Citizen Action for Sustainable Dengue Control in Sub-Saharan Africa

This project focuses on addressing arboviral outbreaks in Ivory Coast by involving local communities in the sustainable control of Aedes mosquitoes, utilizing scientific advice and environmental interventions. It will evaluate the impact of a participatory strategy on decreasing mosquito populations and the risk of virus transmission, aiming to provide insights for policy development on disease prevention.

Study Overview

• Status: Completed
• Conditions: Dengue
• Intervention / Treatment: Behavioral: Community-based larval source management; Device: Enhanced Aedes adults trapping (BG-GAT); Combination product: Community-based larval source management with Enhanced Aedes adults trapping (BG-GAT)

Detailed Description

This project targets the growing threat of Aedes mosquito-borne diseases such as dengue in Africa, focusing on the Anono and Gbagba communities in Abidjan, Ivory Coast, by transitioning from traditional control approaches to a community-driven strategy. It focuses on educating and involving communities in the design of sustainable mosquito management measures, such as breeding site eradication and adult mosquito capturing, with scientific experts guiding the efforts. The approach will entail conducting sociocultural surveys and interactive workshops while also encouraging local participation and multi-sectoral collaboration. A randomized controlled trial (RCT) will test this effectiveness of this novel integrated community-based participatory intervention approach in reducing the transmission of Aedes mosquito and other arboviruses. This effort seeks to develop a scalable model for arboviral disease control, promote community resilience, and inform policy recommendations for better public health outcomes in resource-constrained urban settings.

• Study Type: Interventional
• Enrollment (Actual): 40
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Côte D'Ivoire
  • Abidjan, Côte D'Ivoire
    • Centre Suisse de Recherches Scientifiques en Cote d'Ivoire

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion criteria:

1. Geographical location: households must be located within the designated clusters in the two districts involved in the trial.
2. Participation in cluster arms: households must belong to a cluster that is assigned to one of the four arms (1. Control, 2. Community-based larval source management, 3 Enhanced Aedes adults trapping (BG-GAT), 4. Enhanced Aedes adults trapping (BG-GAT) + Community-based larval source management).
3. Willingness to participate: households agreed to allow researchers to place mosquito traps and conduct larval and adult mosquito surveys.
4. Socio-Environmental Data: households must agree and provide consent to participate to the socio-environmental questionnaire.

Exclusion Criteria:

1. Outside of trial clusters: households located outside the designated clusters in the two districts were excluded.
2. Refusal to participate: households that do not consent to mosquito trap placement or surveys
3. Inaccessibility: households that are not accessible for regular visits or data collection (e.g., due to relocation or difficult terrain).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Factorial Assignment
• Masking: Single

