Evaluation of the effectiveness of a door-to-door intervention campaign of integrated mosquito management in the urban environment of Tirana, Albania

Abstract In Europe, the invasive Asian tiger mosquito, Aedes albopictus, is the principal vector of dengue, chikungunya and Zika viruses. This mosquito species is established and widespread in Albania since the 1970s. One of the most important obstacles to planning effective vector control strategies is a weak evidence base, due to the paucity of robust (entomological or epidemiological) trials, including of vector control strategies of Ae. albopictus in Europe. We performed a pairwise cluster randomised controlled trial (CRCT) with entomological outcomes together with a community knowledge, attitude, and (control) practices (KAP) survey to assess the effectiveness of a door-to-door intervention as an integrated vector control campaign. The door-to-door intervention included active education, source reduction and larviciding activities on private properties in Tirana, Albania. Eight pairs of clusters of about 20 hectares were selected, and the intervention was randomly assigned to one cluster of each pair. Adult abundance of Ae. albopictus and Culex pipiens was sampled by BG-Sentinel traps and the egg abundance of Ae. albopictus by ovitraps. No reduction in the abundance of Ae. albopictus or Culex pipien s adult females were detected. However, we detected a significant reduction in the number of Ae. albopictus eggs, taking a one-week lag (incidence rate ratio (IRR): 0.75, 95% confidence interval (CI): 0.56–0.99) or two-week lag (IRR: 0.73, 95% CI: 0.54–0.98) between the interventions and the ovitrap sampling, related to the biological larval development time. While the results are not conclusive, this study demonstrates that it is possible to obtain significant results when evaluating the effectiveness of integrated vector control campaigns for Ae. albopictus with entomological CRCTs.