havana, Cuba
| | | | - Christian Dagenais
- School of Public Health, University of Montreal, Montréal, Québec, Canada
| | | | - Neil Andersson
- McGill University, Montréal, Canada.,Universidad Autonomy De Guerrero, Acapulco, Mexico
| | - Valéry Ridde
- French Institute for Research on Sustainable Development, Paris, France
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