Simposio: Perspectivas integrales para la acción: lecciones aprendidas en los territorios
SIMPOSIO
Perspectivas integrales para la acción: lecciones aprendidas en los territorios
COORDINA: Ana Laura Carbajal de la Fuente & Mariana Sanmartino
Integrative perspectives for action: lessons learned in the territories
Este simposio explora lecciones clave aprendidas en el terreno, asociadas a problemas de salud vinculados a vectores, desde una perspectiva multidimensional. Enfocado en la enfermedad de Chagas, el dengue y la malaria, la sesión destaca estrategias interdisciplinarias que abordan cuestiones socioambientales relacionadas con la salud, la participación comunitaria y las intervenciones innovadoras. Especialistas de América Latina compartirán experiencias de campo, enfatizando la integración de perspectivas ecológicas, sociales e institucionales para el manejo de vectores. El simposio busca fomentar diálogos sobre la traducción de la evidencia científica en políticas accionables, priorizando una perspectiva integral y la sostenibilidad. A través del análisis de experiencias territoriales, la propuesta busca fortalecer las capacidades regionales para enfrentar enfermedades transmitidas por vectores mediante enfoques integradores y sensibles al contexto.
Palabras clave: Trabajo de campo, Perspectiva multidimensional, Intervenciones innovadoras.
Aedes aegypti and humans – defining the relationship
VALLE, Denise
Laboratório de Medicina Experimental e Saúde, IOC, Fiocruz
dvalle@ioc.fiocruz.br
In Brazil, coexistence with Aedes aegypti and the arboviruses it transmits is historical. It was introduced in the 16th century, with the trade of slaves from Africa. In early 20th century, the transmission of urban yellow fever mobilized the country. Brazil ‘erradicated’ Aedes aegypti twice (1958, 1973). Currently, the circulation of four dengue serotypes since 2010 and the entry of chikungunya and Zika in 2014/2015 stand out. ‘A good mosquito is a dead mosquito’ – metaphors of war, of combat, are a standard system of diseases in the West: war on drugs, cancer, AIDS, and also on mosquitoes. This conception is the basis for the development of solutions to reduce, or eliminate, mosquito populations. New insecticides, transgenic mosquitoes, Wolbachia, sterile male mosquitoes, are just a few examples. However, these are all technical solutions, focused on the mosquito. Technical solutions do not solve structural issues – social, economic, political determinants. Inequalities; in access to water supply, garbage collection, sanitation, just to name a few. Technical solutions that, additionally, can generate a false sense of security. ‘An adequate treatment depends on a correct diagnosis’, and therefore it is necessary to ask: is the mosquito the problem? Aedes aegypti is an urban, ‘domestic’ mosquito, extremely adapted to human habits. Eight out of ten breeding sites, in general, are intradomestic, which challenges many concepts, including meaning and limits of ‘public’ and ‘private’. In Brazil, there are thousands of health agents responsible for home visits: they are public agents inspecting private environments. This means potential for conflicts and mistaken assignments of responsibilities. Complex issues are not solved by single actions. In particular, we investigate solutions that prioritize citizenship and social participation, rather than ‘magic bullets’ or welfare-based options. In this context, communication, in its original sense, ‘putting things in common’, has the potential to make a difference. This was the case with the launch of the “10 minutes against dengue” concept (now “10 minutes against Aedes”), which shared with society a feasible action proposal based on an easily assimilated knowledge. The action: to invest 10 minutes per week in identifying and eliminating domestic breeding sites. The knowledge: Aedes aegypti life cycle, from egg to adult, is 7 to 10 days; only the adult vector transmits the virus. Dissemination of this concept In Rio de Janeiro State resulted in reduction to one third of infested municipalities. Today, the ‘interface with society’ has more robust and consistent contours. This term was even included as a specific chapter in the new National Guidelines for the Prevention and Control of Urban Arboviruses. Another important point is the deepening and sharing of the replacement of the ‘eradication’ logic by that of ‘control’ in the routine, both in the work of public health agents and in communication with society.
