Nava-Aguilera Elizabeth, Morales-Pérez Arcadio, Balanzar-Martínez Alejandro, Rodríguez-Ramírez Ofelia, Jiménez-Alejo Abel, Flores-Moreno Miguel, Gasga-Salinas David, Legorreta-Soberanis José, Paredes-Solís Sergio, Morales-Nava Pedro Antonio, de Lourdes Soto-Ríos María, Ledogar Robert J, Coloma Joséfina, Harris Eva, Andersson Neil
Centro de Investigación de Enfermedades Tropicales (CIET), Universidad Autónoma de Guerrero, Acapulco, Guerrero, Mexico.
Facultad de Medicina, Universidad Autónoma de Guerrero, Taxco, Guerrero, Mexico.
BMC Public Health. 2017 May 30;17(Suppl 1):435. doi: 10.1186/s12889-017-4291-y.
The Mexican arm of the Camino Verde trial of community mobilisation for dengue prevention covered three coastal regions of Guerrero state: Acapulco, Costa Grande and Costa Chica. A baseline cross-sectional survey provided data for community mobilisation and for adapting the intervention design to concrete conditions in the intervention areas.
Trained field teams constructed community profiles in randomly selected clusters, based on observation and key informant interviews. In each household they carried out an entomological inspection of water containers, collected information on socio-demographic variables and cases of dengue illness among household members in the last year, and gathered paired saliva samples from children aged 3-9 years, which were subjected to ELISA testing to detect recent dengue infection. We examined associations with dengue illness and recent dengue infection in bivariate and then multivariate analysis.
In 70/90 clusters, key informants were unable to identify any organized community groups. Some 1.9% (1029/55,723) of the household population reported dengue illness in the past year, with a higher rate in Acapulco region. Among children 3-9 years old, 6.1% (392/6382) had serological evidence of recent dengue infection. In all three regions, household use of anti-mosquito products, household heads working, and households having less than 5 members were associated with self-reported dengue illness. In Acapulco region, people aged less than 25 years, those with a more educated household head and those from urban sites were also more likely to report dengue illness, while in Costa Chica and Costa Grande, females were more likely to report dengue illness. Among children aged 3-9 years, those aged 3-4 years and those living in Acapulco were more likely to have evidence of recent dengue infection.
The evidence from the baseline survey provided important support for the design and implementation of the trial intervention. The weakness of community leadership and the relatively low rates of self-reported dengue illness were challenges that the Mexican intervention team had to overcome. The higher dengue illness occurrence among women in Costa Grande and Costa Chica may help explain why women participated more than men in activities during the Camino Verde trial.
“绿径”登革热预防社区动员试验的墨西哥分部覆盖了格雷罗州的三个沿海地区：阿卡普尔科、大科斯塔和小科斯塔。一项基线横断面调查为社区动员以及使干预设计适应干预地区的具体情况提供了数据。
经过培训的实地团队基于观察和关键信息提供者访谈，在随机选择的群组中构建社区概况。他们在每户家庭中对储水容器进行了昆虫学检查，收集了社会人口统计学变量以及去年家庭成员中登革热病例的信息，并采集了3至9岁儿童的配对唾液样本，对其进行酶联免疫吸附测定（ELISA）检测以检测近期登革热感染情况。我们在双变量分析然后多变量分析中研究了与登革热疾病和近期登革热感染的关联。
在70/90个群组中，关键信息提供者无法识别任何有组织的社区团体。约1.9%（1029/55723）的家庭人口报告在过去一年中患过登革热疾病，阿卡普尔科地区的发病率更高。在3至9岁的儿童中，6.1%（392/6382）有近期登革热感染的血清学证据。在所有三个地区，家庭使用防蚊产品、户主有工作以及家庭成员少于5人的家庭与自我报告的登革热疾病有关。在阿卡普尔科地区，年龄小于25岁的人、户主受教育程度较高的人以及来自城市地区的人也更有可能报告登革热疾病，而在小科斯塔和大科斯塔地区，女性更有可能报告登革热疾病。在3至9岁的儿童中，3至4岁的儿童以及居住在阿卡普尔科的儿童更有可能有近期登革热感染的证据。
基线调查的证据为试验干预的设计和实施提供了重要支持。社区领导力薄弱以及自我报告的登革热疾病发病率相对较低是墨西哥干预团队必须克服的挑战。大科斯塔和小科斯塔地区女性登革热疾病发病率较高可能有助于解释为什么在“绿径”试验期间女性比男性更多地参与活动。
