Prevention and control of mosquito-borne arboviral diseases: lessons learned from a school-based intervention in Brazil (Zikamob).

BACKGROUND: Since the 1980s, when dengue was reintroduced in Brazil, outbreaks and epidemics caused by different arbovirus strains transmitted by vector mosquitoes such as Aedes aegypti have been an annual occurrence. The aim of this study was to evaluate the behavioural change of high school students and teachers who participated in an educational intervention for the prevention and vector control of arboviral diseases. METHODS: In this school-based intervention, a self-reported questionnaire was used in a pre-post intervention methodology to assess environmental risk factors, sociodemographic variables and to measure attitudes and behaviours. In all, 883 high school students and teachers from the city of Campina Grande, in the state of Paraíba, northeastern Brazil, participated. The e-health intervention consisted of a competition between schools to comply with preventive actions via content production for social networks, and the monitoring was performed over a period of three months through the ZikaMob software developed by the researchers. RESULTS: Out of the 883 survey participants, 690 were students ranging in age from 14 to 41 years, with an average of 17 ± 2 years; and 193 were teachers from 22 to 64 years old, averaging 38 ± 9 years. The analysis of the data shows that significant differences in most of the target behaviours were apparent after the intervention, with an increase of about 10% in the performance of inspection actions; a 7% greater separation of recyclables and a 40% increase in the screening of windows among students. Students showed lower fear of, and a lower self-perception of the risk of, acquiring arboviruses than teachers on average. CONCLUSIONS: ZikaMob is an innovative strategy with the potential to be replicated in any location that has an internet network and can involve an unlimited number of participants.

Spatial modelling of the infestation indices of Aedes aegypti: an innovative strategy for vector control actions in developing countries.

BACKGROUND: Larval indices such as the house index (HI), Breteau index (BI) and container index (CI) are widely used to interpret arbovirus vector density in surveillance programmes. However, the use of such data as an alarm signal is rarely considered consciously when planning programmes. The present study aims to investigate the spatial distribution pattern of the infestation of Aedes aegypti, considering the data available in the Ae. aegypti Infestation Index Rapid Survey (LIRAa) for the city of Campina Grande, Paraíba State in Brazil. METHODS: The global and local Moran's indices were used in spatial analysis to measure the effects of spatial dependencies between neighbourhoods, using secondary data related to HI and BI gathered from surveillance service. RESULTS: Our analysis shows that there is a predominance of high rates of mosquito infestation, placing Campina Grande at a near-constant risk of arbovirus outbreaks and epidemics. A highly significant Moran's index value (P < 0.001) was observed, indicating a positive spatial dependency between the neighbourhoods in Campina Grande. Using the Moran mapping and LISA mapping, the autocorrelation patterns of Ae. aegypti infestation rates among neighbourhoods have revealed hotpots that should be considered a priority to preventive actions of the entomological surveillance services. Predominance of high infestation rates and clearer relationships of these between neighbourhoods were observed between the months of May and July, the period with the highest rainfall in the city. CONCLUSIONS: This analysis is an innovative strategy capable of providing detailed information on infestation locations to the relevant public health authorities, which will enable a more efficient allocation of resources, particularly for arbovirus prevention.

The prevention of arboviral diseases using mobile devices: a preliminary study of the attitudes and behaviour change produced by educational interventions.

OBJECTIVES: In Brazil, the National Policy for Dengue Control seeks to incorporate the lessons of national and international experience in dengue control, emphasising the need for health education activities. The objective of this study was to evaluate and compare knowledge, attitudes and behaviours related to the prevention of arboviruses before and after a two-month educational intervention using a learning platform on mobile devices. METHODS: This quasi-experimental study corresponds to the first phase of the project 'Impact of mobile learning in the prevention and management of complications caused by arboviruses (Zika, Dengue, Chikungunya) - ZIKAMOB', sponsored as part of the British Council Newton Fund. RESULTS: Thirty of the 93 participants were first-year undergraduate university students (36.7% male), and 63 were police officers (84.1% male). The pattern of attitudes and behaviour was very similar in both groups before the intervention. The students changed their attitudes and behaviour (P = 0.032) in relation to their engagements in actions for the prevention of arboviral diseases and several other activities related to house inspections and precautions with water tanks (P < 0.01). However, recycling and surveillance activities were not as effective in changing behaviour. Female participants showed more motivation to participate in preventive activities, but living alone and working were barriers to participation. Individuals who already perform selective waste collection and are cultivating gardens demonstrated both a positive attitude and a positive behaviour towards actions for the prevention of arboviral diseases. CONCLUSION: Mobile learning and behaviour change theories might be successful as the basis for school-based and community-based interventions to avoid arboviruses. These outcomes need to be confirmed in broader future studies.

OBJECTIFS: Au Brésil, la politique nationale de lutte contre la dengue cherche à intégrer les leçons tirées des expériences nationales et internationales en matière de lutte contre la dengue, en insistant sur la nécessité d'activités d'éducation sur la santé. L'objectif de cette étude était d'évaluer et de comparer les connaissances, les attitudes et les comportements liés à la prévention des arbovirus avant et après une intervention éducative de deux mois à l'aide d'une plate-forme d'éducation basée sur des appareils mobiles. MÉTHODES: Cette étude quasi expérimentale correspond à la première phase du projet "Impact de l'éducation mobile dans la prévention et la prise en charge des complications causées par les arbovirus (Zika, Dengue, Chikungunya) - ZIKAMOB", parrainé dans le cadre du British Council Newton Fund. RÉSULTATS: Trente des 93 participants étaient des étudiants de première année d'université (36,7% d'hommes) et 63 étaient des agents de police (84,1% d'hommes). Le modèle des attitudes et de comportement était très similaire dans les deux groupes avant l'intervention. Les étudiants ont changé leurs attitudes et comportements (P = 0,032) en ce qui concerne leur participation à des actions de prévention des maladies à arbovirus et à plusieurs autres activités liées aux inspections des maisons et aux précautions d'utilisation des réservoirs d'eau (P < 0,01). Cependant, les activités de recyclage et de surveillance n'étaient pas aussi efficaces pour le changement de comportement. Les participantes étaient plus motivées à participer aux activités de prévention, mais le fait de vivre seul et de travailler constituait un obstacle à la participation. Les personnes qui effectuent déjà une collecte sélective des déchets et cultivent des jardins ont démontré à la fois une attitude positive et un comportement positif à l'égard des actions de prévention des maladies à arbovirus. CONCLUSION: Les théories sur l'éducation mobile et le changement de comportement pourraient être couronnées de succès en tant que base d'interventions en milieu scolaire et communautaire visant à éviter les arbovirus. Ces résultats doivent être confirmés dans des études supplémentaires plus larges.

Peri-implant bone microstructure determines dynamic implant cut-out.

Dynamic implant cut-out is a frequent complication associated with surgical fracture fixation. In this in vitro study, we investigated the influence of the local trabecular bone microstructure on the rate and path of implant migration. Dynamic hip screws were implanted into six human femoral head specimens with a wide range of bone volume fractions. The specimens were subjected to image-guided failure assessment using physiological dynamic hip loading. Mechanical testing was used intermittently with high-resolution computed tomography scanning. A high correlation was found between the bone volume fraction and implant migration (R(2)=0.95). Profiles of the bone-implant interface were computed based on the positions of the screw and the femoral head. With a larger interface, the implant migration rate was smaller. The bone-implant interface was significantly smaller on the approximated screw migration path than if it had been on a straight line in loading direction. We thus hypothesize that implants migrate on a path of least resistance. This would indicate a relevant mechanism for targeted surgical intervention.