title: Community-centred eco-bio-social approach to control dengue vectors: an intervention study from Myanmar.
abstract: OBJECTIVE
  To build up and analyse the feasibility, process, and effectiveness of a partnership-driven ecosystem management intervention in reducing dengue vector breeding and constructing sustainable partnerships among multiple stakeholders.
  
  
  METHODS
  A community-based  intervention study was conducted from May 2009 to January 2010 in Yangon city. Six high-risk and six low-risk clusters were randomized and allocated as intervention and routine service areas, respectively. For each cluster, 100 households were covered. Bi-monthly entomological evaluations  (i.e. larval and pupal surveys) and household acceptability surveys at the end of 6-month intervention period were conducted, supplemented by qualitative evaluations. Intervention description: The strategies included eco-friendly multi-stakeholder partner groups (Thingaha)  and ward-based volunteers, informed decision-making of householders, followed by integrated vector management approach.
  
  
  RESULTS
  Pupae per person index (PPI) decreased at the last evaluation by 5·7% (0·35-0·33) in high-risk clusters. But in low-risk clusters,  PPI remarkably decreased by 63·6% (0·33-0·12). In routine service area, PPI also decreased due to availability of Temephos after Cyclone Nargis. As for total number of pupae in all containers, when compared to evaluation 1, there was a reduction of 18·6%  in evaluation 2 and 44·1% in evaluation 3 in intervention area. However, in routine service area, more reduction was observed. All intervention tools were found as acceptable, being feasible to implement by multi-stakeholder partner groups.
  
  
  CONCLUSIONS
  The efficacy of community-controlled  partnership-driven interventions was found to be superior to the vertical approach in terms of sustainability and community empowerment.
authors: Ministry of Health of Myanmar, Yangon, Myanmar. khinthetwaidmr@gmail.com
authors: Khin Thet
authors: KT
authors: Wai
authors: Pe Than
authors: PT
authors: Htun
authors: Tin
authors: T
authors: Oo
authors: Hla
authors: H
authors: Myint
authors: Zaw
authors: Z
authors: Lin
authors: Axel
authors: A
authors: Kroeger
authors: Johannes
authors: J
authors: Sommerfeld
authors: Max
authors: M
authors: Petzold
mesh_terms: D000330:Aedes / Q000254:growth & development; D000818:Animals; D003153:Community Health Services / Q000458:organization & administration*; D003715:Dengue / Q000517:prevention & control* / Q000523:psychology / Q000635:transmission; D004197:Disease Reservoirs / Q000821:virology; D017753:Ecosystem; D004772:Entomology / Q000379:methods; D005240:Feasibility Studies; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007303:Insect Vectors / Q000254:growth & development; D009032:Mosquito Control / Q000458:organization & administration*; D002052:Myanmar; D011209:Power, Psychological; D011679:Pupa / Q000254:growth & development; D014871:Water Microbiology; D014881:Water Supply; D014887:Weather