Exploring community needs in combating aedes mosquitoes and dengue fever: a study with urban community in the recurrent hotspot area.

BACKGROUND: Aedes mosquitoes are the main vector of dengue infection, a global health threat affecting millions of people annually. Conventional prevention and control methods against dengue outbreaks have only achieved marginal success. Recognizing the complex issue at hand, a multilevel participatory approach is crucial. Thus, alternative strategies that involve community engagement are increasingly being considered and attempted. While community-based vector control programs have been conducted, sustaining behavioral changes among the population remains a challenge. This study aimed to identify the specific community needs in combating Aedes mosquitoes and dengue fever as a basis to guide the development of community-driven initiatives and foster a deeper sense of ownership in the fight against dengue. METHODS: Between 1 August 2022 and 30 November 2022, we conducted a study in Hulu Langat district, Selangor, using a mixed-method design. All participants consented to the study, which comprised 27 participants (FGDs) and 15 participants (IDIs). The IDIs included two participants with a history of dengue fever, one community leader, one faith leader, seven local authorities, and four district health officers. Semi-structured interviews and discussions were performed among stakeholders and community members recruited via purposive and snowball sampling techniques. All interviews were audio-recorded before being analyzed using reflexive thematic analysis. RESULTS: These results derived from qualitative data explored the perspectives and needs of communities in combating Aedes mosquitoes and dengue fever. Interviews were conducted with various stakeholders, including community members, leaders, and health officers. The study identified the necessity of decisive actions by authorities to address the impact of the dengue epidemic, the importance of community engagement through partnerships and participatory approaches, the potential benefits of incentives and rewards to enhance community participation, and the need for sustained community engagement and education, especially via the involvement of young people in prevention efforts. These findings provide valuable insights into the design of effective strategies against Aedes mosquitoes and dengue fever. CONCLUSIONS: In short, there is an urgent need for a comprehensive approach involving multiple stakeholders in the fight against Aedes mosquitoes and dengue fever. The approach should incorporate efforts to raise awareness, provide practical resources, and foster community responsibility. The active involvement of teenagers as volunteers can contribute to long-term prevention efforts. Collaboration, resource allocation, and community engagement are crucial for effective dengue control and a healthier environment.

[Clinical Update on Diagnosis, Treatment and Prevention of Dengue]. / Atualização Clínica sobre Diagnóstico, Tratamento e Prevenção da Dengue.

Dengue is a vector-borne disease that has a significant impact on global public health. The vector mosquito belongs to the genus Aedes. Two species play a key role in human transmission: Ae. aegypti, which has adapted to the urban environment of highly populated areas in tropical and subtropical countries, leading to a dramatic increase in dengue cases over the years, and Ae. albopictus, which poses a potential threat to temperate climate countries due to its ability to adapt to colder climates. The disease is widespread across the world, posing a risk to nearly half of the world's population. Although most cases are asymptomatic, dengue causes a burden on healthcare systems and mainly affects the younger population. The disease is also spreading to temperate climate countries, thus becoming a global threat. Vector control measures and vaccine development have been the main prevention strategies, as there is still no effective treatment for the disease.

A dengue é uma doença transmitida por um vetor hematófago (mosquito) que possui um impacto significativo na saúde pública mundial. O mosquito transmissor pertence ao género Aedes. São duas as espécies responsáveis pela transmissão humana: o Ae. aegypti, que se adaptou ao ambiente urbano de áreas altamente populosas de países tropicais e subtropicais, resultando num aumento dramático dos casos de dengue ao longo dos anos; e o Ae. Albopictus, que representa uma potencial ameaça para os países de clima temperado pela sua capacidade de adaptação aos climas mais frios. A doença está presente em grande parte do mundo, colocando cerca de metade da população do planeta em risco. Embora a maioria dos casos seja assintomática, a dengue causa uma sobrecarga nos sistemas de saúde e impacta principalmente os jovens. A doença também tem vindo a alastrar-se a países de clima temperado, tornando-se uma ameaça global. As medidas de controlo vetorial e o desenvolvimento de vacinas têm sido as principais estratégias de prevenção, uma vez que não existe ainda um tratamento eficaz para a doença.

