The effectiveness of community health programmes can be evaluated within the “REAIM” framework (the reach, efficacy, adoption, impact, and maintenance of the programme).1 Programmes for the control of Aedes aegypti mosquitoes and prevention of dengue fever are deemed successful if they reach a large proportion of an extensive audience, are effective under ideal conditions, are adopted by most of the community, have a confirmed effect on human behaviour related to control of the vector, and can be maintained over a sufficiently long time.2

In the linked cluster randomised trial (doi:10.1136/bmj.b1959), Vanlerberghe and colleagues assess the effectiveness of community involvement in the control of the dengue vector in Guantánomo, Cuba.3 The trial randomised 32 districts (“circumscriptions”) of about 2000 inhabitants each to control and intervention clusters. The routine Aedes control programme (entomological surveillance, breeding site reduction, selective killing of adult mosquitoes, …