Developing the active larval indices surveillance system for dengue solution in low and high dengue risk primary care units, Southern Thailand

Abstract

Purpose: The purpose of this paper is to develop an active larval indices surveillance system and compare the outcomes of the implementation in primary care units (PCUs) at low and high risk of dengue. Design/methodology/approach: The study design was conducted by implementing a community participation action research system in low and high dengue risk PCUs in Lansaka district, Nakhon Si Thammarat province, in the Southern Region of Thailand. There were five phases to the process including preparation of all stakeholders, situation assessment, development of the surveillance system, program implementation and evaluation. The system was developed in ten villages that were categorized as either low dengue risk PCUs (comprising six villages) or high dengue risk PCUs (four villages). A village was assigned as being at high or low dengue risk according to pre-determined criteria. The low dengue risk PCU assessments were conducted on a seven-step active larval indices surveillance system where PCU officials were additionally involved in coordinating, teaching, coaching and supporting the village health volunteers (VHVs) for dengue prevention activities. The high dengue risk PCUs, on the other hand, only followed a basic larval indices surveillance system with no follow-up support. Findings: The outcomes of using intervention systems showed that the VHVs’ dengue knowledge and larval indices understanding in both PCUs increased significantly (p<0.01). Furthermore, the low dengue risk PCUs had a higher larval indices level than the high dengue risk PCU (p<0.01). Originality/value: This study showed that the low dengue risk PCU followed an active larval indices surveillance system at the sub-district level which is appropriate for villages. This study also revealed that VHVs are needed to strengthen the capacity in terms of knowledge and skills of developing such a system to ensure reduced levels of dengue in the community.