Questions/Answers

Aedes aegypti and Ae. albopictus are vectors of mosquito-borne diseases, such as Dengue fever, Chikungunya fever and Zika fever. The epidemic of these diseases is a serious health problem that need immediate and appropriate response. As there is no effective vaccine to prevent these diseases, mosquito management, including chemical, biological and physical strategies, are the main practices used to control them. The World Health Organization has estimated the number of dengue patients to be 390 million from 129 countries and about 70% of them are in Asia. The number of dengue cases in Thailand is the 6th highest of the world. In 2013, there were 154,369 cases of dengue fever in Thailand with 133 deaths. There is no effective vaccine to prevent the people from these diseases. The only way to prevent the disease is to make efforts to decrease Aedes mosquito population as low as possible. The project called “The LeO-Trap with Community Participation: An Innovation to Overcome Dengue, Chikungunya, and Zika Fever” was established with 2 main objectives. The first one was to create an innovation which reduces Aedes mosquito populations long term with minimal use of chemicals. It should be measurable and approachable for every remote area with reasonable and comparable price. The second one was to impart knowledge to the communities in the high risk areas to create the “Dengue-infected free zone”. The people should be able to take care of themselves sustainably, confidently and equally. No one would be left behind. The project created a two-way communication means with social media and applications through the cooperation of government agencies, private sector and people for the faster notification of high-risk area prediction.

The project aligned with the 2nd category as it increased the performance of the government in controlling mosquito populations through close collaboration among researchers, private sector, local authorities and people in communities. It lifted the standard and confidence of the authorities with the tool that they could approach communities with less cost. The communication among the collaboration network is real-time through Line Application and Aor Sor Mor Online. There is the warning and reporting service through social media. Everyone can access the information and stop the outbreak before it even starts. This is the protection built with community participation.

The project supports objectives of the 3rd SDG (Good Health and Well-being), the 6th SDG (Clean Water and Sanitation) and the 15th SDG (Life on Land). The LeO-Trap could reduce Aedes mosquito populations and disease incidence significantly. After launching the innovation and initiating the LeO-Trap to the epidemic communities of 14 provinces, 56 villages, 11,200 houses, the result was 100% of LeO-Trap users did not catch dengue fever. The number of cases of dengue fever was reduced tremendously. There were 146,082 cases in 2015, but the number was reduced to 63,843 cases in 2020. The zeolite larvicide would maintain the quality of water for the use of washing and drinking. With these good characteristics, people are willing to use zeolite larvicide to control mosquito larvae in their water storage containers. The LeO-Trap is doing the big part helping reduce the overuse of chemical fogging. It helps to restore the populations of beneficial insects. It reduces air pollution and brings balance to the healthy eco-system. In the epidemic communities described previously, the use of chemical fogging was reduced to almost zero. The populations of Asiatic honey bee have increased by 50% which is good to the ecology and pollination.

Social dimension: Leo-Trap creates equality in access to better quality of life and public health for long term, especially the vulnerable groups in areas suffering from dengue fever infection through community participation with social network. Economic dimension: LeO-Trap provides jobs and income in Thailand instead of importing expensive pesticides. It can save up to 80% of costs instead of the traditional mosquito control. Environmental dimension: LeO-Trap reduces the number of Aedes mosquitoes up to 10 times more than the chemical control and reduce electric energy by 100%. It helps to maintain the quality of clean water and biodiversity.

Thailand is a tropical country. Heavy rain and flood are normal. And mosquitos are the main problem coming along with water. However, the authority could prevent the diseases transmitted from mosquitoes with innovation. LeO-Trap is an innovation that is the tool to terminate the life cycle of mosquito since birth. It will protect everybody in the house from Aedes-borne diseases since the young larvae will be killed after they hatched from eggs, then no Aedes mosquitoes come out. It replaces the use of chemical fogging for at least 6 months. With the cooperation of the health volunteers in setting up the LeO-Trap and reporting in two-way communication through social media and mobile application, the authority could manage their time to take care of every area needing attention. For example, Songkhla was once the epidemic area. After setting up LeO-Trap in 108 houses, 16,765 mosquito eggs were terminated within 4 days. Half of them were 8,382 females and one female mosquito could give birth to 500 offspring. So, this means 4,191,000 mosquitos were terminated since the start of life cycle. The authority can save a lot of money from eliminating chemical fogging.

