ABSTRACT

Introduction Vector-borne diseases (VBDs) are a serious threat in many Indian states, including Kerala. Community-based decentralized planning and engagement are effective strategies that can make positive behavioral changes to control VBDs. Methods This community-based implementation research was conducted during November 2016 – October 2018 in Alappuzha municipality in Kerala, India. It was conducted in two phases. In the first phase, formative research was conducted to know the community’s profile and perceptions and thus to plan and develop an appropriate intervention. Baseline data on some entomological indicators were also collected. These data were used to assess the impact of the intervention by comparing with the post-intervention data. In the second phase, an intervention through the community’s engagement was implemented in selected wards. The activities included the formation of community committees and the vector control and source reduction activities with the community engagement and inter-sectoral coordination. Results The intervention resulted in a positive change among the community to engage in vector control activities. These efforts along with inter-sectoral coordination resulted in successfully implementing vector source reduction activities. In both wards, pre- and post-intervention entomological data (house index: 16.7 vs 6.0 and 64.2 vs. 8.6; container index: 24.8 vs. 12.1 and 37.7 vs. 18.1; and Breteau index: 21.3 vs. 7.3 and 47.7 vs. 8.6) revealed a considerable vector source reduction. Conclusion The findings of this study suggest considering and including community engagement in public health policy as the main thrust to control VBDs.

摘要

简介媒介传播疾病 (VBD) 在包括喀拉拉邦在内的许多印度邦是一个严重威胁。基于社区的分散规划和参与是有效的策略，可以通过积极的行为改变来控制 VBD。方法这项基于社区的实施研究于 2016 年 11 月至 2018 年 10 月在印度喀拉拉邦的阿拉普扎市进行。它分两个阶段进行。在第一阶段，进行了形成性研究，以了解社区的概况和看法，从而计划和制定适当的干预措施。还收集了一些昆虫学指标的基线数据。这些数据用于通过与干预后数据进行比较来评估干预的影响。在第二阶段，通过社区参与在选定的病房实施干预。这些活动包括社区委员会的成立以及社区参与和跨部门协调的媒介控制和源减少活动。结果干预导致社区发生积极变化，参与媒介控制活动。这些努力与跨部门协调一起成功地实施了减少病媒来源的活动。在两个病房中，干预前后的昆虫学数据（房屋指数：16.7 vs 6.0 和 64.2 vs 8.6；容器指数：24.8 vs. 12.1 和 37.7 vs. 18.1；和 Breteau 指数：21.3 vs. 7.3 和 47.7 vs. 8.6）揭示了相当大的矢量源减少。结论本研究的结果表明，将社区参与纳入公共卫生政策作为控制 VBDs 的主要推动力。