Gubler D J, Clark G G
Division of Vector-Borne Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, CO 80522, USA.
Acta Trop. 1996 Apr;61(2):169-79. doi: 10.1016/0001-706x(95)00103-l.
In the past 15 years, there has been a dramatic resurgence of dengue and dengue hemorrhagic fever worldwide, with increased frequency of epidemics and geographic expansion of both the mosquito vectors and the viruses. The reasons for this resurgence are not well understood, but include uncontrolled and unplanned urbanization, increased movement of people and viruses by airplane and lack of effective control of Aedes aegypti, the principal mosquito vector of dengue viruses. The recommended method for Ae. aegypti control during the past 20 years has been ultra-low volume (ULV) application of insecticides, a method which targets the adult mosquito. Lack of efficacy of the ULV approach led to a reevaluation of recommended strategies for prevention and control of epidemic dengue and ultimately, resulted in development and widespread use of community-based, integrated approaches to Ae. aegypti control. This chapter reviews the use of community participation for controlling Ae. aegypti via larval source reduction and critically discusses programs in four countries from the standpoint of effectiveness and sustainability. It is concluded that a combination of vertically structured centralized and community-based approaches should provide short-term success as well as long-term sustainability.
在过去15年里，登革热和登革出血热在全球范围内急剧复苏，疫情爆发频率增加，蚊媒和病毒的地理分布范围扩大。这种复苏的原因尚不完全清楚，但包括无节制和无规划的城市化、人员和病毒通过飞机的流动增加以及对登革病毒主要蚊媒埃及伊蚊缺乏有效控制。在过去20年里，推荐的埃及伊蚊控制方法是超低容量（ULV）喷洒杀虫剂，该方法针对成年蚊子。超低容量方法效果不佳导致对登革热流行预防和控制推荐策略进行重新评估，最终促成了基于社区的埃及伊蚊综合控制方法的开发和广泛应用。本章回顾了通过减少幼虫滋生地利用社区参与控制埃及伊蚊的情况，并从有效性和可持续性的角度批判性地讨论了四个国家的项目。得出的结论是，垂直结构的集中式方法与基于社区的方法相结合应能实现短期成功以及长期可持续性。
