Publication: Reducing costs and operational constraints of dengue vector control by targeting productive breeding places: A multi-country non-inferiority cluster randomized trial
Issued Date
2009-09-01
Resource Type
ISSN
13653156
13602276
13602276
Other identifier(s)
2-s2.0-69249201083
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Mahidol University
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SCOPUS
Bibliographic Citation
Tropical Medicine and International Health. Vol.14, No.9 (2009), 1143-1153
Suggested Citation
W. Tun-Lin, A. Lenhart, V. S. Nam, E. Rebollar-Téllez, A. C. Morrison, P. Barbazan, M. Cote, J. Midega, F. Sanchez, P. Manrique-Saide, A. Kroeger, M. B. Nathan, F. Meheus, M. Petzold Reducing costs and operational constraints of dengue vector control by targeting productive breeding places: A multi-country non-inferiority cluster randomized trial. Tropical Medicine and International Health. Vol.14, No.9 (2009), 1143-1153. doi:10.1111/j.1365-3156.2009.02341.x Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/27666
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Title
Reducing costs and operational constraints of dengue vector control by targeting productive breeding places: A multi-country non-inferiority cluster randomized trial
Other Contributor(s)
Department of Medical Research (Lower Myanmar)
Liverpool School of Tropical Medicine
Ministry of Health Vitenam
Universidad Autonoma de Nuevo Leon
University of California, Davis
Mahidol University
Universidad De Los Andes, Merida
Kenya Medical Research Institute
University of East
Universidad Autonoma de Yucatan
Organisation Mondiale de la Sante
Prins Leopold Instituut voor Tropische Geneeskunde
Nordiska Hogskolan for folkhalsovetenskap
Liverpool School of Tropical Medicine
Ministry of Health Vitenam
Universidad Autonoma de Nuevo Leon
University of California, Davis
Mahidol University
Universidad De Los Andes, Merida
Kenya Medical Research Institute
University of East
Universidad Autonoma de Yucatan
Organisation Mondiale de la Sante
Prins Leopold Instituut voor Tropische Geneeskunde
Nordiska Hogskolan for folkhalsovetenskap
Abstract
SummaryObjectives To test the non-inferiority hypothesis that a vector control approach targeting only the most productive water container types gives the same or greater reduction of the vector population as a non-targeted approach in different ecological settings and to analyse whether the targeted intervention is less costly. Methods Cluster randomized trial in eight study sites (Venezuela, Mexico, Peru, Kenya, Thailand, Myanmar, Vietnam, Philippines), with each study area divided into 18-20 clusters (sectors or neighbourhoods) of approximately 50-100 households each. Using a baseline pupal-demographic survey, the most productive container types were identified which produced ≥55% of all Ae. aegypti pupae. Clusters were then paired based on similar pupae per person indices. One cluster from each pair was randomly allocated to receive the targeted vector control intervention; the other received the 'blanket' (non-targeted) intervention attempting to reach all water holding containers. Results The pupal-demographic baseline survey showed a large variation of productive container types across all study sites. In four sites the vector control interventions in both study arms were insecticidal and in the other four sites, non-insecticidal (environmental management and\or biological control methods). Both approaches were associated with a reduction of outcome indicators in the targeted and non-targeted intervention arm of the six study sites where the follow up study was conducted (PPI, Pupae per Person Index and BI, Breteau Index). Targeted interventions were as effective as non-targeted ones in terms of PPI. The direct costs per house reached were lower in targeted intervention clusters than in non-targeted intervention clusters with only one exception, where the targeted intervention was delivered through staff-intensive social mobilization. Conclusions Targeting only the most productive water container types (roughly half of all water holding container types) was as effective in lowering entomological indices as targeting all water holding containers at lower implementation costs. Further research is required to establish the most efficacious method or combination of methods for targeted dengue vector interventions. © 2009 Blackwell Publishing Ltd.