Stakeholder Engagement in Dengue Control; One Year After the Major Dengue Outbreak in Sri Lanka—Lessons for Future Mosquito-Borne Infection Prevention and Control

Dengue is the fastest spreading mosquito-borne viral disease in the world spreading from tropical regions to most subtropical regions, causing human suffering and considerable socioeconomic losses and hence considered as a global public health challenge. The frequent emergence of epidemics with more severe forms of the disease has now led Sri Lanka to be categorized as a hyper-endemic country, producing the largest outbreak in 2017 with an incidence of 833.9 per 100,000 population and with 0.24% case fatality rate. As a resultant, proactive strategies were identified for its prevention and control. Accordingly, stakeholder groups were identified on evidence generated by the various Dengue surveillance mechanisms and the Presidential task force was reconvened in 2017 to interlink the health sector with stakeholder ministries. This analysis aims to evaluate the outcomes of stakeholder engagement in Dengue control after implementation of intensified interventions during 2017 major Dengue outbreak by comparing relevant premise inspection and vector surveillance data for the year 2017 and 2018. A desk-based review was conducted to describe the premise inspection surveys and entomological surveillance data in order to explore the sustainable engagement of key stakeholders in dengue control in Sri Lanka. During the 2017 outbreak of dengue the following key interventions were adopted namely; the reformation of the multi-stakeholder accountability framework, implementation of integrated actions via multi-stakeholder engagement, and launching of widespread communication campaigns to empower stakeholders. The Impact of stakeholder engagement was measured by using premise inspection data gathered via door to door Special Mosquito Control Campaigns (SMCCs) in 2017 and 2018. Accordingly, nineteen (19) SMCC’s covering 2.7 million premises and Thirteen (13) SMCC’s covering 1.4 million premises were carried out in 2017 and 2018 respectively. Of them, 20 and 21% of premises reported having potential breeding places and 1.98 and 2.29% of premises were reported to have larvae positive in the respective years. Thus, the data revelation pointed towards an overall increase in potential and positive breeding places in 2018 compared to 2017. The entomological survey results for the years 2017 and 2018, when compared, also reflected an increase in premise index (PI) in 13 out of 26 districts, ranging from 1.9 to 109%.