Scaling up of Eco-Bio-Social Strategy to Control Aedes aegypti in Highly Vulnerable Areas in Fortaleza, Brazil: A Cluster, Non-Randomized Controlled Trial Protocol

Suyanne Freire de Macêdo, Kellyanne Abreu Silva, Renata Borges de Vasconcelos, Izautina Vasconcelos de Sousa, Lyvia Patrícia Soares Mesquita, Roberta Duarte Maia Barakat, Hélida Melo Conrado Fernandes, Ana Carolina Melo Queiroz, Gerarlene Ponte Guimarães Santos, Valter Cordeiro Barbosa Filho, Gabriel Carrasquilla, Andrea Caprara and José Wellington de Oliveira Lima
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Suyanne Freire de Macêdo: Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil
Kellyanne Abreu Silva: Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil
Renata Borges de Vasconcelos: Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil
Izautina Vasconcelos de Sousa: Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil
Lyvia Patrícia Soares Mesquita: Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil
Roberta Duarte Maia Barakat: Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil
Hélida Melo Conrado Fernandes: Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil
Ana Carolina Melo Queiroz: Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil
Gerarlene Ponte Guimarães Santos: Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil
Valter Cordeiro Barbosa Filho: Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil
Gabriel Carrasquilla: Santa Fe de Bogotá Foundation, Bogota 110311, Colombia
Andrea Caprara: Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil
José Wellington de Oliveira Lima: Collective Health Postgraduate Program, State University of Ceará, Fortaleza 60714-903, Brazil

IJERPH, 2021, vol. 18, issue 3, 1-23

Abstract: Aedes aegypti is a cosmopolitan vector for arboviruses dengue, Zika and chikungunya, disseminated in all Brazilian states. The Eco-Bio-Social (EBS) strategy is vital in Aedes aegypti control as it mobilizes stakeholders (government, professionals, society, and academics) to promote healthy environments. This paper describes the rationale and methods of expanding the EBS strategy for Aedes aegypti control in Fortaleza, Northeast Brazil. A cluster, non-randomized controlled clinical trial was developed to analyze the strategy’s effectiveness in vulnerable territories (high incidence of dengue and violent deaths; low HDI; substandard urban infrastructure, high population density, and water scarcity). We selected two intervention and two control groups, resulting in a sample of approximately 16,000 properties. The intervention consisted of environmental management by sealing large elevated water tanks, introduction of beta fish in waterholes, elimination of potential breeding sites, and mobilization and training of schoolchildren, endemic disease workers, health workers, social mobilizers, and community leaders; community surveillance of arboviruses; construction and validation of a booklet for the prevention of arboviruses in pregnant women. We analyzed the costs of arboviruses to government and households, the intervention cost-effectiveness, chikungunya’s chronicity, and acceptance, sustainability, and governance of vector control actions. The primary outcome (infestation) was analyzed using the house, container, and Breteau indices. We hope that this study will help us understand how to scale up strategies to fight Aedes aegypti in vulnerable areas.

Keywords: health impact assessment methods; Aedes aegypti; Brazil; scaling up; community-based intervention; dengue; chikungunya; Zika virus; mixed methods; vector control (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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