Understanding dengue solution and larval indices surveillance system among village health volunteers in high- and low-risk dengue villages in southern Thailand.

Background: Successful dengue solutions require community collaboration between agencies engaged in human health, vector control and the environment. In Thailand, village health volunteers emphasize the need for a health working group to interact, collaborate, and coordinate actions. The objectives of this study were to acquire an understanding of dengue solutions, as well as the larval indices surveillance system of village health volunteers in high- and low-risk dengue villages. Methods: After 12 months of training in dengue prevention and setting larval indices surveillance systems, an analytical cross-sectional survey was conducted. A total of 117 villages were included in the 18 primary care facilities within one district in southern Thailand, and they were divided into 71 high-risk and 46 low-risk dengue villages. Sample size was determined using the G*power formula. The content validity index and reliability values of Cronbach's alpha coefficient for the questionnaires were 0.91 and 0.83, respectively. A random sampling approach was used to acquire data. The chi-square test, t-test, and odds ratio were used to assess the sample's level of understanding. Results: The study included 1302 village health volunteers, including 895 and 407 from high- and low-risk dengue communities, respectively. In total, 87.9% were female, 51.6% were 20-35 years old, 48.8% had worked as a village health volunteer for 11-20 years, 27.1% had an upper elementary education, and 59.1% had dengue in the previous 12 months. Understanding of the dengue solution and larval indices surveillance system varied across high- and low-risk dengue villages. Village health volunteers with a high level of understanding of the dengue solution and larval indies surveillance system were 1.064 and 1.504 times more likely to stay in high-risk dengue villages, respectively (odds ratio [OR] = 1.064, 95% confidence interval [CI]:0.798-1.419, p = 0.672 and OR = 1.504, 95% CI:1.044-2.167, p = 0.028). Conclusions: Village health volunteers require ongoing training to understand the prevention and control of dengue and larval indices surveillance systems, promote awareness, and monitor dengue in both high- and low-risk dengue villages.

A qualitative study of governance predicament on dengue prevention and control in Malaysia: the elite experience.

BACKGROUND: The challenges faced by healthcare personnel in relation to dengue prevention and control are perennial but noticeably unexplored. It is often difficult to translate policies and decision making by the elite into astute management in consonance with the needs of rank-and-file personnel. In this study, we assess the impact of governance on dengue prevention and control activities in Malaysia as narrated by the elite. METHODS: A qualitative study using a case-study approach was conducted between January 2019 and November 2019 in the districts of Gombak and Klang, where the relevant key informants were located. Nineteen interviews were conducted among elite healthcare personnel from different divisions: management, vector, laboratory, inspectorate, health promotion and entomology. Semi-structured interviews were conducted. The sample size was determined through saturation point criteria. Purposive sampling techniques were used to recruit the participants. The interviews were audio recorded, and the transcribed text was analysed with deductive thematic analysis. RESULTS: Data analysis led to the development of 5 themes and 13 categories. The major principles of governance were embodied in a milieu of predicament, linked to constraints but also opportunities. The constraints resulted from inherent determinants of dengue outbreaks, the serviceability of governing policies and the macro-economics of budget allocation. The opportunities to sustain governance at the local operating level stem from a prevalent supportive internal management system, collaborative efforts among corresponding external government agencies and willingness to innovate and embrace novel technology. CONCLUSION: Elites are influential, often well-informed personnel tasked with making decisions that can reverberate across an organisation, impacting future plans and strategic policies. Political arrangements at higher levels will reflect in advance the tone of how governance in dengue prevention and control is operationalised by entities and individuals at lower levels of the health system. The prevailing centralised structure in the Malaysian health system will continue to entrench the position of the elite and intertwine it with governance and its predicaments.

