title: Community mobilization and household level waste management for dengue vector control in Gampaha district of Sri Lanka; an intervention study.
abstract: BACKGROUND
  Waste management through community mobilization to reduce breeding places at household level could be an effective and sustainable dengue vector control strategy in areas where vector breeding takes place in small discarded water containers. The objective of this  study was to assess the validity of this assumption.
  
  
  METHODS
  An intervention study was conducted from February 2009 to February 2010 in the populous Gampaha District of Sri Lanka. Eight neighborhoods (clusters) with roughly 200 houses each were selected randomly from high and low  dengue endemic areas; 4 of them were allocated to the intervention arm (2 in the high and 2 in the low endemicity areas) and in the same way 4 clusters to the control arm. A baseline household survey was conducted and entomological and sociological surveys were carried out simultaneously at  baseline, at 3 months, at 9 months and at 15 months after the start of the intervention. The intervention programme in the treatment clusters consisted of building partnerships of local stakeholders, waste management at household level, the promotion of composting biodegradable household waste,  raising awareness on the importance of solid waste management in dengue control and improving garbage collection with the assistance of local government authorities.
  
  
  RESULTS
  The intervention and control clusters were very similar and there were no significant differences in pupal  and larval indices of Aedes mosquitoes. The establishment of partnerships among local authorities was well accepted and sustainable; the involvement of communities and households was successful. Waste management with the elimination of the most productive water container types (bowls,  tins, bottles) led to a significant reduction of pupal indices as a proxy for adult vector densities.
  
  
  CONCLUSIONS
  The coordination of local authorities along with increased household responsibility for targeted vector interventions (in our case solid waste management due to the type  of preferred vector breeding places) is vital for effective and sustained dengue control.
authors: University of Kelaniya, Faculty of Medicine, Thalagolla Road, Ragama, Sri Lanka. wabeyewickreme@yahoo.com
authors: W
authors: W
authors: Abeyewickreme
authors: A R
authors: AR
authors: Wickremasinghe
authors: K
authors: K
authors: Karunatilake
authors: J
authors: J
authors: Sommerfeld
authors: Kroeger
authors: K
authors: Axel
mesh_terms: D000328:Adult; D000330:Aedes / Q000254:growth & development; D000818:Animals; D003153:Community Health Services / Q000379:methods / Q000458:organization & administration*; D003715:Dengue / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology / Q000635:transmission; D004197:Disease Reservoirs / Q000821:virology; D017753:Ecosystem; D005260:Female; D015438:Health Behavior; D006801:Humans; D007303:Insect Vectors / Q000254:growth & development; D008297:Male; D008875:Middle Aged; D009032:Mosquito Control / Q000379:methods* / Q000458:organization & administration; D011679:Pupa / Q000254:growth & development; D012737:Sex Factors; D013188:Sri Lanka / Q000453:epidemiology; D014504:Urban Health / Q000706:statistics & numerical data; D018505:Waste Management / Q000379:methods*; D014871:Water Microbiology; D014881:Water Supply