title: Evidence on impact of community-based environmental management on dengue transmission in Santiago de Cuba.
abstract: During the dengue outbreak that struck Santiago de Cuba in 2006-2007, we conducted an observational study in the Mariana Grajales district, the former setting of a community trial for Aedes aegypti control. In the trial, community working groups (CWG) had been created in 29 randomly selected intervention house blocks, and routine vector control activities alone were conducted in the remaining 30 control blocks. The CWG elaborated and implemented with the population plans and activities to reduce Aedes infestation. They were still functional in 2006 and continued organizing community-based environmental management activities. The attack rate of dengue fever during the outbreak was 8.5 per 1000 inhabitants in the former intervention blocks and 38.1 per 1000 inhabitants in the control blocks, which corresponds to a relative risk of 4.5 (95% CI 3.1-6.5). There was a significantly higher proportion of unaffected intervention blocks, and affected blocks had on average substantially less cases than affected control blocks. This study indicates that community-based environmental management inserted in the routine A. aegypti control programme can not only sustainably curb vector infestation but also have an impact on dengue transmission.
authors.affiliation: Instituto de Medicina Tropical Pedro Kourí, Habana, Cuba. mariaeugenia@ipk.sld.cu
authors.forename: Maria E
authors.initials: ME
authors.lastname: Toledo
authors.forename: Adriana
authors.initials: A
authors.lastname: Rodriguez
authors.forename: Luis
authors.initials: L
authors.lastname: Valdés
authors.forename: Rigoberto
authors.initials: R
authors.lastname: Carrión
authors.forename: Georgina
authors.initials: G
authors.lastname: Cabrera
authors.forename: Digna
authors.initials: D
authors.lastname: Banderas
authors.forename: Enrique
authors.initials: E
authors.lastname: Ceballos
authors.forename: Mireya
authors.initials: M
authors.lastname: Domeqc
authors.forename: Carilda
authors.initials: C
authors.lastname: Peña
authors.forename: Alberto
authors.initials: A
authors.lastname: Baly
authors.forename: Veerle
authors.initials: V
authors.lastname: Vanlerberghe
authors.forename: Patrick
authors.initials: P
authors.lastname: Van der Stuyft
mesh_terms: D000330:Aedes; D000818:Animals; D003153:Community Health Services / Q000379:methods / Q000458:organization & administration*; D003462:Cuba / Q000453:epidemiology; D003715:Dengue / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D004196:Disease Outbreaks; D006801:Humans; D007303:Insect Vectors; D009032:Mosquito Control / Q000379:methods