In most areas, men are responsible for working outside the home, while women would spend their time on raising children. If an epidemic of dengue fever occurred in the area, women and children usually were the main victims. LeO-Trap then brings equality to the communities. It provides health safety to everyone with economic and environmental aspects. The project trains health volunteers which mostly are women and elderlies to help people. Among 14,000 health volunteers, 84% are elderlies and 86% are women. This is the encouragement for women to become a leader of taking care of people in the communities.

There were 2 target groups for this project. The first one is pregnancy and child group, they are delicate and need close protection from mosquito-borne diseases. If the pregnant woman catches the disease, the hazard is high to mother and her child which could lead to miscarriage or neurotic complications in child. The child may be disabled with microcephaly by Zika infection. The healthier and better educated mothers have healthier and better educated children. So, the project has cooperated with health volunteers mostly women, to educate mothers and their children, building the youth community participation. The youth could help to get rid of Aedes mosquito breeding places in their communities. They are the future generations who will protect their communities from mosquitoes and the diseases transmitted. The second group is the people who live in the high risk areas. LeO-Trap could save everybody in the house from biting of Aedes mosquitoes. The project encouraged them to build community participation through training and practices by health volunteers. The online training for the remote areas would be established. They pass on the cooperative missions with real-time Aor Sor Mor Online and Line Application, creating the self-awareness and self-reliance in the communities.

The Department of Medical Sciences (DMSc) successfully developed temephos zeolite granules to replace temephos sand granules in 2004. The new larvicide could be used to control mosquito larvae for 3-6 months without oil film or bad smell. It was entrusted to Ikari Trading (Thailand) Co., Ltd. to produce as industrial scale for distributing to public. However, the dengue fever cases have been high, so it needs a new idea to control the disease. Dr. Usavadee Thavara, the researcher of DMSc, had accidentally discovered the attractant derived from carpet shell in 2004. It lures many gravid Aedes mosquitoes to lay eggs in the trap instead of the scattered breeding places. This could save time, manpower and money of the responsible authorities as they don’t need to operate chemical fogging frequently. In 2015, the DMSc researchers had invented and developed the mosquito trap. It was tested both in laboratory and field to get the most effective prototype. The attractant extracted from carpet shell were also formulated by new technology as microcapsules and coated it in the trap. This is the unique trap of the world and the DMSc had patented in Thailand as LeO-Trap. During 2015-2016, the field results of LeO-Trap showed that the attractant lasted 3 months with high efficacy of luring mosquitoes. Also, LeO-Trap reduced 92.9% Aedes mosquito populations in rubber plantation within 3 months. In 2019, DMSc launched a project in Chanthaburi in order to reduce vector mosquitoes and the diseases as they are high risk areas. The project has received good collaboration among government agencies and people in the communities. People are satisfied with the reduction of mosquito populations and the diseases and willing to participate in the project continuously. They said it effectively lured mosquitoes to lay eggs and reduced mosquito populations in their houses significantly.

The obstacles found in this project were lack of disease awareness of people and community participation. We then launched the project by providing training courses about the diseases and their vectors to network, including local authorities and health volunteers. These people would be the trainers to transfer the knowledge and mission to villagers. The knowledge would be transferred to the target groups by various kind of media, such as meeting, teleconference, short movie clips, practice and appropriate documents. Also, there are continuous communication among network using social media, such as Line Group and Aor Sor Mor Online.

LeO-Trap was originally innovated for the integrated control against Aedes mosquito vectors in Thailand since 2015. It was created from combination of a physically-attractive design of the ovitrap, with the attractant derived from carpet shell extract and the larvicide formulated from zeolite granules containing 1% temephos. The project was created from the responsibility to solve the health problems effectively by using an innovative device, collaborating among central and local government agencies, private sector and people in communities. It is the best way to encourage people to mobilize the operation by themselves to achieve sustainability.

