article - Achieving Behaviour Change For Dengue Control:...

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Achieving Behaviour Change For Dengue Control: Methods, Scaling-Up, And Sustainability Working paper for the Scientific Working Group on Dengue Research, convened by the Special Programme for Research and Training in Tropical Diseases, Geneva, 1-5 October 2006 Full text source: Scientific Working Group, Report on Dengue, 1-5 October 2006, Geneva, Switzerland, Copyright © World Health Organization on behalf of the Special Programme for Research and Training in Tropical Diseases, 2007 http://www.who.int/tdr/publications/publications/swg_dengue_2.htm John Elder 1 and Linda S. Lloyd 2 1 Department of Behavioral Sciences, Graduate School of Public Health, San Diego State University, San Diego, CA 92182, USA 2 3443 Whittier St., San Diego, CA 92106, USA Introduction With the global resurgence of dengue and its more severe form, dengue hemorrhagic fever (DHF), the disease has re-emerged as a major threat to public health. Typical approaches to dengue control and vector control involve vertical programmes to reduce the source of transmission. Physical (e.g. destruction or other physical manipulation of water-holding containers), biological (e.g. use of fish), and chemical (e.g. use of larvicides, spraying with systemic insecticides) control methods can be successful if substantial administrative and political support is provided. However, such efforts often result in short-term control as the areas become reinfested in a fairly short period of time. Vertical vector control programmes may be ineffective because communities are not active partners in the control actions but rather are passive participants or recipients of the control efforts [ 13 ]. In light of the restructuring efforts by ministries of health to decentralize services, and of the generalized chronic underfunding of dengue control programmes, and in order to provide effective control measures, it is critical to address issues such as: (1) how to maintain quality of control in a decentralized system where decision-making takes place at regional, state, provincial or municipal levels; (2) how to ensure that funding is adequate to maintain programme infrastructure; and (3) how to ensure, where traditionally staff have been under the purview of the ministry of health (e.g. communications, entomology) rather that the regional or municipal health department, that there are trained staff in technical areas at the local level. Dengue may present as a mild illness episode, leading many people to underestimate its seriousness and therefore the importance of controlling the mosquito vector. Some residents may be unaware of how dengue is transmitted, and some may be unaware of the source of the vector mosquito; others however may know where the
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Ae. aegypti mosquito is produced and how the breeding sites can be controlled or eliminated but are not motivated to take preventive action. Even those who do follow the recommended actions may still have Ae. aegypti or other mosquitoes in their houses and, worse still, may suffer dengue infections if their neighbours do not
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article - Achieving Behaviour Change For Dengue Control:...

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