To eliminate vector breeding sites, community involvement and inter-sectoral collaboration is of utmost importance. Though the dengue control programme takes much effort with massive investments for DF/DHF prevention and control, the situation is getting worsened with increasing cases over the last three decades.
National Dengue control program was initially set up in Sri Lanka in 1998, however, the number of reported cases has increased by 10-folds since the 2000s and it was estimated the total cost of dengue control and hospitalizations was US$3.45 million (US$1.50 per capita) in Colombo district in 2012 (Thalagala et al.,2016). Elimination of breeding sites of vector mosquitoes is the key to control dengue. Abeyewickreme et al (2013) studied community mobilization and household waste management for dengue control in Gampaha, one of the most populous districts in Sri Lanka. The results from the study indicated there was a reduction in aedes larvae and pupae.
In addition, the involvement of local government bodies communities and awareness programs for school children and cleaning campaigns are necessary for the control of DH/DHF in the island (Sirisena and Noordeen, 2014; Abeyewickreme et al.,2013). Likewise, Sri Lanka highly depends on chemical spraying for mosquito and disease control which is not successful. Thus, implementing community knowledge on vector ecology and disease epidemiology is crucial. A positive correlation was observed between education intervention programs and the use of environmentally sound methods for mosquito control such as bed net use, breeding site elimination and environmental cleanup (Yasuoka et al., 2006). Besides, it is significant to take into account the spatial-temporal distribution of dengue in Sri Lanka where not all 25 districts are associated with climatic factors, as a result, non-climatic factors need to be addressed for control measures on dengue (Sun et al., 2017).
Early Warning Systems
Currently, early warning of DF/DHF transmission is based only on the epidemiological and entomological data which can give warning a month ahead. The skill of predictions and the lead time can be extended to 2-3 months ahead if weather and climatic observations and predictions are incorporated. This may induce the decision-makers, disease control managers and increases community response as this warning would be more evidence-based. (Figure)