The project has inspiration from the researchers of the Department of Medical Sciences (DMSc) in order to minimize the incidence and deaths caused by Dengue fever, Chikungunya and Zika fever in Thailand. Dengue fever has been in Thailand for over 60 years and the previous control strategies are ineffective. Therefore, it needs to explore the innovations to overcome these diseases by effective control strategies. Although there are many lethal ovitraps sold in the market, but they are not so effective to control Aedes mosquitoes. LeO-Trap was then invented to control Aedes mosquitoes and applied through collaboration and community participation.

This project employed LeO-Trap, an innovation to reduce Aedes mosquito populations. The trap is coated inside with the attractant derived from carpet shell extract that was formulated as microencapsulated form. The temephos zeolite granules is also an innovation of new larvicide to be used in LeO-Trap to kill Aedes larvae. The numbers of positive trap and mosquito eggs have been used for further analysis, using the geographic information system and spatial analysis in order to analyze and point out the high risk areas for the diseases. The information would be communicated among the collaborating network through mobile applications.

According to the report of the Department of Disease Control, Songkla, one of southern provinces of Thailand, was once the most epidemic area of dengue fever. No matter how often the government officers killed the mosquitoes by fogging, the cases still rose almost every year. So, we selected this province for field testing of the Leo-Trap by placing them in 108 houses. Within 4 days, we could eliminate 16,765 mosquito eggs. It means we reduced the Aedes populations of the next generation of about 4.2 million mosquitoes. In 2019- 2020, the local authorities and health volunteers had setup Leo-Trap in more than 5,600 houses across the country. Among 14,000 health volunteers, 84% are elderlies and 86% are women. This project builds the life appreciation society through the help for others. Now, in 2020, the government together with the health volunteers pioneer setting up the Leo-Trap in risky areas of 56 villages in 14 provinces. The number of dengue fever from all over the country was decreased from 146,082 cases in 2015 to 66,369 cases in 2020.

The project has been already transferred and established in many provinces of Thailand. However, it will be expanded to more provinces with as high as coverage areas. The expanded provinces could use their government budget received annually to set up the project in their high risk areas for the diseases with collaboration with the Department of Medical Sciences (DMSc), other government agencies and people in the communities. However, the new digital technology would also be used to facilitate the project to achieve the final goal of better health and well-being.

Researchers of the Department of Medical Sciences (DMSc) were principal investigators who invented LeO-Trap, attractant and zeolite larvicide with additional help from staff of Ikari Trading (Thailand) Co., Ltd. Researchers of Mahidol University provided chemical analysis of the attractant. DMSc spent fund about $50,000 to launch the pilot project in 14 provinces with collaboration among various sectors. DMSc provided LeO-Trap, zeolite larvicide and training course to local authorities to implement project in the district. Local authorities and health volunteers were assigned to contact villagers for community participation. Mobile applications were used for communication among network group without cost.

The results obtained from the pilot villages demonstrated excellent output in terms of substantial reduction of Aedes mosquito populations and dengue incidence. This makes confidence in disease control for local authorities, village leaders, health volunteers and villagers. People participating in this pilot project insisted to continue their roles continuously. Moreover, other local authorities have been interested to launch this project in their areas by using their own budget received from government annually. Each local authority can purchase LeO-Trap using government budget up to 30% of the total amount received as it is in the Thai Innovation Government List.

Yes

The project was externally evaluated by two government agencies, the Wang Saem Health Promoting Hospital (WSHPH) and the National Research Council of Thailand (NRCT). The WSHPH evaluated the concept of innovation for implementation, methodology use, collaborative network, creative for better society and the output, outcome, and impact of the project for public. The NRCT assessed the overall concept and creativity of the content, academic validity, knowledge management of research for utilization in various aspects, further development, presentation, art and design.

The indicators of WSHPH included the new concept and innovation to solve problems of the areas, the methodology with academic validity and the right concept for applying the knowledge, the collaboration among various government agencies and communities, development and extension to create better societies and clear demonstration of the output, outcome and impact of performance. The indicators of NRCT were readily available, functional and sustainable content, clear educational issues, appropriate research methodology and correct technical standards, technological transfer to private sector and community, development and expanding the result for public benefit, clear presentation with interesting and attractive attention.

