Dengue Clinical Trial
Official title:
Cluster Randomized Controlled Trial: Efficacy of Gravid Oviposition Sticky Trap (GOS) and Dengue NS1 Antigen Rapid Diagnostic Test for Early Surveillance of Dengue Among Adult Aedes Mosquitoes to Reduce Dengue Outbreaks in PJU10, Damansara Damai, Selangor, Malaysia
During dengue outbreaks, the Ministry of Health Malaysia employs various methods to control the spread of disease, including killing the larvae of Aedes mosquitoes, fogging, together with educating and disseminating information about the dengue outbreak, to the community. However, this is too late. Research has shown that when an outbreak has occurred, the viral infection has already spread among the community. Therefore, this current trial aims to educate the public (via questionnaire survey and interactions with the residential managements, mainly), detect dengue-infected mosquitoes, inform the communities of the presence of dengue-infected mosquitoes, followed by approaching and educating them to take precautionary measures before the outbreak happens. Trapping (using gravid oviposition sticky (GOS) traps) and detecting dengue virus non-structural 1 (NS1) antigen (using dengue NS1 kit) in the Aedes mosquitoes will be a more reliable way to alert the community before a potential dengue outbreak in their housing area. The community will receive information of presence of infected mosquitoes and probable dengue infections before dengue cases are reported. This will be an ideal time for clean-ups and for search and destroy activities. With this shift in approach and the use of newer techniques, it is hoped that deaths and epidemics due to dengue will be reduced.
This cluster randomised controlled trial will be conducted to provide evidence on the
efficacy of an integrated active vector surveillance and preventive strategy in the
community. It aims to demonstrate effectiveness of a new proactive paradigm in reducing
dengue epidemics. The main hypotheses are 1) This new paradigm (GOS trap and dengue NS1 kit
for detection of dengue in Aedes) will reduce dengue epidemics compared to the usual current
vector surveillance/control carried out by the Ministry of Health. 2) Community will be more
receptive to this new surveillance activity as they will receive information of dengue
transmissions before dengue cases are reported.
The study sites at PJU10, Damansara Damai, Petaling Jaya, Selangor, Malaysia are
1. Intervention arm: Harmoni Apartment, Impian Apartment, Park Avenue Condominium, and
Suria Shop Apartment
2. Control arm: Permai Apartment, Lestari Apartment, Indah Apartment, and Vista Shop
Apartment
Activities to be carried out include:
A. Questionnaire survey and blood taking for dengue seroprevalence among residents from both
arms When people in the community are gathered at an identified, suitable area, the
Knowledge, Attitude and Practice (KAP) questionnaires will be distributed for them to answer.
After the questionnaire survey, about 3 ml of venous blood would be taken by trained
personnel for dengue IgG and IgM serology.
B. Placement of the GOS mosquito trap in the intervention arm The GOS mosquito traps will be
placed in the intervention arm and serviced weekly. The trapped Aedes mosquitoes would be
checked for dengue virus via dengue NS1 rapid diagnostic test kit.
The GOS mosquito traps will also be placed randomly in the control arm once per month for
entomological survey.
C. If a dengue-positive mosquito is found, flyers and banners will be distributed and hung to
inform the residents of the presence of dengue transmission in the apartment block/apartment.
Alternatively, the residents may also be approached house-to-house or an educational booth
set up at strategic locations in the apartment to warn and educate the residents.
D. The KAP questionnaire survey will be carried out again 3 months before the completion of
the trial in the intervention arm to gauge the communities' perception of this intervention.
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