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control; Non-intervened control arm: no community-based larval source management (LSM) or BG-GAT intervention
Experimental: Community-based larval source management; LSM intervention arm: Aedes larval source reduction carried out by trained and supervised local community members	Behavioral: Community-based larval source management; This project will foster active engagement with community stakeholders, including healthcare workers, community leaders, and other key informants, through participatory meetings aimed at co-creating and developing larval source reduction measures tailored to community's needs. This method emphasizes a participatory framework, ensuring that interventions are both community-informed and culturally relevant.
Experimental: Enhanced Aedes adults trapping (BG-GAT); BG-GAT intervention arm: Aedes adult mass trapping by BG-GAT set up and maintained by trained and supervised local community members	Device: Enhanced Aedes adults trapping (BG-GAT); Furthermore, the project intends to determine whether the addition of cost-effective, gravid female mosquito-targeting traps, specifically two Biogents Gravid Aedes Traps (BG-GAT) per household, can improve the overall success of these community-based intervention.
Experimental: Community-based larval source management + Enhanced Aedes adults trapping (BG-GAT); Combined LSM and BG-GAT intervention arm: simultaneous Aedes larval source reduction and Aedes adult mass trapping by BG-GAT carried out by trained and supervised local community members	Combination product: Community-based larval source management with Enhanced Aedes adults trapping (BG-GAT); The community-based interventions and the BG-GAT deployment will be evaluated in combination to assess their individual and synergistic effects on vector control. This dual strategy combines local participation and practical, evidence-based solutions to address mosquito-borne illness transmission.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Aedes aegypti mean number per trap per day	Biting rate is the mean number of Aedes females per trap and per day. The proportion of unfed, fed, half-gravid and gravid females will be estimated.	Continuously during months 1-4 (baseline) and months 5-17 (trial)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
House index	House index: proportion of houses with at least one larva	Before (month 1), twice during (month 4, 8) and once at the end of the trial (month 12)
Pupal indices: pupae per person index, pupa index and pupae per hectare index	Pupae per person index: number of pupae per person Pupa index: number of pupae per house Pupae per hectare index: number of pupae per ha	Before (month 1), twice during (month 4, 8) and once at the end of the trial (month 12)
Adults: parity rate	The parity rate (PR) (proposition of parous females) will be calculated to estimate vector longevity.	Continuously during months 1-4 (baseline) and months 5-17 (trial)
Knowledge, attitudes, and practices on Dengue prevention among the population of Cocody-Bingerville	A Knowledge, Attitudes, and Practices (KAP) study will be conducted to assess the communities' understanding, attitudes, practices, and beliefs related to dengue. This will be done using a structured questionnaire developed specifically for this trial. The questionnaire comprises both multiple-choice and open-ended questions, allowing for a comprehensive assessment of: 1) Knowledge: Understanding of dengue transmission, symptoms, and prevention, 2) Attitudes: Perceptions of dengue risk and confidence in prevention methods, 3) Practices: Reported behaviors to prevent dengue, such as mosquito control measures. This structured tool will be used at both baseline and endline to measure changes and assess the effectiveness of the intervention."	Before (month 1) the start of the trial and at the end of the trial (month 12)
Mapping and describe Aedes aegypti breeding sites, focusing on their geographic and ecological characteristics. This mapping will be used to enhance targeted larval control efforts in these areas.	The geographic survey will collect household and environmental data, including demographic details, public space quality, water provision, sanitation access, and waste management practices. It will map housing conditions, examining building types, construction materials, and key features like water storage and solid waste management. The survey will also assess local built environments to inform interventions for improving living conditions and controlling mosquito breeding sites.	Before (month 1) the start of the trial and at the end of the trial (month 12)
Container index	Proportion of positive containers	before (month 1), twice during (month 4, 8) and once at the end of the trial (month 12)
Breteau index	Number of positive containers per 100 houses	Before (month 1), twice during (month 4, 8) and once at the end of the trial (month 12)

Collaborators and Investigators

• Sponsor: Swiss Tropical & Public Health Institute
• Collaborators: Centre Suisse de Recherches Scientifiques en Cote d'Ivoire
• Investigators: Principal Investigator: Pie Müller, PD, PhD, Swiss Tropical & Public Health Institute

Study record dates

Study Major Dates

• Study Start (Actual): July 15, 2023
• Primary Completion (Actual): July 31, 2024
• Study Completion (Actual): September 30, 2024

Study Registration Dates

• First Submitted: July 1, 2024
• First Submitted That Met QC Criteria: October 16, 2024
• First Posted (Actual): October 18, 2024

Study Record Updates

• Last Update Posted (Actual): October 22, 2024
• Last Update Submitted That Met QC Criteria: October 21, 2024
• Last Verified: December 1, 2023

More Information

Terms related to this study

• Keywords: Africa; Dengue; Community based intervention; Vector control; Ivory Coast; Participatory research; Aedes Aegypti
• Additional Relevant MeSH Terms: Vector Borne Diseases; Mosquito-Borne Diseases; Infections; RNA Virus Infections; Virus Diseases; Arbovirus Infections; Flavivirus Infections; Flaviviridae Infections; Hemorrhagic Fevers, Viral; Dengue
• Other Study ID Numbers: C21047

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No