Empirical evidence of the effect of school gathering on the dynamics of dengue epidemics

Dengue fever is an important vector-transmitted disease that affects more than 100 countries worldwide. Locations where individuals tend to gather may play an important role in disease transmission in the presence of the vector. By controlling mosquitoes' breeding places, this study aims to analyze the effect of reducing transmission in elementary schools (grades 1-9) on the dynamics of the epidemic at a regional level. In 2007, we implemented a massive campaign in a region of México (Colima state, 5,191 km 2 , population 568,000) focused on training janitors to locate and avoid mosquitoes' breeding places, the objective being to maintain elementary schools free of mosquitoes. We observed 45% reduction in dengue incidence compared to the previous year. In contrast, the rest of Mexico observed an 81% increase in incidence on average. Costs associated with campaigns focusing on cleaning schools are very low and results seem to be promising. Nevertheless, more controlled studies are needed.