|Guidelines for Dengue Surveillance and Mosquito Control, 1995 (WHO - OMS, 1995, 112 p.)|
|8. COMMUNITY BASED ACTION|
Other aspects of community participation also need to be considered. Decision-making and evaluation have generally been left to specialized health personnel, but it is important that the results of the evaluation be communicated to the community at large. The impact of source reduction and the resulting benefits should be made known clearly and simply to the target community. This promotes a sense of achievement and accomplishment in the community vis-a-vis the last campaign, and ensures future cooperation and participation.
Other aspects of community participation, which are linked to community education, are as follows:
1. At the individual level, challenge each household to adopt routine health measures that will help in the control of DF and DHF including source reduction and implementation of proper personal protection measures.
2. At the community level, organize clean-up campaigns two or more times a year to control the larval habitats of the vectors in public and private areas of the community. Some key factors for the success of such campaigns are: extensive publicity via mass media; posters and pamphlets; proper planning, pre-campaign evaluation of foci; execution to the community as promised and follow-up evaluations. Promote participation by municipal sanitation services.
3. Where community-wide participation is difficult to arrange for geographical, occupational or demographic reasons, participation can be arranged with voluntary associations of people. These people may interact daily in work or institutional settings, or come together for special purposes, such as in religious organizations, clubs, womens groups and schools.
4. Emphasize school-based programmes targeting parents and children in schools to eliminate vector breeding at home and at school.
5. Challenge commercial corporations to participate in the beautification and sanitary improvement of a community as sponsors, emphasizing source reduction of dengue vectors.
6. Combine community participation in DHF control with other aspects of community development. Where municipal services (such as refuse collection, wastewater disposal, provision of potable water, etc.) are either lacking or inadequate in a community, the population can be mobilized to improve such services, and at the same time, reduce the larval habitats of Aedes vectors as part of an overall effort at community development.
7. Combine dengue vector control with control of all species of disease-bearing and nuisance mosquitos and vermin to ensure greater benefits for the community and consequently greater participation in any neighbourhood campaign.
8. Arrange novel incentives for those who participate in community programmes for dengue control. For example, a nationwide competition can be promoted to identify the communities with the lowest larval indices within the urban setting.
Community activities against larvae and adults can include:
· cleaning and covering water storage containers;
· keeping surroundings clean and improving basic sanitation measures;
· burning mosquito coils to kill or repel mosquitos;
· burning coconut shells and husks to repel mosquitos which also eliminates these potential outdoor breeding sites;
· screening houses, particularly bedrooms;
· making available hand aerosols for killing mosquitos;
· clearing weeds and tall grass to reduce available outdoor resting places for adult mosquitos near houses; and
· using mosquito nets to protect infants and small children from bites during the day time, and also insecticide-treated mosquito nets and curtains to kill mosquitos attempting to bite through the nets or resting on the nets or curtains.
Specific activities for controlling larvae are:
· Collection, removal, disposal, burying or burning of all unusable tin cans, jars, bottles, tyres, coconut shells and husks, cocoa pods and other items that can collect and hold water.
· Keeping tyres, metal boxes, discarded appliances, sinks, basins, vehicle frames and parts of other items on industrial and commercial premises in sheltered areas protected from rainfall.
· Arranging clean-up campaigns once or twice a year by the local health authorities or community leaders in order to collect and remove all unusable containers and potential breeding sites in and around houses.
· Turning 200 litre water drums and small earthen jars upside down once a week. This emptying and cleaning procedure is easier when the water level is low.
· Periodically scrubbing the insides of water containers to destroy Aedes eggs at the time of container cleaning.
· Regular emptying of water in flower vases in houses and offices at least once a week.
· Properly covering 200 litre water drums with burlap bags or other material which allows rainwater to enter but not mosquitos.
· Covering large volume (500 litres +) water storage tank inlets and overflow outlets with mosquito wire mesh.
· Shredding or cutting old tyres into flat pieces and disposing of them in properly constructed and managed landfills away from populated areas.
· Turning canoes and small fishing boats upside down.
· Cleaning roof gutters and placing salt in ant traps.
· Constructing rectangular cement water tanks with a plug in the bottom to allow easy drainage for weekly cleaning.
· Puncturing holes in tyres used for recreational purposes by children in schools, parks and beaches.
· Draining water logged tree holes.
· Turning tin cups used to collect sap from rubber trees in rubber plantations upside down when not in use.
· Levelling or filling in tops of bamboo fences to prevent accumulation of water and breeding sites.
· Filtering water from one container to another through cloth in order to trap and dislodge larvae and pupae.
· Pouring boiling water into small earthenware jars to kill larvae when the water level is low.
· Scrubbing down the sides of jars to kill mosquito eggs.
· Removing from a pond or lake small copepod crustaceans of the genus Mesocyclops and placing several of them in a water storage container to kill mosquito larvae.
· Removing small larvivorous fish from a pond, stream or canal and placing one or two of them in a water storage container to kill larvae.