Research on intervention solutions to reduce the risk of dengue fever in Gia Rai district, Bac Lieu province

Outputs such as insect index, knowledge index, attitude, practice of people, acceptance index and implementation of solutions proposed by the program.

The integrated quantitative and qualitative research method was applied in two phases: before and after the study to study the risk factors and factors affecting the process of behavioral change. Within the framework of this study, we intervened to improve people's knowledge, attitudes and practices by combining health education communication measures with testing two solutions: (1) using rubber covers and (2) creating fish breeding points. The limitation of our study is that in the early intervention phase, the solutions were implemented separately and not in parallel, so the results of the change after one year were not high (through the results of rapid community assessment combined with qualitative results). Therefore, we could not compare the results achieved after the intervention of each individual solution but only evaluated the overall results of the entire intervention program.

In addition, we are also limited in human resources, facing difficulties in people's attitudes and habits. The network of collaborators is often unstable, it is difficult to recruit replacements, some collaborators are old, have low education level so work is ineffective; the attitude of some people in the commune is still dependent. However, the remaining collaborators are very enthusiastic and dedicated to the work, in addition to the local government's strong support, so when the research is finished, the possibility of maintenance is still high. In addition, we also encountered many difficulties in terms of weather. Although we anticipated difficulties in intervention due to changes in temperature and rainfall, weather factors still affected the use of lid products and fish during the testing process.

Because the intervention commune and the control commune have similar characteristics, it can cause limitations due to information interference. The intervention commune and the control commune belong to the same district, although they are far apart, they can also be easily interfered with.

Maybe you are interested!

trust in intervention activities from the interventionist to the witnessing or vice versa due to the

General management of the district health center, which may affect the practice rate of the people.

4.6. Lessons learned from developing and implementing solutions in research

Over the course of our research, we have learned the following lessons in a community intervention research design:

Rank

best,

Building and strengthening a network of collaborators plays a very important role.

important for the success of an intervention study.

Second, one should not rush to judge the immediate feasibility of the product, but should conduct further follow-up evaluation studies to investigate the acceptability, longevity, effectiveness, distribution costs and promotion of the lid product before introducing it to the public.

Rank

three,

Regularly monitor progress

implementation is an activity

important action to help promptly assess and correct factors affecting the solution if the solution does not achieve the desired results and to respond promptly to any changes in the program.

Fourth, there is a need for flexibility in the way communication is delivered in terms of the use of intervention materials (covers).

Fifth, instead of focusing on all DCCN users, we only need to focus on the group of users who already use the lid but not tightly or not regularly to increase the effectiveness of the solution.

CONCLUDE

1. Epidemiological characteristics of Dengue fever in Bac Lieu from 2006 to 2012 and some related factors

From 2006 to 2012, dengue fever has been circulating in all years in Bac Lieu, with outbreaks tending to change from 3 to 4 years. The disease has a clear seasonal nature from June to November every year, peaking in July, September, and October. The number of dengue fever cases between urban and rural areas does not differ much (urban areas have 1295.2 cases/100,000 people; rural areas have 1262.6 cases/100,000 people). All ages are at risk of the disease, but the age group with the highest incidence is from 6 years old.

15 years old (50.2%), the average age of infection over the years in the 16-25 year old group is higher than the 0-5 year old group. Every year, in Bac Lieu, there are usually 2 types of viruses circulating in parallel, the main disease-causing viruses are types DEN 1, DEN 2 and DEN 4.

Factors related to the increase in dengue fever are vectors.

Disease vectors were always present at the survey points in all months of the year. The main vector was Aedes aegypti. There were 3.5% of water bugs in the rainy DCCN. Larvae nests were mainly concentrated in DCCN with a volume of 100 liters or more (41.9%), the rate of larvae in waste was low (2.6%). Larvae were still found in boats and flagpole holes, but the rate was low. There was a strong correlation between rainfall and the number of cases (Pearson's r = 0.897), between temperature and HI BG and BI indexes (0.7 < Pearson's r < 0.9).

2. Develop and pilot community intervention solutions to prevent Dengue fever

Experimental intervention solution: Based on the use of DCCN of

people, we build 2 solutions: (1) For DCCN long-term storage

or for cooking, use rubber with bamboo rim to cover tightly; (2) For

DCCN used in daily life provides fish from breeding points. Integrated with solutions is the work of TTGDSK to change people's knowledge, attitudes and practices.

Results achieved in building activities : 22 people were mobilized to directly implement solutions including the collaborator group, hamlet women, youth union and hamlet chief. Commitments were signed between 3,948 households and local authorities. Activities carried out in the 2 years of intervention were :

7,000 leaflets and 4,000 rubber covers, creating 86 fish breeding points at commune health stations and hospitals.

