University of Kelaniya, Faculty of Medicine, Thalagolla Road, Ragama, Sri Lanka.
Pathog Glob Health. 2012 Dec;106(8):479-87. doi: 10.1179/2047773212Y.0000000060.
Waste management through community mobilization to reduce breeding places at household level could be an effective and sustainable dengue vector control strategy in areas where vector breeding takes place in small discarded water containers. The objective of this study was to assess the validity of this assumption.
An intervention study was conducted from February 2009 to February 2010 in the populous Gampaha District of Sri Lanka. Eight neighborhoods (clusters) with roughly 200 houses each were selected randomly from high and low dengue endemic areas; 4 of them were allocated to the intervention arm (2 in the high and 2 in the low endemicity areas) and in the same way 4 clusters to the control arm. A baseline household survey was conducted and entomological and sociological surveys were carried out simultaneously at baseline, at 3 months, at 9 months and at 15 months after the start of the intervention. The intervention programme in the treatment clusters consisted of building partnerships of local stakeholders, waste management at household level, the promotion of composting biodegradable household waste, raising awareness on the importance of solid waste management in dengue control and improving garbage collection with the assistance of local government authorities.
The intervention and control clusters were very similar and there were no significant differences in pupal and larval indices of Aedes mosquitoes. The establishment of partnerships among local authorities was well accepted and sustainable; the involvement of communities and households was successful. Waste management with the elimination of the most productive water container types (bowls, tins, bottles) led to a significant reduction of pupal indices as a proxy for adult vector densities.
The coordination of local authorities along with increased household responsibility for targeted vector interventions (in our case solid waste management due to the type of preferred vector breeding places) is vital for effective and sustained dengue control.
通过社区动员来管理废物，以减少家庭层面的滋生地，这可能是一种在蚊虫滋生于小型废弃水容器的地区有效且可持续的登革热病媒控制策略。本研究的目的是评估这一假设的有效性。
本干预研究于 2009 年 2 月至 2010 年 2 月在斯里兰卡人口稠密的加勒地区进行。从高和低登革热流行地区随机选择 8 个街区（群集），每个街区约有 200 户；其中 4 个被分配到干预组（高流行区 2 个，低流行区 2 个），同样，4 个街区被分配到对照组。进行基线家庭调查，并在基线、3 个月、9 个月和干预开始后 15 个月同步进行昆虫学和社会学调查。治疗组的干预方案包括建立地方利益攸关方的伙伴关系、家庭层面的废物管理、促进可生物降解家庭废物的堆肥、提高对固体废物管理在登革热控制中的重要性的认识以及在地方政府当局的协助下改善垃圾收集。
干预组和对照组非常相似，伊蚊蛹和幼虫指数没有显著差异。地方当局之间建立伙伴关系得到了很好的接受和可持续发展；社区和家庭的参与是成功的。通过废物管理消除最具生产力的水容器类型（碗、罐、瓶），导致作为成蚊密度替代指标的蛹指数显著减少。
协调地方当局，同时增加家庭对有针对性的病媒干预措施的责任（在我们的案例中，由于首选病媒滋生地的类型，是固体废物管理），对于有效和持续的登革热控制至关重要。
