Sustainability and cost of a community-based strategy against Aedes aegypti in northern and central Vietnam.

We previously reported a new community-based mosquito control that resulted in the elimination of Aedes aegypti in 40 of 46 communes in northern and central Vietnam. During 2007 and 2008, we revisited Nam Dinh and Khanh Hoa provinces in northern and central Vietnam, respectively, to evaluate whether or not these programs were still being maintained 7 years and 4.5 years after formal project activities had ceased, respectively. Using a previously published sustainability framework, we compared 13 criteria from Tho Nghiep commune in Nam Dinh where the local community had adopted our community-based project model using Mesocyclops from 2001. These data were compared against a formal project commune, Xuan Phong, where our successful intervention activities had ceased in 2000 and four communes operating under the National Dengue Control Program with data available. In Khanh Hoa province, we compared 2008 data at Ninh Xuan commune with data at project completion in 2003 and benchmarked these, where possible, against an untreated control commune, Ninh Binh, where few control activities had been undertaken. The three communes where the above community-based strategy had been adopted were rated as well-sustained with annual recurrent total costs (direct and indirect) of $0.28-0.89 international dollars per person.

Development of a framework for evaluating the sustainability of community-based dengue control projects.

There are currently no frameworks developed specifically for assessing community-based dengue control project sustainability. We first review the literature for frameworks for assessing project sustainability and second validate the framework criteria against the oldest community-based intervention using Mesocyclops in Xuan Phong commune, Nam Dinh province, north Vietnam, the subject of an intervention in 1998-2000. The framework used 13 criteria, clustered into three categories: 1) maintenance of health benefits from the original project, 2) continued delivery of community activities, and 3) human resource development. To provide consistency between criteria and to allow comparison both over time and with non-intervention communes, a five-point scale for each criterion was used, with the overall sustainability score calculated as the mean of all criteria. The framework offers a practical tool for assessing sustainability, and is amenable to adaptation for specific interventions without compromising the framework as a whole.