Prevention of Dengue Fever: An Exploratory School-Community Intervention Involving Students Empowered as Change Agents

Authors

  • Wasantha P. Jayawardene MD,

    Corresponding author
    1. Graduate Student, (wajayawa@indiana.edu), Department of Applied Health Science, School of Health, Physical Education and Recreation, Indiana University Bloomington, Room 116, 1025 E Seventh Street, Bloomington IN 47405.
      Wasantha P. Jayawardene, Graduate Student, (wajayawa@indiana.edu), Department of Applied Health Science, School of Health, Physical Education and Recreation, Indiana University Bloomington, Room 116, 1025 E Seventh Street, Bloomington IN 47405.
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  • David K. Lohrmann PhD, CHES,

    1. Professor, (dlohrman@indiana.edu), Department of Applied Health Science, School of Health, Physical Education and Recreation, Indiana University Bloomington, Room 116, 1025 E Seventh Street, Bloomington IN 47405.
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  • Ahmed H. YoussefAgha PhD,

    1. Assistant Professor, (ahmyouss@indiana.edu), Department of Applied Health Science, School of Health, Physical Education and Recreation, Indiana University Bloomington, Room 116, 1025 E Seventh Street, Bloomington IN 47405.
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  • Dayani C. Nilwala MBBS

    1. Medical Doctor, (nadyachampi@yahoo.com), Base Hospital Homagama, Homagama, Colombo, Sri Lanka.
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Wasantha P. Jayawardene, Graduate Student, (wajayawa@indiana.edu), Department of Applied Health Science, School of Health, Physical Education and Recreation, Indiana University Bloomington, Room 116, 1025 E Seventh Street, Bloomington IN 47405.

Abstract

BACKGROUND: Dengue fever and dengue hemorrhagic fever (DF/DHF) are epidemic and endemic in tropical and subtropical countries including Sri Lanka. Numerous structural and community interventions have been shown to be effective in interrupting the life cycle of mosquitoes that transmit DF/DHF; however, these interventions are not always implemented intensely and/or consistently enough to control the mosquito populations and suppress the disease. Following a planned and systematic training and mobilizing program, in conjunction with a public information campaign, seventh-, eighth-, and ninth-grade students in 2 schools performed multiple mosquito control and education interventions in their communities once a week for 8 weeks.

METHODS: Five actions identified in previous literature and executed by students were tracked and secondary entomology data were obtained from public health surveillance systems. The Z-test for determining differences between proportions was utilized to determine significant changes between pre- and post-entomological survey findings in 2 intervention areas, 1 rural and 1 urban. Pre- and post-incidence rates from the intervention areas and comparable control areas were compared.

RESULTS: In intervention areas, all proportions of larval indexes were found to be significantly lower following the intervention. Surveillance data showed a 73% reduction in case load for the urban area and a 61% reduction in the rural area during the year following intervention.

CONCLUSION: If properly involved and guided, school children can be an asset to mosquito-borne disease control; the education sector could be an important partner in DF/DHF control.

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