Keywords: Aedes aegypti, Interface with society, 10’ X Aedes
Lessons from the eco-bio-social approach in Fortaleza
CAPRARA,_Andrea1, PITOMBEIRA, Mardênia V2, DANTAS, Maria do S3, LIMA, José 1, BARAKAT, Roberta D, MACÊDO, Suyanne ,; MOURA, Francisca J4, SOARES, Fernanda V.1
1. Universidade Estadual do Ceará,Ceará, Brasil.
2. Universidade Estadual do Ceará,Ceará, Brasil.
3. Ministério da Saúde, Brasil.
4. Secretaria de Saúde do Estado do Ceará, Ceará, Brasil.
5. Universidade Federal do Piauí,Piauí, Brasil.
E-mail address: andrea.caprara@uece.br
Several key lessons were learned with the eco-bio-social approach in Fortaleza, Brazil, particularly in the context of dengue prevention. The research is part of a broader initiative supported by the TDR/WHO to integrate the Aedes aegypti control ecological, biological, and social dimensions. The main lesson learned was that active community involvement with the support of endemic workers leads to greater sustainability and acceptance of vector control strategies. A key breeding site for mosquitoes is water containers, and better management implies covering them with nets. Success requires coordination among health, sanitation, education, and urban planning sectors. This integrated approach ensures that vector control is part of broader urban governance. Solutions have to be context-specific, considering local housing conditions, water storage practices, and cultural perceptions of disease and risk. Some strategies were more effective in specific blocks due to social cohesion or existing neighborhood associations. The research using Photovoice in schools is another example of participatory research in health promotion and education, particularly in urban and underserved communities. It empowered young people to understand and coordinate the link between the environment and health and identify potential dengue breeding sites. Another crucial lesson in Fortaleza is ovitraps, which help monitor the mosquito population and guide interventions. Concerning research methods, georeferencing houses for dengue control was vital to risk assessment. As for qualitative research methods, focus groups and in-depth interviews helped to understand how residents perceive dengue and mosquito control. These methods revealed barriers to behavioral change that might not emerge through surveys. The approach uncovered that poor waste management, irregular water supply, and urban infrastructure deficits favored mosquito proliferation.
Keywords: Eco-biosocial approach, Community participation, Integrated vector management.
A kaleidoscope to multiply and enrich the perspectives (and actions) on the Chagas problem
BARZOLA, Luciana1, CARBAJAL DE LA FUENTE1, Ana L., SANMARTINO Mariana1
1 Grupo ¿De qué hablamos cuando hablamos de Chagas?, La Plata, Argentina
E-mail address: lubarzola@gmail.com
Integrating arts, sciences, and diverse forms of knowledge to understand the Chagas problem has been one of the core principles guiding the work of the Grupo ¿De qué hablamos cuando hablamos de Chagas? for over 14 years. We do this because we are dealing with a complex socio-environmental health issue, where components of different nature converge and interact. For this reason, we believe that Chagas must be addressed from multiple dimensions, encompassing not only biomedical and epidemiological aspects, but also cultural, educational, political, economic, environmental, and social ones. Taking on this type of approach —challenging the view of populations as passive recipients of educational programs developed by “experts”— is key when working with complex issues such as Chagas. It allows for the recognition and dialogue of multiple ways of knowledges, aiming both to highlight the social impact and complexity of the issue, and to question the hegemonic narratives surrounding it. We adopt a critical perspective on scientific practice and aim to approach, understand, and communicate the Chagas problem through a kaleidoscopic lens. In this way, we are committed to building and promoting multiple ways of seeing, understanding, and addressing Chagas through collective work with a wide range of social actors, across various action areas: research, training proposals, communication activities, development of strategies and educational resources, joint work with schools and health centers, collaboration with social organizations, activism, and technical support to national and international institutions. Education and communication, in a broad and inclusive sense, are key fields for bridging gaps between different types of knowledge and for co-constructing alternatives that can generate meaningful and transformative impact. With this in mind, we promote joint efforts among researchers, teachers, students, and communities across all educational levels (school, technical, and professional training) and in all possible contexts (rural/urban, formal/informal, where vector insects are present or not), seeking to increase the number and diversity of voices speaking about Chagas.
Keywords: Territory-based strategies; Community engagement; Inclusive health communication.
An immune system for the city: integrating adaptive, community-based strategies for Chagas vector surveillance in urban Peru
LEVY, Michael Z.1, TAMAYO, Laura D.2, CONDORI-PINO, Carlos E.2, AREVALO-NIETO, Claudia R2, CASTILLO-NEYRA, Ricardo1, PAZ-SOLDAN, Valerie A3.
