The design of a community-based health education intervention for the control of Aedes aegypti.

This report describes the process used to develop locally appropriate educational materials and to implement the education component of a community-based Aedes aegypti control program in Merida, Yucatan, Mexico. The process is broken into five stages: formative research, developing recommendations for behavior change, development of educational messages, development and production of educational materials, and distribution of the materials. Appropriate terminology and taxonomies for dengue were obtained from open in-depth interviews; baseline data from a knowledge, beliefs, and practices questionnaire served to confirm this information. A larval survey of house lots was carried out to identify the Ae. aegypti larval production sites found on individual house lots. This enabled the program to target the most important larval habitats. Community groups were organized to work on the development of messages and production of the educational materials to be used. The education intervention was successful in stimulating changes in both knowledge and behavior, which were measured in the evaluations of the intervention. To be successful, community-based strategies must be flexible and adapted to the local setting because of ecologic, cultural, and social differences between localities.

PIP: Aedes aegypti mosquito is a vector of yellow fever and dengue hemorrhagic fever. It was eradicated that seventeen different Latin American countries during the 1950s and 1960s, but has reappeared in almost all of these countries as a result of laxness in monitoring ports and border crossings for potential importations of eggs and adult mosquitoes. This paper describes the process used to develop locally appropriate educational materials and implement the education component of a community-based Ae. aegypti control program in Merida, Yucatan, Mexico, over the period June 1989 to December 1990. Merida is the capital of Yucatan and harbors a population of approximately 700,000. Dengue was epidemic in 1979 and 1984, and its transmission is now endemic in the city. The process consisted of the following five stages formative research, developing recommendations for behavior change, development of educational methods, development and production of educational materials, and distribution of the materials. Terminology and taxonomies for dengue were obtained from open, in-depth interviews, while baseline data were gathered via a knowledge, beliefs, and practices questionnaire. A larval study of house lots was then carried out to identify the Ae. aegypti larval production sites found on individual house lots, thus enabling the program to target the most important larval habitats. Community groups were organized to work on message development and production of educational materials to be used in the program. The education intervention proved overall to be successful in stimulating changes in knowledge and behavior measured in the evaluations of the intervention. Finally, the authors hold that community-based strategies must be flexible and adapted to varied ecological, cultural, and social differences between localities in order to be successful.

Results of a community-based Aedes aegypti control program in Merida, Yucatan, Mexico.

This report describes the results of a community-based Aedes aegypti control program in Merida, Yucatan, Mexico. Baseline surveys concerning knowledge, beliefs, and practices of 577 women and a larval survey of 616 house lots were carried out in October 1989. Following development of a public health communication intervention from this data, the program was implemented in six communities. Evaluation used an untreated control group design with pretest and two post-tests, one at completion and one six months later. Significant changes in knowledge and behavior were seen in the treatment group in both post-tests. Women in the intervention group were able to identify the Ae. aegypti mosquito, the larval production sites of the mosquito, and appropriate control methods. A behavior change proxy was measured by examining changes in the Breteau (number of positive containers/100 houses surveyed) and container indices. The Breteau index remained the same in the intervention group while it increased significantly in the comparison group. Changes were also seen with respect to individual containers. This project demonstrated that a community-based communication program aimed at larval production site elimination or control can be effective in changing behavior and reducing larval production sites.