Developing Risk Assessment Criteria and Predicting High- and Low-Dengue Risk Villages for Strengthening Dengue Prevention Activities: Community Participatory Action Research, Thailand

Facilitators and barriers to engaging communities in health service research on dengue control in Indo-Pacific region: a systematic review

BACKGROUND

Dengue is a public health problem in the Indo-Pacific countries. There are concerns over the facilitators and barriers to community engagement in health service research aimed at dengue control. The objective of his study was to identify and synthesize facilitators and barriers to community engagement in health service research aimed at dengue control.

METHODOLOGY

The Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) checklist was used to perform this review. Health-related databases including PubMed, Ovid, and Google Scholar were searched for relevant studies. A consolidated framework with five domains was developed after undertaking a six-phase reflective thematic assessment of the data.

RESULTS

Thirteen studies were identified, spanning eight low-and middle-income countries of the Indo-Pacific region including Cambodia, India, Indonesia, Myanmar, Philippines, Sri Lanka, Thailand, and Vietnam. The studies in this review covered the period from 2002 to 2021. A broad range of study designs and objectives were revealed across these 13 studies. An array of communities such as the local government, project-related health staff, local health services staff, community leaders, local communities/residences/general public, heads of households, community health volunteers, school teachers, and schoolchildren participated in these dengue related studies. The five Consolidated Framework for Implementation Research (CFIR) domains of 'intervention characteristics', 'inner setting', 'outer setting',' individual characteristics', and 'program implementations' were used to identify and describe barriers and facilitators.

CONCLUSIONS

The findings indicate a range of barriers and facilitators to community engagement in dengue control in the selected LMIC in the Indo-Pacific countries. Future health services research on dengue control approaches should be carefully planned, methodologically constructed, aligned with community engagement principles, and involve considerable community participation at all stages of the research.

Understanding dengue solution and larval indices surveillance system among village health volunteers in high- and low-risk dengue villages in southern Thailand

Background

Successful dengue solutions require community collaboration between agencies engaged in human health, vector control and the environment. In Thailand, village health volunteers emphasize the need for a health working group to interact, collaborate, and coordinate actions. The objectives of this study were to acquire an understanding of dengue solutions, as well as the larval indices surveillance system of village health volunteers in high- and low-risk dengue villages.

Methods

After 12 months of training in dengue prevention and setting larval indices surveillance systems, an analytical cross-sectional survey was conducted. A total of 117 villages were included in the 18 primary care facilities within one district in southern Thailand, and they were divided into 71 high-risk and 46 low-risk dengue villages. Sample size was determined using the G*power formula. The content validity index and reliability values of Cronbach's alpha coefficient for the questionnaires were 0.91 and 0.83, respectively. A random sampling approach was used to acquire data. The chi-square test, t-test, and odds ratio were used to assess the sample's level of understanding.

Results

The study included 1302 village health volunteers, including 895 and 407 from high- and low-risk dengue communities, respectively. In total, 87.9% were female, 51.6% were 20–35 years old, 48.8% had worked as a village health volunteer for 11–20 years, 27.1% had an upper elementary education, and 59.1% had dengue in the previous 12 months. Understanding of the dengue solution and larval indices surveillance system varied across high- and low-risk dengue villages. Village health volunteers with a high level of understanding of the dengue solution and larval indies surveillance system were 1.064 and 1.504 times more likely to stay in high-risk dengue villages, respectively (odds ratio [OR] = 1.064, 95% confidence interval [CI]:0.798–1.419, p = 0.672 and OR = 1.504, 95% CI:1.044–2.167, p = 0.028).

Conclusions

Village health volunteers require ongoing training to understand the prevention and control of dengue and larval indices surveillance systems, promote awareness, and monitor dengue in both high- and low-risk dengue villages.

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Village health volunteers' understandings of dengue-related issues were explored.

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High-risk dengue village volunteers better understood the larval indices surveillance system.

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Continuous dengue education training programs and surveillance system are needed to build the capacity of the volunteers.

Effects of the Developing and Using a Model to Predict Dengue Risk Villages Based on Subdistrict Administrative Organization in Southern Thailand

The purpose of this study was to evaluate the effects of developing and using a model to predict dengue risk in villages and of a larval indices surveillance system for 2372 households in 10 Thai villages. A community participatory action research method was used in five steps: (1) community preparation covering all stakeholders, (2) assessment of the understanding of a dengue solution and a larval indices surveillance system, (3) development of a prediction and intervention model for dengue risk villages, (4) implementation of the model that responds to all stakeholders, and (5) evaluation of the effects of using the model. The questionnaires to assess and evaluate were validated and reliability tested. The chi-square test and Fisher's exact test were used to analyze the quantitative data collected by means of questionnaires. Thematic analysis was applied to the qualitative data collected through interviews. The results found that the model consisted of six main activities, including (1) setting team leader responsibility, (2) situation assessment, (3) prediction of the dengue risk in villages, (4) the six steps of the larval indices surveillance system, (5) the understanding of the dengue solution and the understanding of the larval indices surveillance system training program, and (6) local wisdom innovation. The effects of using the model showed a statistically significant increase in correct understanding among 932 family leaders, 109 village health volunteers, and 59 student leaders regarding dengue prevention and control (p < 0.05). The larval indices and dengue morbidity were diminished and related to the nine themes present in the community leaders' reflections and to the satisfaction of the community members. Hence, local administrative organizations should use community-based approaches as the subdistrict dengue solution innovation to reduce the dengue problem.