Kalva Prathik, Forsyth Jenna, Mutuku Francis, Agola Gladys, Lutt Mwashee, LaBeaud Angelle Desiree
Department of Pediatrics, Stanford University School of Medicine, Stanford, California, United States of America.
School of Medicine, Baylor College of Medicine, Houston, Texas, United States of America.
PLOS Glob Public Health. 2025 Jun 4;5(6):e0004567. doi: 10.1371/journal.pgph.0004567. eCollection 2025.
Aedes aegypti mosquitoes are the primary vectors for important arboviral health threats including chikungunya (CHIKV) and dengue (DENV) viruses, primarily breeding in domestic plastic containers. Previous studies have highlighted a severe lack of knowledge about non-malarial mosquito-borne diseases in Kenya, so we proposed a household and school-based educational intervention in urban coastal Kenya to determine whether it could bring about long-term improvements in knowledge, attitudes, and practices related to the source reduction of arboviral disease vectors. In this cluster-randomized controlled trial, 249 households from 5 villages were placed in the intervention arm and 243 households from 5 other similar villages were placed in the control arm. From each household, one fourth grade child was enrolled. Data on the child participants' knowledge, attitudes, and practices (KAP) were collected at baseline and 3- and 12-months post-intervention, along with counts of immature mosquitoes in containers in the participants' households. At 3 months, the intervention group showed significantly greater improvement in attitude scores compared to the control group (p = 0.01), with no significant differences in knowledge or practices. However, by 12 months, the intervention group demonstrated significant improvements in knowledge (1.51 vs. 0.35, p < 0.001), attitude (0.268 vs. -0.263, p < 0.001), and practice (0.118 vs. -0.235, p < 0.001) scores compared to the control group. Additionally, the house index (houses with at least one productive container) increased in both the intervention (13.9% to 25.6%) and control (9.4% to 28.4%) households, signifying that although the intervention improved knowledge and some practices, a more targeted approach is needed to address challenges in vector control. This study demonstrates that long-term advances in knowledge, attitudes, and practices regarding arboviral diseases can be achieved through household and school-based educational interventions.
埃及伊蚊是包括基孔肯雅病毒（CHIKV）和登革热病毒（DENV）在内的重要虫媒病毒健康威胁的主要传播媒介，主要在家庭塑料容器中繁殖。先前的研究强调肯尼亚对非疟疾蚊媒疾病的了解严重不足，因此我们在肯尼亚沿海城市提出了一项以家庭和学校为基础的教育干预措施，以确定其是否能在与减少虫媒病毒病媒介来源相关的知识、态度和行为方面带来长期改善。在这项整群随机对照试验中，来自5个村庄的249户家庭被纳入干预组，来自其他5个类似村庄的243户家庭被纳入对照组。从每个家庭中招募一名四年级儿童。在基线以及干预后3个月和12个月收集儿童参与者的知识、态度和行为（KAP）数据，同时统计参与者家庭容器中未成熟蚊子的数量。在3个月时，与对照组相比，干预组的态度得分有显著更大的改善（p = 0.01），在知识或行为方面没有显著差异。然而，到12个月时，与对照组相比，干预组在知识（1.51对0.35，p < 0.001）、态度（0.268对 -0.263，p < 0.001）和行为（0.118对 -0.235，p < 0.001）得分方面都有显著改善。此外，房屋指数（至少有一个滋生容器的房屋）在干预组（从13.9%增至25.6%）和对照组（从9.4%增至28.4%）家庭中都有所增加，这表明尽管干预改善了知识和一些行为，但需要更有针对性的方法来应对病媒控制方面的挑战。这项研究表明，通过以家庭和学校为基础的教育干预，可以在虫媒病毒疾病的知识、态度和行为方面取得长期进展。
