Proactive Vector Control Strategies and Improved Monitoring and Evaluation Practices for Dengue Prevention
Proactive Vector Control Strategies and Improved Monitoring and Evaluation Practices for Dengue Prevention
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DOI：
10.1603/033.046.0601
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发表时间：
2009-11-01
影响因子：
2.1
通讯作者：
Scott, Thomas W.
中科院分区：
文献类型：
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作者：
Eisen, Lars;Beaty, Barry J.;Scott, Thomas W.
尽管登革热流行国家的公共卫生组织做出了巨大努力，但已证明难以实现对主要登革热病毒载体埃及伊蚊（Aedes aegypti（L.）并有效地阻止登革热的爆发。这个问题有多个根源，包括不受控制的城市化，登革热病毒全球传播的增加，以及媒介和登革热控制方案没有得到足够的资源。在这篇论坛文章中，我们概述了病媒和登革热控制计划的基本要素，并描述了一个持续改进的周期性模型，通过定期努力识别无效的方法和劣质技术，然后用性能更好的替代品取代它们，从而系统地、逐步地提高控制计划的性能。第一步包括评估病媒/登革热控制方案活动的总体资源分配、目前使用的病媒控制方法的效力以及用于支持方案的技术的适当性。我们预计这将揭示：1）目前使用的一些病媒控制方法并不有效，2）资源分配往往偏向于被动的病媒控制措施，3）积极主动的方法通常资金不足，因此执行不力。接下来的步骤是对所使用的病媒控制方法或技术的预期变化进行概念化，然后在试点研究中确定这些变化是否可能改善控制程序的性能。随后应改变资源分配，以更有效和经过操作检验的替代办法取代无效的方法和劣质技术。持续改进模式的周期性和自我改进性质将产生适合当地的管理战略，这些战略将不断适应病媒种群或登革热病毒传播动态的变化。我们讨论了有前途的主动病媒控制方法，以及病媒和登革热控制界继续需要采用新兴技术，并与学术界、商界和广大社区合作，以确定减少登革热的新解决方案。
Despite tremendous efforts by public health organizations in dengue-endemic countries, it has proven difficult to achieve effective and sustainable control of the primary dengue virus vector Aedes aegypti (L.) and to effectively disrupt dengue outbreaks. This problem has multiple root causes, including uncontrolled urbanization, increased global spread of dengue viruses, and vector and dengue control programs not being provided adequate resources. In this forum article, we give an overview of the basic elements of a vector and dengue control program and describe a continuous improvement cyclical model to systematically and incrementally improve control program performance by regular efforts to identify ineffective methods and inferior technology, and then replacing them with better performing alternatives. The first step includes assessments of the overall resource allocation among vector/dengue control program activities, the efficacy of currently used vector control methods, and the appropriateness of technology used to support the program. We expect this will reveal that 1) some currently used vector control methods are not effective, 2) resource allocations often are skewed toward reactive vector control measures, and 3) proactive approaches commonly are underfunded and therefore poorly executed. Next steps are to conceptualize desired changes to vector control methods or technologies used and then to operationally determine in pilot studies whether these changes are likely to improve control program performance. This Should be followed by a shift in resource allocation to replace ineffective methods and inferior technology with more effective and operationally tested alternatives. The cyclical and self-improving nature of the continuous improvement model will produce locally appropriate management strategies that Continually are adapted to counter changes in vector population or dengue virus transmission dynamics. We discuss promising proactive vector control approaches and the continued need for the vector and dengue control community to incorporate emerging technologies and to partner with academia, business and the community-at-large to identify new solutions that reduce dengue.