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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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Klafke F, Barros VG, Henning E. Solid waste management and Aedes aegypti infestation interconnections: A regression tree application. WASTE MANAGEMENT & RESEARCH : THE JOURNAL OF THE INTERNATIONAL SOLID WASTES AND PUBLIC CLEANSING ASSOCIATION, ISWA 2023; 41:1684-1696. [PMID: 37013436 DOI: 10.1177/0734242x231164318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Public health is at the core of all environmental and anthropic impacts. Urban and territorial planners should include public health concerns in their plans. Basic sanitation infrastructure is essential to maintaining public health and social and economic development. This infrastructure deficiency causes diseases, death and economic losses in developing countries. Framing interconnections among health, sanitation, urbanization and circular economy will assist sustainable development goal achievements. This study aims to identify the relationships between solid waste management indicators in Brazil and the Aedes aegypti mosquito infestation index. Regression trees were employed for modelling due to the complexity and characteristics of the data. The analyses were performed separately from data collected from 3501 municipalities and 42 indicators from the country's five regions. Results show that expenses and personnel indicators were the most critical indicators (in the mid-western, southeastern and southern regions), operational (northeastern (NE) region) and management (northern region). The mean absolute errors ranged from 0.803 (southern region) to 2.507 (NE region). Regional analyses indicate that the municipalities with better SWM results display lower infestation rates in buildings and residences. This research is innovative as it analyses infestation rates rather than dengue prevalence, using a machine learning method, in a multidisciplinary research field that needs further study.
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Affiliation(s)
- Fernanda Klafke
- Department of Civil Engineering, Santa Catarina State University (UDESC), Joinville, SC, Brazil
| | - Virgínia Grace Barros
- Risk and Disaster Management Coordinated Group (CEPED), Department of Civil Engineering, Laboratory of Hydrology, Santa Catarina State University (UDESC), Joinville, SC, Brazil
| | - Elisa Henning
- Department of Mathematics, Santa Catarina State University (UDESC), Joinville, SC, Brazil
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Yek C, Li Y, Pacheco AR, Lon C, Duong V, Dussart P, Young KI, Chea S, Lay S, Man S, Kimsan S, Huch C, Leang R, Huy R, Brook CE, Manning JE. National dengue surveillance, Cambodia 2002-2020. Bull World Health Organ 2023; 101:605-616. [PMID: 37638355 PMCID: PMC10452936 DOI: 10.2471/blt.23.289713] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 06/05/2023] [Accepted: 06/15/2023] [Indexed: 08/29/2023] Open
Abstract
Global dengue incidence has increased dramatically over the past few decades from approximately 500 000 reported cases in 2000 to over 5 million in 2019. This trend has been attributed to population growth in endemic areas, rapid unplanned urbanization, increasing global connectivity, and climate change expanding the geographic range of the Aedes spp. mosquito, among other factors. Reporting dengue surveillance data is key to understanding the scale of the problem, identifying important changes in the landscape of disease, and developing policies for clinical management, vector control and vaccine rollout. However, surveillance practices are not standardized, and data may be difficult to interpret particularly in low- and middle-income countries with fragmented health-care systems. The latest national dengue surveillance data for Cambodia was published in 2010. Since its publication, the country experienced marked changes in health policies, population demographics, climate and urbanization. How these changes affected dengue control remains unknown. In this article, we summarize two decades of policy changes, published literature, country statistics, and dengue case data collected by the Cambodia National Dengue Control Programme to: (i) identify important changes in the disease landscape; and (ii) derive lessons to inform future surveillance and disease control strategies. We report that while dengue case morbidity and mortality rates in Cambodia fell between 2002 and 2020, dengue incidence doubled and age at infection increased. Future national surveillance, disease prevention and treatment, and vector control policies will have to account for these changes to optimize disease control.
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Affiliation(s)
- Christina Yek
- Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, 12735 Twinbrook Parkway, Rockville, MD20852, United States of America (USA)
| | - Yimei Li
- Department of Ecology and Evolution, University of Chicago, Chicago, USA
| | - Andrea R Pacheco
- International Center of Excellence in Research, National Institute of Allergy and Infectious Diseases, Phnom Penh, Cambodia
| | - Chanthap Lon
- International Center of Excellence in Research, National Institute of Allergy and Infectious Diseases, Phnom Penh, Cambodia
| | - Veasna Duong
- Biological Sciences Department, University of Texas at El Paso, El Paso, USA
| | - Philippe Dussart
- Virology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Katherine I Young
- Biological Sciences Department, University of Texas at El Paso, El Paso, USA
| | - Sophana Chea
- International Center of Excellence in Research, National Institute of Allergy and Infectious Diseases, Phnom Penh, Cambodia
| | - Sreyngim Lay
- International Center of Excellence in Research, National Institute of Allergy and Infectious Diseases, Phnom Penh, Cambodia
| | - Somnang Man
- International Center of Excellence in Research, National Institute of Allergy and Infectious Diseases, Phnom Penh, Cambodia
| | - Souv Kimsan
- National Center of Parasitology, Entomology, and Malaria Control, Ministry of Health, Phnom Penh, Cambodia
| | - Chea Huch
- National Center of Parasitology, Entomology, and Malaria Control, Ministry of Health, Phnom Penh, Cambodia
| | - Rithea Leang
- National Center of Parasitology, Entomology, and Malaria Control, Ministry of Health, Phnom Penh, Cambodia
| | - Rekol Huy
- National Center of Parasitology, Entomology, and Malaria Control, Ministry of Health, Phnom Penh, Cambodia
| | - Cara E Brook
- Department of Ecology and Evolution, University of Chicago, Chicago, USA
| | - Jessica E Manning
- Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, 12735 Twinbrook Parkway, Rockville, MD20852, United States of America (USA)
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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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