Knowledge, attitudes and practices about dengue among pupils from rural schools in Colombia / Conocimientos, actitudes y prácticas sobre dengue en estudiantes de escuelas rurales en Colombia

Abstract Introduction: Dengue is a public health problem in tropical and subtropical regions of the world. Studies on dengue in rural areas are scarce since the disease is considered mainly urban. Objective: To determine the knowledge (K), attitudes (A) and practices (P) of dengue in an endemic area in Colombia. Materials and methods: We conducted a cross-sectional study with 515 pupils (7-16 years old) in 34 rural schools in Anapoima and La Mesa municipalities during 2011. Each KAP category was evaluated independently by a scoring system and then categorized into high, medium or low. Results: Pupils recognized knowledge variables such as the symptoms (fever, bone pain), transmission route (mosquito bites), and mosquito breeding sites (uncovered wáter tanks, solid waste). Average scores on attitude were high in both municipalities indicating a well-developed perception of disease severity. Seeking treatment in medical centers and self-medication for fever management and the use of mosquito net and space-spraying of insecticides were the most frequently identified practices. Discussion: This is the first KAP dengue study performed in a rural area in Colombia and as such it contributes to the understanding of dengue perceptions by the inhabitants of these areas. It showed a medium level of knowledge about dengue and a lower level of preventive practices in pupils from rural schools. It also showed that pupils considered space-spraying as crucial for vector control. The presence of the vector in rural areas of the country underlines the need to improve surveillance and education to more effectively control the vector and promote prevention methods including community participation.

Resumen Introducción. El dengue es un problema de salud pública en las regiones tropicales y subtropicales del mundo. Los estudios sobre la enfermedad en áreas rurales son escasos debido a que se presenta principalmente en los núcleos urbanos. Objetivo. Determinar los conocimientos, las actitudes y las prácticas sobre el dengue en un área rural endémica en Colombia. Materiales y métodos. Se hizo un estudio transversal con 515 estudiantes, entre los 7 y los 16 años de edad en 34 escuelas rurales de los municipios de Anapoima y La Mesa en el 2011. Cada categoría se evaluó por separado con un puntaje clasificado como alto, medio o bajo. Resultados. Los estudiantes reconocieron los síntomas (fiebre, dolor de huesos), la ruta de transmisión (picadura de mosquitos) y los criaderos (depósitos de agua destapados, residuos sólidos). El promedio de los puntajes de actitudes fue alto en ambos municipios, lo que indica que percibían la gravedad del dengue. Las prácticas más frecuentes de tratamiento de la fiebre fueron la consulta médica y la automedicación, en tanto que los métodos de control más frecuentes fueron el uso de mosquiteros y el rociamiento con insecticidas. Discusión. Este es el primer estudio de conocimientos, actitudes y prácticas sobre el dengue en un área rural de Colombia. Los resultados contribuyen a entender las percepciones de la enfermedad en sus habitantes y evidenciaron niveles medios de conocimiento y puntuaciones bajas en cuanto a las prácticas entre los estudiantes de las escuelas rurales. Los estudiantes consideraron que la fumigación es importante para el control del vector. La presencia del mosquito en áreas rurales del país resalta la necesidad de mejorar la vigilancia y la educación para lograr un control efectivo del vector y promover métodos de prevención que incluyan la participación comunitaria.

Sustainable dengue prevention and control through a comprehensive integrated approach: the Sri Lankan perspective

