Monitoring and evaluation of programmes

Monitoring refers to a continuous tracking of a programme’s process or performance. The aim is to

estimate the spread and burden of the disease over different periods of time. A sound and
thorough monitoring and evaluation strategy allows decision makers to asses the effectiveness of
various strategies on dengue transmission.

Methods of surveillance include:

1. Disease surveillance
Tracking the number of infected human cases.

Effective surveillance of dengue cases is essential:

i. To detect outbreaks in order to initiate timely and effective control measures;

ii. Monitor the trends of incidence including temporal and geographic distribution of cases;
iii. To monitor number of severe dengue cases and deaths;
iv. To assess and confirm possibility of outbreaks based on serological evidence;
v. To monitor the impact of control interventions.
Epidemiological surveillance requires the report on the following indicators:

 Suspected (clinical) cases of dengue and severe dengue;

 Confirmed (laboratory-tested) cases of dengue and severe dengue;
 Circulating serotypes (DEN-1,-2,-3 or -4);
 Number of deaths from dengue or severe dengue;
 Number of deaths among severe dengue cases, suspected or confirmed.
The effective prevention and control of epidemic dengue requires an active laboratory-based
disease surveillance programme (using serological and virological diagnosis) that can provide
early warning of impending epidemic transmission. However, for early detection of suspected
cases, routine monitoring of fever cases in sentinel sites should be considered.

2. Vector surveillance
Tracking mosquito populations in areas of potential risk.

Surveillance on Ae. aegypti density is important in determining factors related to dengue

transmission, in order to prioritize areas and seasons for vector control. Selection of appropriate
surveillance strategies are based upon outcome/objective, also taking into consideration time,
resources, and infestation levels.

Additionally, vector surveillance is required to sustain the control measures and detect any
increase in vector density.

The most used indicators for vector surveillance are:

Larval surveys:
House index (HI): percentage of houses infested with larvae and/or pupae.

Container index (CI): percentage of water-holding containers infested with larvae or pupae.

Breteau index (BI): number of positive containers per 100 houses inspected.

Pupae surveys:
Pupa index (PI): number of pupae per 100 houses inspected.

Adult surveys:
Estimating adult population density using ovitraps, sticky traps, human landing collections or any
similar traps.

Additional information is available on vector surveillance equipment in Dengue guidelines, Chapter

5.2.2.
3. Monitoring behavioural impact
Observing whether behaviours aimed to reduce dengue transmission are adopted and sustained
by the community.