title: Community-centred approach for the control of Aedes spp. in a peri-urban zone in the Andaman and Nicobar Islands using temephos.
abstract: BACKGROUND
  Chikungunya fever struck the Andaman and Nicobar Islands in July 2006. From the entomological point of view, dengue and chikungunya are hard to control due to the high prevalence of Aedes aegypti in both urban and rural areas. Mobilizing communities for the control of Aedes aegypti has not been attempted in India.
  
  
  METHODS
  We did a prospective observational feasibility study in one peri-urban locality (Brookshabad) to assess the Aedes spp. infestation and subsequently test the efficacy of a community-based approach to control Aedes aegypti. An Aedes infestation larval survey was done with the assistance of community volunteers using the single larval survey (SLS) technique. House index, container index and Breteau index reflecting the relative prevalence and infestation levels were estimated. Various information, education and communication (IEC) campaign tools were developed to disseminate information about the prevalent situation. Several talks were organized to sensitize and motivate the people to realize the problem and participate in solving it. A two-pronged strategy, viz. environmental management through source reduction and anti-larval campaign using temephos was adopted to combat Aedes infestation through community involvement.
  
  
  RESULTS
  A total of 533 water-holding containers were searched for Aedes larvae, both indoors (188/533, 35.3%) and outdoors (345/533, 64.7%) from 104 (104/235, 44.3%) premises. Of these, 109 containers (95% CI 17.19%-24.03%) were found to support Aedes spp. larval breeding (20.45%). The Breteau index was 104.8%. Aedes aegypti predominated followed by Aedes albopictus. The most abundant water-holding containers supporting Aedes breeding were plastic, metal drums and cement tanks. These water-holding containers were targeted for temephos application by the community volunteers. Forty rounds of temephos applications were carried out during the study period. The number of containers supporting Aedes aegypti breeding reduced significantly within 1 month post-intervention by community volunteers. As a result the Breteau and house indices dropped from 104.8% to 2.7% and 44.23% to 2.6%, respectively. Thereafter, the indices remained at zero level till completion of the study.
  
  
  CONCLUSIONS
  Larval indices indicate that Aedes aegypti is well established in peri-urban Brookshabad. Predominance of this mosquito species indicates infiltration into the peri-urban locality and beginning of displacement of Aedes albopictus. Epidemiologically, 3 categories of water-holding containers, viz. plastic, metal drums and cement tanks facilitate breeding of Aedes aegypti. Consequently, targeted source reduction as one way of selectively attacking the most important types of containers with temephos is feasible. Community involvement and networking with the residents allowed for a community-centred approach to combat Aedes aegypti infestation. As an outcome of this approach, the larval indices reduced significantly and remained low. We suggest that a control strategy emphasizing the use of temephos through a community-centred approach should be considered for these islands. However, close monitoring of this approach is warranted for long term sustainability.
authors.affiliation: Regional Medical Research Centre, Indian Council of Medical Research (ICMR), Post Bag 13, Port Blair 744101, Andaman and Nicobar Islands, India.
authors.forename: A N
authors.initials: AN
authors.lastname: Shriram
authors.forename: A P
authors.initials: AP
authors.lastname: Sugunan
authors.forename: S P
authors.initials: SP
authors.lastname: Manimunda
authors.forename: P
authors.initials: P
authors.lastname: Vijayachari
mesh_terms: D000330:Aedes; D018354:Alphavirus Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D000704:Analysis of Variance; D000818:Animals; D016009:Chi-Square Distribution; D002646:Chikungunya virus; D003715:Dengue / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D005240:Feasibility Studies; D007194:India / Q000453:epidemiology; D007303:Insect Vectors; D007306:Insecticides; D009032:Mosquito Control / Q000379:methods*; D015995:Prevalence; D011446:Prospective Studies; D000002:Temefos; D014504:Urban Health
chemical_list: D007306:Insecticides; D000002:Temefos