![]() Several cluster trials have since shown an impact on vector densities. However, none of these earlier studies used clustered designs. A 2007 systematic review of community-based dengue control programmes, including two randomised controlled trials, found only weak evidence “that community-based dengue control programmes alone and in combination with other control activities can enhance the effectiveness of dengue control programmes”. ![]() Multiple serotypes of dengue virus continue to move northward through Latin America.įailure to curb the dengue epidemic has led to resurgence of interest in community mobilisation for its vector control. Several reviews have shown pace-spraying with pesticide to kill adult mosquitoes to be of little value. In Nicaragua and Mexico, as in most dengue endemic countries, the national pesticide-dependent approaches have failed to curb the spread of this mosquito-borne disease. Recognition of dengue as a major health issue is increasing, especially in Asia and Central and South America. ![]() After 18 months, a follow-up study will compare dengue history, serological evidence of recent dengue virus infection (via measurement of anti-dengue virus antibodies in saliva samples) and entomological indices between intervention and control sites. Following a common evidence-based education protocol, each cluster will develop and implement its own collective interventions including house-to-house visits, school-based programmes and inter-community visits. After a baseline study, computer-driven randomisation will allocate to intervention one half of the sites, stratified by country, evidence of recent dengue virus infection in children aged 3–9 years and, in Nicaragua, level of community organisation. A random sample from the most recent census in three coastal regions of Guerrero state in Mexico will generate 90 study clusters and the equivalent sampling frame in Managua, Nicaragua will generate 60 clusters, making a total of 150 clusters each of 137–140 households. The Camino Verde (Green Way) is a pragmatic parallel group trial of pesticide-free dengue vector control, adding effectiveness to the standard government dengue control.
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