Related Experiment Video
Updated: Jul 2, 2026
Remote Laboratory Management: Respiratory Virus Diagnostics
Published on: April 6, 2019
Addressing the COVID-19 pandemic challenges for operational adaptations of a cluster randomized controlled trial on
Mitra Saadatian-Elahi1,2, Neal Alexander3, Tim Möhlmann4
1Service Hygiène, Epidémiologie, Infectiovigilance Et Prévention, Centre Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France. mitra.elahi@chu-lyon.fr.
Insights
The COVID-19 pandemic challenged dengue research in Malaysia. Integrated Vector Management (IVM) trial continuity was maintained through safety measures, adapted intervention schedules, and remote community engagement (CE).
Area of Science:
- Public Health
- Epidemiology
- Infectious Diseases
Background:
- The COVID-19 pandemic strained global healthcare systems, potentially impacting other infectious diseases like dengue.
- Co-occurrence of COVID-19 and dengue presented diagnostic challenges due to overlapping symptoms.
- Research continuity for dengue epidemiology trials was disrupted by the pandemic's novelty and evolving safety protocols.
Purpose of the Study:
- To report challenges and implemented measures for continuing the intervention for Dengue Epidemiology in Malaysia (iDEM) project during the COVID-19 pandemic.
- To assess the effectiveness of Integrated Vector Management (IVM) on dengue incidence in urban Malaysia.
- To adapt research methodologies to ensure trial continuity amidst unprecedented public health crises.
Main Methods:
- A randomized controlled trial assessing Integrated Vector Management (IVM) components: targeted outdoor residual spraying (TORS), auto-dissemination devices (ADDs), and community engagement (CE).
- Operational activities commenced prior to COVID-19 non-pharmaceutical interventions.
- Adaptation strategies included ensuring field worker safety, adjusting intervention timelines, and implementing remote CE.
Main Results:
- Ensured field worker safety through personal protective equipment and regular COVID-19 testing.
- Maintained intervention intervals by overlapping cycles (TORS and ADDs) instead of sequential application, despite minor delays.
- Continued community engagement (CE) activities remotely via phone calls and text messages.
Conclusions:
- The iDEM project successfully continued despite significant COVID-19 pandemic challenges.
- Adaptation strategies, including prioritizing worker safety and flexible intervention scheduling, were crucial.
- Sustained management effort, Ministry of Health collaboration, and adaptive trial organization facilitated research continuity.
Introduction:
The COVID-19 pandemic placed an unprecedented overload on healthcare system globally. With all medical resources being dedicated to contain the spread of the disease, the pandemic may have impacted the burden of other infectious diseases such as dengue, particularly in countries endemic for dengue fever. Indeed, the co-occurrence of COVID-19 made dengue diagnosis challenging because of some shared clinical manifestations between the two pathogens. Furthermore, the sudden emergence and novelty of this global public health crisis has forced the suspension or slow-down of several research trials due to the lack of sufficient knowledge on how to handle the continuity of research trials during the pandemic. We report on challenges we have faced during the COVID-19 pandemic and measures that were implemented to continue the iDEM project (intervention for Dengue Epidemiology in Malaysia).
Methods:
This randomized controlled trial aims to assess the effectiveness of Integrated Vector Management (IVM) on the incidence of dengue in urban Malaysia by combining: targeted outdoor residual spraying (TORS), deployment of auto-dissemination devices (ADDs), and active community engagement (CE). Our operational activities started on February 10, 2020, a few weeks before the implementation of non-pharmaceutical interventions to contain the spread of COVID-19 in Malaysia.
Results:
The three main issues affecting the continuity of the trial were: ensuring the safety of field workers during the interventions; ensuring the planned turnover of TORS application and ADD deployment and services; and maintaining the CE activities as far as possible.
Conclusions:
Even though the pandemic has created monumental challenges, we ensured the safety of field workers by providing complete personal protective equipment and regular COVID-19 testing. Albeit with delay, we maintained the planned interval time between TORS application and ADDs services by overlapping the intervention cycles instead of having them in a sequential scheme. CE activities continued remotely through several channels (e.g., phone calls and text messages). Sustained efforts of the management team, significant involvement of the Malaysian Ministry of Health and a quick and smart adaptation of the trial organisation according to the pandemic situation were the main factors that allowed the successful continuation of our research.
Trial Registration:
Trial registration number: ISRCTN-81915073 . Date of registration: 17/04/2020, 'Retrospectively registered'.
