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Presentacion proyecto enfoque ecosistemico ENGLISH 14 05 2013

Proyecto Arauca y Armenia 2013
by

mauricio fuentes

on 26 February 2016

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Transcript of Presentacion proyecto enfoque ecosistemico ENGLISH 14 05 2013

GOALS
Ecosystem approach for the design and implementation of sustainable strategies for dengue prevention and control in Colombia
Ecohealth research
STUDY SITES
Endemic urban area for dengue
High number of dengue and severe dengue cases
Presence of Vector Borne Diseases programs
Geographic area large enough to identify 20 clusters required for the study
Established alliances
OBJECTIVE
To contribute to the improvement of dengue prevention through the better understanding of the ecological, biological and social determinants, and to evaluate community based and intersectoral interventions for reducing dengue vector (Aedes aegypti)
METHODS
SAMPLE SIZE AND SELECTION
DATA COLLECTION
Quantitative
Qualitative

20 clusters: 100 households each
Quantitative & Qualitative
Diagnosis
Co-construction
of interventions
5 years
Intervention evaluation
Scaling up and incidence in public policy
Intervention implementation
Phase I:
Cross-sectional study
1
2
3
4
5
Variables
Vector density: Pupa index*
* Rapid sweeping method:
C.M.E. ROMERO-VIVAS, H. LLINÁS, A.K.I. FALCONAR. J. Med. Entomol. (2007).
It's an ecosystem approach to health, aiming to study and manage ecosystems in relation to human health, applied to prevention and control of vector borne diseases integrating the following principles:

Systems Thinking
Transdisciplinary Research
Participation
Sustainability
Gender and Social Equity
Knowledge to Action
PROCESS
Vector density
Ecological biological
Socioeconomic
and cultural
Political context
Climate
Breeding sites
Feeding opportunities
Community dynamics
People’s knowledge, attitudes and practice towards dengue
Public services
Profile and interests of stakeholders
Public policies dengue
Vector borne diseases programs
Instruments:
Instruments:
Categories:
Interest groups:
Place of data collection:
PROJECT
PHASES

Girardot
Arauca
Armenia
1. To implement an evidence based intervention and to analyze its
effectiveness
on reducing dengue vector density

2. To estimate the
feasibility
of ecosystem management interventions based on the prior eco-bio-social analysis of phase 1.

3. To estimate the
costs
of the implemented ecosystem management intervention and to compare cost effectiveness with current vector control practices.

4. To evaluate the potential
scaling up
of the recommended community centered intense intersectoral intervention.
1. Describe the ecosystem, vector's biology and ecology, social context and vector control programs at the study sites

2. Identify the ecological, biological and social factors associated to vector density
Cluster randomized
trial
Arunchalam N, Asian Bulletin World Health Organization 2010 & Kroeger A, BMJ 2006
Desired power 80% with a significance level of 5%

Mean number of pupae per person in intervention groups: 0.3

Mean number of pupae per person in control groups: 3.0

Negative binomial distribution with a dispersion coefficient of 0.02 and an intra-cluster coefficient of 0.05
Arauca
Armenia
Girardot
Charron D, Ecohealth research in practice (2012)
Accumulated number of dengue cases
per municipality, 1999 - 2010
5% (1,122) of the municipalities accumulate 70% of the cases
+24,000 Cases
+8,000 Cases
+6,000 Cases
STUDY DESIGN
Arauca & Armenia
The study involves quantitative and qualitative methods for data collection, aiming to triangulate different sources of information in the analysis
Girardot
Phase III & IV:
Cluster Randomized Trial
Population:
94,400
Average temperature:
>75°F
Main activity:
Internal tourism
Of all pupae collected in phase I in Girardot,
79% in wet season and 76% in dry season were found in low tanks (Albercas)

Low tanks are common in households and frequently used to store water for daily activities (washing and hygiene purposes)
Long lasting Insecticide (deltamethrin)
treated curtains and low tank covers
Population:
74,600
Average temperature:
>75°F
Main activity:
Petroleum extraction,
border city
Population:
280,880
Average temperature:
66-75°F
Main activity:
Internal and
international tourism,
coffee economy
Full transcript