Social and environmental determinants of Aedes aegypti infestation in Central Havana: results of a case-control study nested in an integrated dengue surveillance programme in Cuba.
OBJECTIVE
To characterize the social and environmental risk factors associated with the presence of Aedes aegypti in order to improve community dengue control.


METHODS
A case-control study with 'cases' being households with entomologically confirmed A. aegypti infestation; personal interviews in Central Havana, a densely populated inner city area characterized by overcrowded housing and irregular water service. The participants were residents of 278 houses with infestation and 556 houses without infestation.


RESULTS
Greater risk of infestation was associated with lack of preventive measures, such as no larvicide in the water tanks (OR = 2.21) and use of flower vases for religious practice (1.93), not being economically active (1.64), vulnerable populations with higher risks in households with older people (1.52) and households with children (1.94).


CONCLUSIONS
Efforts to reduce infestations should continue to focus on water tank sanitation and improving housing conditions, but also engage community religious leaders to help promote safe practices. Vulnerable populations should be especially targeted by prevention activities. A surveillance programme can produce evidence to guide interventions.
Spiegel
Jerry M
JM
Global Health Research Program, Liu Institute for Global Issues, University of British Columbia, Vancouver, BC, Canada. jerry.spiegel@ubc.ca
Bonet
Mariano
M
Ibarra
Ana-Maria
AM
Pagliccia
Nino
N
Ouellette
Veronic
V
Yassi
Annalee
A
D000328:Adult; D000330:Aedes; D000818:Animals; D016022:Case-Control Studies; D003462:Cuba / Q000453:epidemiology; D003715:Dengue / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006798:Housing; D006801:Humans; D007303:Insect Vectors; D008297:Male; D008875:Middle Aged; D009032:Mosquito Control / Q000379:methods; D011159:Population Surveillance / Q000379:methods; D012067:Religion; D012307:Risk Factors; D012959:Socioeconomic Factors; D014038:Toilet Facilities; D014504:Urban Health; D014881:Water Supply / Q000592:standards