Dengue is a leading public health problem in Sri Lanka. All 26 districts and allage groups are affected, with high disease transmission; the estimated averageannual incidence is 175/100 000 population. Harnessing the World HealthOrganization Global strategy for dengue prevention and control, 2012–2020, SriLanka has pledged in its National Strategic Framework to achieve a mortality fromdengue below 0.1% and to reduce morbidity by 50% (from the average of thelast 5 years) by 2020. Turning points in the country’s dengue-control programmehave been the restructuring and restrategizing of the core functions; this hasinvolved establishment of a separate dengue-control unit to coordinate integratedvector management, and creation of a presidential task force. There has beengreat progress in disease surveillance, clinical management and vector control.Enhanced real-time surveillance for early warning allows ample preparednessfor an outbreak. National guidelines with enhanced diagnostics have significantlyimproved clinical management of dengue, reducing the case-fatality rate to 0.2%.Proactive integrated vector management, with multisector partnership, has createda positive vector-control environment; however, sustaining this momentum is achallenge. Robust surveillance, evidence-based clinical management, sustainablevector control and effective communication are key strategies that will beimplemented to achieve set targets. Improved early detection and a standardizedtreatment protocol with enhanced diagnostics at all medical care institutions willlead to further reduction in mortality. Making the maximum effort to minimizeoutbreaks through sustainable vector control in the three dimensions of riskmapping, innovation and risk modification will enable a reduction in morbidity

Dengue in the deserts: Search and Destroy Operations.

Dengue, a viral disease transmitted by the Aedes mosquito has the potential to cause outbreaks in urban settings. Planned and coordinated actions including entomological surveillance need to be undertaken at the community level, through synergized efforts by all partners and stakeholders. The experience of conducting such a Task Force based action plan for prevention and control of dengue, in a desert township is highlighted in this study.

Management dilemmas in the treatment of dengue fever.

This paper is aimed at highlighting some of the dilemmas faced by clinicians in the management of adultpatients with dengue and my views in resolving these issues.Even though early diagnosis and prompt fluid therapy are central to reduce morbidity and mortality indengue, achieving these goals are contentious issues and are often hampered by the limited access to expensive laboratory data in most developing countries which would enable a rapid and accurate diagnosis. My viewpoint on overcoming these dilemmas is to make an early diagnosis on the clinical features, and apply clinical predictors of disease severity in selecting patients for interventions. In thisregard, diffuse blanching erythema in a patient with features of a viral fever during dengue epidemicswould suffice to diagnose and treat the patient as a dengue case. Laboratory confirmatory data areexpensive, not readily available and could delay treatment. Fluid therapy and intervention modalitiesfor thrombocytopaenia should be judged clinically on an individual basis rather than the blind, strictadherence to theoretical fluid regimens with the potential risk of fluid overloading. Capillary refill time,pulse pressure, cervical lymphadenopathy, and changes in the sensorium are useful clinical parameters for selection of patients for intervention as well as subtle adjustments and termination of fluid therapy.A practically feasible step-wise approach to dengue management is described in this paper.

Increased utilization of treatment centre facilities during a dengue fever outbreak in Kolkata, India.

An outbreak of febrile illness occurred in Kolkata (formerly Calcutta), India, which led to an increased utilization of treatment centre facilities during August – September 2005. The etiological agent was confirmed to be dengue by analysing 308 acute-phase clinical specimens for virus-specific IgM antibodies.

Community participation and social engagement in the prevention and control of dengue fever in rural Cambodia.

The prevention and control strategies for dengue fever require community involvement to succeed.Drawing on data collected in 2003–2004 as part of an ethnographic study in eastern Cambodia, weexplore the role of community participation and the factors that influence its success in the preventionand control of dengue fever in Cambodia. Community participation has the potential for effective andefficient control of the disease, but this is subject to how communities are engaged in specific activities. Historical, political, social and economic factors have undermined the social institutions and conventionsin the study villages that could facilitate community involvement. In particular, poverty and differencesin local interests influence the capacity for people to be involved. Villagers regarded the maintenanceof the domestic environment as a personal responsibility and were reluctant to extend their action to awider domain. Comprehensive programmes, which draw on local institutions and understandings of community and enable community members to participate in the planning and management ofprevention and control activities, are essential to ensure programme sustainability and effectiveness.

Applied informatics manipulation for fight against dengue.

Dengue is an important tropical infectious disease. This infection has been widely studied and there aremany reports on its pre-clinical and clinical aspects. In the era of information technology, scientists can successfully manipulate the large amount of information available on dengue for use in the diagnosis,treatment and control of this disease. In this article, the author briefly summarizes and comments on applied informatics manipulation for the prevention and control of dengue.