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Presentacion proyecto enfoque ecosistemico ENGLISH 14 05 2013
Transcript of Presentacion proyecto enfoque ecosistemico ENGLISH 14 05 2013
Ecosystem approach for the design and implementation of sustainable strategies for dengue prevention and control in Colombia
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
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)
SAMPLE SIZE AND SELECTION
20 clusters: 100 households each
Quantitative & Qualitative
Scaling up and incidence in public policy
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:
Gender and Social Equity
Knowledge to Action
People’s knowledge, attitudes and practice towards dengue
Profile and interests of stakeholders
Public policies dengue
Vector borne diseases programs
Place of data collection:
1. To implement an evidence based intervention and to analyze its
on reducing dengue vector density
2. To estimate the
of ecosystem management interventions based on the prior eco-bio-social analysis of phase 1.
3. To estimate the
of the implemented ecosystem management intervention and to compare cost effectiveness with current vector control practices.
4. To evaluate the potential
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
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
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
Arauca & Armenia
The study involves quantitative and qualitative methods for data collection, aiming to triangulate different sources of information in the analysis
Phase III & IV:
Cluster Randomized Trial
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