Family Vector Control Response Kit: Equipping Households to Prevent Amplification of Aedes-transmitted Diseases
Authors: Thomas John H. , Alenwi Nfornuh , Trevett Andrew , Ochomo Eric , Grieve Timothy , Allan Richard 
Published: September 2021

Abstract
BACKGROUNDNatural disasters, such as earthquakes, hurricanes, and floods create ideal mosquito breeding conditions while simultaneously disrupting government services that prevent outbreaks where Aedes-transmitted diseases, and possibly other vector-borne diseases (VBD), are circulating. UNICEF, the MENTOR Initiative, and Kenya Medical Research Institute (KEMRI) evaluated novel UNICEF Family Vector Control Response Kits distributed to households (HH) in Wajir Town, Northeast (NE) Kenya at the end of the rainy season (January/February 2019). This region regularly experiences epidemics of VBD during, and for several months after, rainy seasons. The premise behind this study was to determine if HHs can adopt the use of the kit contents based solely on pictures rather than needing a comprehensive education campaign. This was necessary for the following two reasons: 1. Successful disruption of a disease outbreak often requires transmission be stopped at the HH level as soon as possible, 2. In the beginning of most large-scale rapid response emergencies, it is challenging to enact and align comprehensive education campaigns with delivery of supplies. To stop transmission early, it is often faster, in UNICEF’s experience, to deliver supplies directly to HHs, especially if the global/regional/national supplies are strategically prepositioned in warehouses. The study aimed to determine key outcomes when HHs were given simple picture-based application instructions, without any other education, for different combinations of evidence-based insecticidal products, including adulticides, spatial repellents, larvicides, insecticidal window curtains, and personal protection. The products were those commonly expected to be found in retail markets or will become available through public health procurement channels. METHODSSix different vector control kit configurations were distributed to six randomly selected groups each of 60 HH in Wajir Town. The number of HH successfully used for data collection totalled 324, comprising 60 HH (19%) for direct observation to document behaviors as the kits were opened and contents were being used, and 264 HH (81%) for interviews after using the kit contents. MENTOR measured the uptake, proper application, ability to follow pictorial directions for use, and acceptability at household level. RESULTSEach kit contained a booklet of pictogram Directions for Use (DFU) that described how the product was to be put to practical use, safety precautions, and specific directions where the products should be applied for best performance against Aedes mosquitoes. No further explanation or education was provided. Most interview respondents indicated positively they understood the pictograms for each product. This was an important outcome, given the low literacy level of the responders. The results of the research study provide an operational evidence-base as to the effectiveness of HH managing their own control practices using these kits in a highly insecure and challenging operational setting. CONCLUSIONSThis is the first such study of its kind and has particular relevance adding a new approach to the emergency response capacity for disease control across similar operational settings. The results of the study are relevant wherever there is potential for disease outbreaks caused by Aedes sp and other mosquito vectors in emergency situations.