Dengue vector control through multisectoral and community-based interventions in Abidjan, Côte d’Ivoire: study protocol for a cluster-randomised trial {1}

Background In Africa, most governmental arbovirus control programmes and outbreak responses mainly follow a vertical, top-down approach for Aedes vector control, leading to short-term effects and re-emergence of dengue in intervened areas once campaigns are over. This study evaluates a horizontal, bottom-up approach built on multisectoral collaborations aiming to empower and engage local communities in controlling Aedes mosquitoes with the guidance of stakeholders and scientists in Abidjan, Côte d’Ivoire. Methods The trial is a two-by-two factorially designed cluster-randomised trial (CRT) of (i) community participatory interventions based on larval source management (LSM) and (ii) adult mass trapping (AMT) of Aedes aegypti using Biogents Gravid Aedes Traps (BG-GATs). It includes 20 contiguous equal area (625 ha) clusters in each of the Anono and Gbagba neighbourhoods, totalling 40 clusters, within the Cocody-Bingerville health district of Abidjan. Initially, baseline entomological, sociocultural, socio-economic and environmental data were collected. In the intervention clusters, local community members were then empowered and engaged in identifying how they could prevent and remove potential Aedes breeding sources, including household water and solid waste containers, and to install, maintain and handle the BG-GATs. The trial protocol was co-designed and co-created by the target community members and leaders, the local and governmental stakeholders and the research team members. Data collection pursued in order to measure the effectiveness of these novel interventions and their tangible benefits upon acceptability of and adherence to their use. Discussion This stepwise and holistic approach based on strengthening local community capacities for taking own preventive actions against Aedes vectors might build citizen resilience and improve adherence for the sustainable control of dengue in intervened areas. Lessons learned from this inclusive and multisectoral intervention model may help with designing regional and global dengue control programmes in Africa. Trial registration {2a and 2b}: ClinicalTrials.gov, ID NCT06648603. Registered on 1 July 2024.