1 Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, USA
2 Zoonotic Disease Research Laboratory, One Health Unit, School of Public Health, Universidad Peruana Cayetano Heredia, Peru
3 Department of Tropical Medicine, Tulane University, USA
Email: arenica2@gmail.com
Urban vector control often relies on rigid, top-down strategies, rooted in military traditions of hierarchy and command. These approaches, although historically effective, frequently fail to address the dynamic realities of urban ecosystems and community complexities. In response, we implemented and evaluated an innovative, community-based surveillance model inspired by the mammalian immune system. This adaptive model promotes local decision-making, integrates digital tools (such as VectorPoint and AlertaChirimacha), and leverages social media to enable rapid detection and containment of vector infestations. A cluster-randomized trial conducted in Arequipa, Peru, revealed that this ‘immune system’ model was significantly more effective than conventional approaches: 23 infested households were detected across multiple foci versus 5 in a single cluster in the control arm. The strategy proved not only more sensitive but also aligned with decentralized, community-driven principles that mirror the functionality of adaptive immunity. This approach show us an ‘integrated perspective for action’ by offering concrete lessons learned from the field and a framework for scalable, participatory disease vector control. As urbanization and vector-borne threats escalate, adaptive surveillance may represent a paradigm shift toward sustainable and inclusive public health systems.
Keywords: Vector Surveillance, Urban Health, Adaptive Systems
Malaria vector control in the Colombian Pacific: coordination between science, institutions, and the community
HERRERA-VARELA, Manuela1,2, PARDO, Raúl 1, MORALES, Carlos3, VARGAS-GARCÍA, Nicole1, DÍAZ-HERRERA, Taylor1, VARGAS, Edward1, LUCUMI-ARAGÓN, Diana1, LENHART, Audrey4, AHUMADA, Martha1, LEVINE, Rebecca4
1 Grupo de Entomología, Dirección de Investigación en Salud Pública, Instituto Nacional de Salud, Bogotá, Colombia
2 Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala
3 Secretaría de Salud Departamental del Cauca, Popayán, Colombia
4 Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, USA
E-mail address: m.herrera.varela@gmail.com
The Colombian Pacific, a region of incredible biological and cultural diversity, has the highest malaria morbidity rate in the country, with a predominance of Plasmodium falciparum infections. Between 2021 and 2023, a study was conducted in the southern part of this region, in the department of Cauca, to evaluate the vector control strategies recommended by the Ministry of Health and Social Protection: indoor residual spraying (IRS) with deltamethrin and long-lasting insecticidal nets (LLINs) with alfa-cypermethrin as active ingredient. The study was a two-arm, randomized cluster trial (n = 20 clusters per arm) and included three components: entomological monitoring, quality control of interventions, and socio-community analysis. A total of 229,619 Anopheles mosquitoes were captured by human landing catches, with An. neivai (85%) being the predominant species, followed by An. albimanus (14.8%) and An. apicimacula (0.2%). An. neivai was most active between 6:00 p.m. and 7:00 p.m., while An. albimanus showed continuous nocturnal activity; both species were most frequently observed outdoors. Twenty An. albimanus and one An. neivai infected with P. falciparum were detected, confirming their role as regional and local vectors, respectively. After six months of use, the insecticidal activity of the LLINs was only 5%. During the same period, 80% of the LLINs retained good physical integrity, decreasing to 60% after one year of use. Analysis of new LLINs showed insecticide concentrations below the 200 mg/m², which is the concentration specified by the manufacturer. Regarding the IRS, coverage decreased from 85% to 64% between the first and fourth rounds of spraying. WHO cone bioassays indicated that ≥80% mortality in susceptible An. albimanus was achieved in only 46–76% of sprayed dwellings, falling short of WHO efficacy thresholds. Residual efficacy was less than three months. Focus groups and surveys on knowledge, attitudes, and practices revealed that the community is aware of malaria and favors the use of long-lasting insecticidal nets (LLINs). However, cultural factors, including frequent washing, the occurrence of allergies, and a preference for traditional small-mesh mosquito nets, limit its use and effectiveness. Although less accepted, the IRS was perceived as effective, with fewer reports of adverse reactions, but doubts persisted about its duration. Collaboration between the community and institutions was essential to identify and implement factors that determine the acceptance and proper use of measures. The success of vector control strategies depends on their adaptation to the social, ecological, and operational dynamics of the territory.
Keywords: Operational research, monitoring, and evaluation, Colombia
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