Neil Andersson|Elizabeth Nava-Aguilera|Jorge Arosteguí|Arcadio Morales-Pérez|Harold Suazo-Laguna|José Legorreta-Soberanis|Carlos Hernández-Álvarez|Ildefonso Fernández?Salas|Sergio Paredes?Solís|Ángel Balmaseda|Antonio Juan Cortés-Guzmán|René Serrano de los Santos|Joséfina Coloma|Robert J. Ledogar|Eva Harris
Evidence based community mobilization for dengue prevention in Nicaragua and Mexico (<i>Camino Verde,</i>the Green Way): cluster randomized controlled trial
McGill University|Autonomous University of Guerrero|Autonomous University of Guerrero|Autonomous University of Guerrero|Autonomous University of Guerrero|Universidad Autónoma de Nuevo León|Autonomous University of Guerrero|Ministerio de Salud|Autonomous University of Guerrero|University of California, Berkeley|ET International (United States)|University of California, Berkeley
test whether community mobilization adds effectiveness conventional dengue controlpragmatic open label parallel group cluster randomized controlled trial assessing outcomes analyzing data blinded group assignment centralized computerized randomization baseline study allocated half sites intervention stratified country evidence recent dengue virus infection children aged 39 vector indicesrandom sample communities managua capital nicaragua three coastal regions guerrero state south mexicoresidents random sample census enumeration areas across countries 75 intervention 75 control clusters 140 households randomized analyzed 60 clusters nicaragua 90 mexico including 85182 residents 18838 householdsa community mobilization protocol began community discussion baseline results intervention cluster adapted basic interventionchemicalfree prevention mosquito reproductionto circumstances clusters continued government run dengue control programprimary outcomes per protocol self reported cases dengue serological evidence recent dengue virus infection conventional entomological indices house index households larvae pupaehouseholds examined container index containers larvae pupaecontainers examined breteau index containers larvae pupaehouseholds examined pupae per person pupae foundnumber residents per protocol secondary analysis examined effect camino verde context temephos usewith cluster unit analysis serological evidence intervention sites showed lower risk infection dengue virus children relative risk reduction 295 95 confidence interval 38 553 fewer reports dengue illness 247 18 512 fewer houses larvae pupae among houses visited house index 441 136 747 fewer containers larvae pupae among containers examined container index 367 245 448 fewer containers larvae pupae among houses visited breteau index 351 167 555 fewer pupae per person 517 362 761 numbers needed treat 30 95 confidence interval 20 59 lower risk infection children 71 48 143 fewer reports dengue illness 17 14 20 house index 37 35 67 container index 10 6 29 breteau index 12 7 31 fewer pupae per person secondary per protocol analysis showed serological evidence protective effect temephosevidence based community mobilization add effectiveness dengue vector control site implementing intervention way advantage local customization strong community engagementisrctn27581154