Dengue fever, a mosquito-borne viral infection, poses a significant public health challenge, especially in impoverished urban areas. The rapid spread of dengue is often exacerbated by inadequate sanitation, limited access to healthcare, and dense living conditions. Addressing this issue requires a comprehensive, multisectoral approach that goes beyond traditional health interventions.
A prime example of such an approach is the initiative undertaken in one of the most underserved regions in a major South American city. This community, originally established by waste pickers six decades ago and now home to approximately 35,000 residents, has long struggled with extreme poverty and substandard living conditions. These factors have contributed to the proliferation of dengue, with over 70% of inhabitants reporting at least one episode of the disease in their lifetime.
In response to this crisis, a collaborative research team implemented a strategy involving the sanitation, urban services, and education sectors. Their goal was to develop sustainable public health solutions to reduce dengue incidence. Key actions included:
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Improving Waste Management: The community’s narrow streets hindered access for waste collection vehicles, leading to garbage accumulation in open areas. To combat this, the Urban Cleaning Service initiated educational campaigns on proper waste disposal. Additionally, the research team provided households with trash bins and supplied schools with water storage tanks to prevent mosquito breeding.
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Enhancing Sanitation Facilities: Recognizing that open waste sorting contributed to mosquito proliferation, an indoor waste sorting facility was established. This move aimed to reduce the amount of exposed waste and, consequently, the mosquito population.
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Deploying Larvicide Stations: To directly target mosquito larvae, 150 stations dispensing the larvicide pyriproxyfen were installed in areas with high dengue transmission rates. This intervention led to a notable 64% reduction in dengue cases between 2022 and 2023.
A cornerstone of this initiative was active community engagement. Researchers held discussions with local leaders, waste pickers, educators, parents, and even children to understand their challenges and perspectives. This inclusive approach ensured that the interventions were culturally appropriate and had community buy-in, which is crucial for the sustainability of public health measures.
This case underscores the importance of multisectoral collaboration in addressing complex health issues like dengue. By integrating efforts across various sectors and involving the community at every step, it is possible to create effective and lasting solutions to combat vector-borne diseases in vulnerable populations.
For more detailed information on this initiative, please refer to the original report: Controlling dengue among vulnerable populations in Brazil.