title: Improved dengue fever prevention through innovative intervention methods in the city of Salto, Uruguay.
abstract: BACKGROUND
  Uruguay is located at the southern border of Aedes aegypti distribution on the South American sub-continent. The reported dengue cases in the country are all imported from surrounding countries. One of the cities at higher risk of local dengue transmission is Salto, a border city with heavy traffic from dengue endemic areas.
  
  
  METHODS
  We completed an intervention study using a cluster randomized trial design in 20 randomly selected 'clusters' in Salto. The clusters were located in neighborhoods of differing geography and economic, cultural and social aspects.
  
  
  RESULTS
  Entomological surveys were carried out to measure the impact of the intervention on vector densities. Through participatory processes of all stakeholders, an appropriate ecosystem management intervention was defined. Residents collected the abundant small water holding containers and the Ministry of Public Health and the Municipality of Salto were responsible for collecting and eliminating them. Additional vector breeding places were large water tanks; they were either altered so that they could not hold water any more or covered so that oviposition by mosquitoes could not take place.
  
  
  CONCLUSIONS
  The response from the community and national programme managers was encouraging. The intervention evidenced opportunities for cost savings and reducing dengue vector densities (although not to statistically significant levels). The observed low vector density limits the potential reduction due to the intervention. A larger sample size is needed to obtain a statistically significant difference.
authors.affiliation: Departamento de Protección Vegetal, Facultad de Agronomía, Universidad de la República, Montevideo, Uruguay cbasso@adinet.com.uy.
authors.forename: César
authors.initials: C
authors.lastname: Basso
authors.affiliation: Departamento de Parasitología Veterinaria, Facultad de Veterinaria, Regional Norte, Universidad de la República, Salto, Uruguay.
authors.forename: Elsa
authors.initials: E
authors.lastname: García da Rosa
authors.affiliation: Departamento de Antropología Social, Facultad de Humanidades y Ciencias de la Educación, Universidad de la República, Montevideo, Uruguay.
authors.forename: Sonnia
authors.initials: S
authors.lastname: Romero
authors.affiliation: Dirección Departamental de Salud, Ministerio de Salud Pública, Salto, Uruguay.
authors.forename: Cristina
authors.initials: C
authors.lastname: González
authors.affiliation: Departamento de Parasitología Veterinaria, Facultad de Veterinaria, Regional Norte, Universidad de la República, Salto, Uruguay.
authors.forename: Rosario
authors.initials: R
authors.lastname: Lairihoy
authors.affiliation: Instituto de Teoría de la Arquitectura y Urbanismo, Facultad de Arquitectura, Universidad de la República, Montevideo, Uruguay.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Roche
authors.affiliation: Departamento de Sistemas Ambientales, Facultad de Agronomía, Universidad de la República, Montevideo, Uruguay.
authors.forename: Ruben M
authors.initials: RM
authors.lastname: Caffera
authors.affiliation: Dirección Departamental de Salud, Ministerio de Salud Pública, Salto, Uruguay.
authors.forename: Ricardo
authors.initials: R
authors.lastname: da Rosa
authors.affiliation: Departamento de Medio Ambiente, Intendencia de Salto, Salto, Uruguay.
authors.forename: Marisel
authors.initials: M
authors.lastname: Calfani
authors.affiliation: Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organizaton (WHO), Geneva, Swirzerland.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Alfonso-Sierra
authors.affiliation: Centre of Applied Biostatistics, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Max
authors.initials: M
authors.lastname: Petzold
authors.affiliation: Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organizaton (WHO), Geneva, Swirzerland Liverpool School of Tropical Medicine, Liverpool, UK.
authors.forename: Axel
authors.initials: A
authors.lastname: Kroeger
authors.affiliation: Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organizaton (WHO), Geneva, Swirzerland.
authors.forename: Johannes
authors.initials: J
authors.lastname: Sommerfeld
mesh_terms: D000330:Aedes / Q000254:growth & development*; D000818:Animals; D016000:Cluster Analysis; D003153:Community Health Services / Q000458:organization & administration*; D003362:Cost-Benefit Analysis; D003715:Dengue / Q000517:prevention & control* / Q000635:transmission; D004197:Disease Reservoirs / Q000469:parasitology*; D017753:Ecosystem; D004772:Entomology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009032:Mosquito Control / Q000458:organization & administration*; D009936:Organizational Innovation; D011679:Pupa / Q000254:growth & development; D014504:Urban Health; D014583:Uruguay / Q000453:epidemiology; D018505:Waste Management / Q000379:methods; D014881:Water Supply
keywords: Aedes aegypti; Community participation; Cost analysis; Eco-bio-social research; Entomological indices; Inter-sectorial approaches