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What do community-based dengue control programmes achieve? A systematic review of published evaluations
C Heintze1, M Velasco Garrido, A Kroeger
1Institute for General Practice & Family Medicine (Charité), Universitätsmedizin Campus Charité Mitte, Schumannstrasse 20/21, 10117 Berlin, Germany.
Transactions of the Royal Society of Tropical Medicine and Hygiene
|November 7, 2006
Summary
Evidence for community-based dengue control programs is weak. While some studies combined community efforts with control tools, methodological flaws limit conclusions on effectiveness, cost, and sustainability for dengue fever prevention.
Area of Science:
- Public Health
- Tropical Medicine
- Epidemiology
Background:
- Dengue fever poses a significant public health challenge in tropical regions due to increased epidemic activity and vector control difficulties.
- Community-based interventions are increasingly explored as a strategy to combat dengue.
Purpose of the Study:
- To systematically review and analyze the evidence on the effectiveness of community-based dengue control programs.
- To assess the achievements and limitations of these programs based on rigorous study designs.
Main Methods:
- A comprehensive literature search was conducted across multiple databases (Medline, EMBASE, WHOLIS, Cochrane) up to March 2005.
- Keywords included 'Aedes', 'dengue', 'breeding habits', 'housing', and 'community intervention'.
- Inclusion criteria focused on high-quality study designs: randomized controlled trials (RCTs), controlled clinical trials (CCTs), controlled before-and-after (CBA) trials, and interrupted time series (ITS).
Main Results:
- Only 11 out of 1091 identified studies met the inclusion criteria (2 RCTs, 6 CBAs, 3 ITS).
- Six studies incorporated community participation with other dengue control measures.
- All included studies exhibited methodological weaknesses, including limited reporting of confidence intervals and P-values, and no assessment of costs or sustainability.
Conclusions:
- The current evidence supporting the effectiveness of community-based dengue control programs, whether standalone or combined with other interventions, is weak.
- Significant methodological limitations across existing studies hinder definitive conclusions about program efficacy and scalability.
- Further research with robust methodologies, including cost and sustainability assessments, is needed to evaluate community-based dengue control strategies.
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