Meta-analysis of studies on chemical, physical and biological agents in the control of Aedes aegypti.
BACKGROUND
Aedes aegypti is a vector of international concern because it can transmit to humans three important arboviral diseases: yellow fever, dengue and chikungunya. Epidemics that are repeated year after year in a variety of urban centers indicate that there are control failures, allowing the vector to continue expanding.


METHODS
To identify the most effective vector control strategies and the factors that contributed to the success or failure of each strategy, we carried out a systematic review with meta-analysis of articles published in 12 databases, from 1974 to the month of December 2013. We evaluated the association between the use of whatever chemical substance, mechanical agent, biological or integrated actions against A. aegypti and the control of the vector, as measured by 10 indicators.


RESULTS
We found 2,791 articles, but after careful selection, only 26 studies remained for analysis related to control interventions implemented in 15 countries, with 5 biological, 5 chemical, 3 mechanical and 13 integrated strategies. The comparison among all of them, indicated that the control of A. aegypti is significantly associated with the type of strategy used, and that integrated interventions consist of the most effective method for controlling A. aegypti.


CONCLUSIONS
The most effective control method was the integrated approach, considering the influence of eco-bio-social determinants in the virus-vector-man epidemiological chain, and community involvement, starting with community empowerment as active agents of vector control.
Universidade Federal do Cariri/Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821 - Príncipe de Gales - Santo André / SP - CEP: 09060-650, Rua Divino Salvador, 284, CEP: 63180000, Barbalha, CE, Brazil. estelitaplima@hotmail.com.
Estelita Pereira
EP
Lima
Universidade Federal de Alagoas, Instituto de Química e Biotecnologia, Universidade Federal de Alagoas, Av. Lourival Melo Mota s/n, Campus Universitário, BR 104, KM 97,6, CEP: 57072900, Maceió, AL, Brazil.
Marília Oliveira Fonseca
MO
Goulart
Universidade Federal do Cariri/Faculdade de Medicina do ABC, Av. Príncipe de Gales, 821 - Príncipe de Gales - Santo André / SP - CEP: 09060-650, Rua Divino Salvador, 284, CEP: 63180000, Barbalha, CE, Brazil.
Modesto Leite
ML
Rolim Neto
D000330:Aedes; D000818:Animals; D001685:Biological Factors; D003256:Community Participation; D006801:Humans; D007303:Insect Vectors; D007306:Insecticides; D008297:Male; D009032:Mosquito Control / Q000379:methods*; D057147:Mosquito Nets
D001685:Biological Factors; D007306:Insecticides