Collaborators, households, raised and distributed 8,960 fish to 3,257 households with DCCN. Design

Received 5 communication products from initiatives of junior high school students including: leaflets, nursery rhymes, communication songs (2 songs), posters and created a separate logo for the program. Organized 4 environmental sanitation campaigns, organized propaganda in hamlets 7 times (1 time/hamlet). Hanged posters, banners, nursery rhymes in crowded places during the campaign for propaganda.

3. Evaluate the effectiveness and sustainability of solutions

3.1. Results achieved from the pilot solutions in the intervention commune

 The effectiveness of the intervention using rubber caps reached 30.5%. The rate of DCCN with caps increased from 53.1% to 69.3%, of which DCCN using rubber accounted for 28.1%.

 The effectiveness of fish release intervention in DCCN compared to the control commune reached 130.9%. The effectiveness index in the intervention commune after 2 years was 134.4%. The rate of DCCN with fish release increased from 25.3% to 40.3%.

 Found 3.5% of natural enemies (water bugs) naturally present in the rain DCCN.

 After intervention, the intervention effectiveness of mosquito index was: DI reached 34.7%; BI reached

81.4% and only

125.9%.

number of bugs

stick is: index

HI BG reached 117.4%; only

CI number achieved

 When compared with the control commune and conducting pre-post intervention evaluation, the intervention commune achieved the following intervention effectiveness: knowledge reached 69.1%; attitude reached 88.4% and practice reached 82.3%.

3.2. Ability to maintain and apply solutions in the community

 Interventions are highly likely to be maintained due to intervention activities

not outside the objectives of the national program of social security and

also not beyond the capacity of the Health Stations, especially

The group of collaborators directly participated in the activities from the beginning of the program, so it was easy to grasp information for propaganda and mobilization. After the intervention, 17.9% of collaborators were one of the fish farming points and 63.4% of households participated in fish farming.

 Intervention solutions are built on participation and input

contributions from health workers, authorities and local people. The solutions are simple, easy to implement, using available materials.

Available locally so easy to get around.

maintain and replicate the model for localities

 The work of monitoring and managing disease vectors is a regular task of the district health center and grassroots health.

RECOMMENDATION

For the people

People living in rural areas:

 Rubber covers should be widely used instead of cement, aluminum, plastic, and wooden covers for DCCN stored for a long time and placed indoors.

 Guppies should be released and monitored regularly to prevent them from being lost or dying in aquariums used in daily life and placed outdoors.

People

in urban areas: use

direct use of rubber coating

up the

DCCN if no bamboo is available to create a lid.

For Bac Lieu Provincial Preventive Medicine Center

Continue to maintain solutions and regularly integrate them into TTGDSK activities to guide people to clearly understand the effectiveness of DCCN classification when using rubber covers and releasing fish.

Continue to replicate fish farming solutions in households, especially in rural communes.

Develop and mobilize people living in urban areas to use rubber covers for indoor DCCN.

It is necessary to pay attention to propaganda to let people know that boats and flagpole holes are breeding grounds for mosquitoes.

For the field of research

Other studies should refer to the lessons learned from the research program to design a similar intervention study to achieve the best results.

Conduct further research on the ecological characteristics of water bugs in DCCN, and study the application potential of this bug species in local social work.

Continue to research connecting communication interventions on secondary school students because this group has many initiatives in social work, especially in designing communication products.

LIST OF PUBLISHED WORKS OF THE AUTHOR RELATED TO THE THESIS TOPIC

1. Pham Thi Nha Truc, Pham Tri Dung (2012), “Dengue fever/Dengue hemorrhagic fever - a challenge for the health sector”, Journal of Practical Medicine, Vol 3(814), pp. 58-61.

2. Pham Thi Nha Truc (2012), “Activities of Dengue Prevention Program Collaborators in Phong Thanh Dong A Commune, Gia Rai District, Bac Lieu Province: a rapid assessment study”, Proceedings of the 9th Mekong Delta Military-Civilian Medical Science and Technology Conference, pp. 684-692.

3. Pham Thi Nha Truc, Pham Tri Dung (2013), “Epidemiological characteristics of Dengue fever/Dengue hemorrhagic fever in Bac Lieu, period 2006 - 2012”, Journal of Practical Medicine, Vol 10(884), pp. 94 98.

4. Pham Thi Nha Truc, Pham Tri Dung (2014), “Evaluation of intervention results to change knowledge, attitudes and practices of people in Gia Rai district, Gia Rai province”.

Bac Lieu about

Dengue fever/dengue hemorrhagic fever”,

Medical Journal

Ho Chi Minh City, Vol 18(1), pp. 131 – 138.

Vietnamese Documents

REFERENCES