The main findings of evaluations were the effective innovation (LeO-Trap) that could reduce Aedes mosquito populations and disease incidence significantly in the implemented areas, the collaborations among government agencies, private sector, and good community participations. LeO-Trap was registered for Patent with proprietary right between the Department of Medical Sciences (DMSc) and Ikari Trading (Thailand) Co., Ltd. This was the outcome of cooperative research between government agency and private sector in order to create an innovative product that could benefit public health and the Thai economy. LeO-Trap can be used easily in natural conditions with compact size, no electricity required, and safe for human use. However, some villagers suggested DMSc staff to create a bigger size of LeO-Trap that can collect more mosquito eggs and they can refill water once a month. People in the areas are satisfied with the reduction of Aedes mosquito populations and the diseases and willing to participate in the project continuously. The project has received good collaboration among government agencies and people in the communities. The local authorities also plan to extend this project to cover the responsible areas as more as possible by the budget of each one received annually.

There were collaborations among central and regional government agencies, local authorities, health volunteers and villagers. The Department of Medical Sciences (DMSc) entrusts the Regional Medical Sciences Center (15 units across the country, each unit takes care 5-6 surrounding provinces) to coordinate with local authorities to facilitate the project in their areas and assess the number of mosquito eggs. The Department of Disease Control (DDC) entrusts the Vector Born Diseases Control Center (13 units across the country, each unit takes care 5-6 surrounding provinces) to assess mosquito eggs and larval indices. The Provincial Public Health Office (PPHO) plans for the disease control at provincial level and The District Public Health Office (DPHO) plans for the disease control at district level. The Sub-district Health Promoting Hospital (SHPH) works as the primary unit for disease prevention and treatment for people in the sub-district. It also cooperates with the health volunteers for disease control in the villages. The health volunteer provides health education and introduces the Leo-Trap to the villagers for their own use. Actually, there are closely collaborative working among DMSc, DDC, PPHO, DPHO and SHPH to prevent and control all of the diseases in their responsible areas.

There was cooperation among various sectors in this project. Researchers of the Department of Medical Sciences (DMSc) invented and developed LeO-Trap which was coated with attractant extracted from carpet shell to attract mosquitoes to lay their eggs and included larvicide (temephos zeolite granules) to eliminate mosquito larvae. Ikari Thailand gave additional ideas and supported to create the prototypes of LeO-Trap and larvicide for testing in laboratory and filed. DMSc transferred the approved technology of both products to Ikari company to produce the products at industrial scale for public use. DMSc launched pilot projects in some provinces by supporting fund, materials and knowledge training for local authorities. The local authorities trained the health volunteers in their district for implementation of LeO-Trap and larvicide in each village. People in villages participated in the project by administrating themselves regularly under close supervision of health volunteers and DMSc researchers through social media and mobile application. The data of mosquito eggs collected from LeO-Trap and Aedes larval indicies were collected by health volunteers and sent to local authorities for further analysis of the risk of dengue epidemic. Now, the project has been established in various provinces and supported by government budget of local authorities.

LeO-Trap showed excellent efficacy in luring gravid female Ae. aegypti and Ae. albopictus into laying their eggs in the trap, and all of the larvae that hatched from the eggs were killed eventually by zeolite granules containing 1% temephos. It is an innovative device that is economically and environmentally friendly for controlling Aedes populations with acceptance of people in the communities. It can be used as an additionally effective tool in the integrated control programs for controlling Aedes-borne diseases in Thailand and elsewhere. The lessons learned are the collaboration among central and local government agencies, private sector, health volunteers and community participations, communications among network using mobile applications, and the high coverage of implementation in the villages. The Department of Medical Sciences (DMSc) plans to continue and expand the project to provinces that have high risk areas in Thailand through the collaboration as described previously. Also, an important thing is the continuous and strong support from the head of each government agency to facilitate the project sustainably.