Sunday, June 20

Neighborhood networks, the best tool against dengue | Future Planet


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In 2020, Argentina not only faced the first wave of coronavirus. In parallel, it went through the dengue epidemic with the highest number of cases recorded in the country’s history: 58,000 infected people. This year, the circulation of the virus is lower compared to the previous season. However, recent weeks have seen an increase in some of the northern provinces. According to him Integrated Surveillance Bulletin, from the Ministry of Health, 10,849 suspected cases have been reported, but so far 1,514 confirmed cases have been registered, predominantly in the north. Today the country’s concern is focused on the arrival of the second wave of covid-19.

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Of the diseases transmitted by mosquitoes, dengue is the most significant in Argentina, which has suffered three outbreaks: in 2009, 2016 and 2019-2020. “After the big epidemics, come a couple of years of low incidence,” explains Manuel Espinosa, head of the Department of Mosquito-borne Diseases of the Mundo Sano Foundation. Another reason why in 2021 the figures are lower is the lower transit of people to other countries due to covid-19.

Since there are no vaccines or specific treatments for these diseases, prevention and control efforts must focus on the control of the transmitting mosquito. Specialists point out that even though the cases are not growing rapidly, it is important to redouble prevention efforts, especially in popular neighborhoods. For the general director for Latin America and the Caribbean of Doctors of the World Gonzalo Basile, the unequal, inequitable and unhealthy urbanism is a determinant for the development of diseases transmitted by mosquitoes.

In the first quarter of 2020, before the covid-19 paralyzed the territorial programs, the organization Doctors of the World worked with referents of popular neighborhoods in the province of Buenos Aires to prevent dengue. The strategy focused on setting up community networks to, in the first place, give early warning of febriles. Another function of the team was to record socio-environmental risks to prevent mosquito breeding. The referents visit house to house, connect with families and deliver dissemination material. They also distribute repellants to those families that do not have the economic resources to buy them. Finally, they are liaison with nearby health centers if there is a fever or warning signs. That is, a referral route for rapid care is developed.

Uneven, inequitable and unhealthy urbanism is a determinant for the development of mosquito-borne diseases

“For the neighborhood community network, it is more important to identify the socio-environmental determinants of the disease than to focus on the responsibility of individuals and families. In general, neighbors are asked to discard (remove pots or water tanks from houses), but in poor neighborhoods every time families open the door of their house they have an open dump or streams that accumulate plastic and waste. These spaces become risk zones for the proliferation of diseases ”, reflects Gonzalo Basile, from Doctors of the World.

Health promoters to raise awareness and detect cases

Marcos Chinchilla is 45 years old, lives in Villa 20, a settlement in Lugano, City of Buenos Aires, and is a health promoter. During 2020, he was involved in operations to detect covid-19 and dengue cases in the neighborhood. “The promoters do campaigns to raise awareness, neighborhood tours and we look for positive cases. We go through the most critical blocks. Those where we know that more ailments tend to manifest themselves, ”he says. On each tour, Marcos comes out with a mask, gloves and glasses.

Chinchilla knows the symptoms of both viruses. In the 2016 outbreak, he and his mother had dengue. Remember that he was lying on the bed for 10 days, without strength. He had a fever, headache, and poor appetite. In September 2020, he had covid-19 and finally this March he received the two doses of the vaccine.

Unlike the coronavirus, which is transmitted from person to person, dengue requires an intermediary. The Aedes aegypti It is the urban and domestic mosquito that transmits dengue, Zika and Chikungunya, viral diseases that can present symptoms common to those of the coronavirus. The mosquito contracts dengue when it bites an infected person and then passes it when it bites a healthy person.

A volunteer from the Mundo Sano Foundation explains the symptoms of dengue from house to house and what formulas are available to prevent it.
A volunteer from the Mundo Sano Foundation explains the symptoms of dengue from house to house and what formulas are available to prevent it.Provided by Mundo Sano

In Argentina it occurs in the form of an epidemic outbreak developing in the period from December to May, because in these months the climatic conditions that favor the proliferation of the mosquito that transmits it occur. Regarding the alarm signs or patterns that may appear in the evolution of dengue, the following can be highlighted: severe abdominal pain, irritability or drowsiness, repeated vomiting, a tendency to lipotension or lipothymia, and nose, gum and intestinal bleeding .

According to a survey by the SC Johnson company, 10% of Argentines are being less careful with mosquito-borne diseases during the pandemic. Repellants for individual use, insecticides and the use of mosquito nets on doors and windows are the most common ways to avoid the mosquito. It is necessary to get used to keeping homes free of elements that have the capacity to store rainwater, since it is there where the Aedes aegyptilays its eggs generating hatcheries.

Fumigation and better urbanization, keys to prevent

The member of the Communal Board 7, made up of the neighborhoods of Flores and Parque Chacabuco of the City of Buenos Aires, Julián Cappa, presented the bill to the Buenos Aires legislatureProgram for the comprehensive approach to mosquito-borne diseases. This norm contemplates the allocation of a fixed budget for the approach of dengue and other diseases transmitted by the mosquito Aedes Aegypti , as well as the creation of Surveillance and Guidance Offices in each of the 15 municipalities of the city. “In addition to the budget to prevent dengue and all viral diseases in popular neighborhoods, it is important to move forward with urbanization,” says Cappa.

The Ministry of Human Development and Habitat of the City of Buenos Aires has a team dedicated to spraying in public spaces and also inside homes. “Through joint work with the Ministry of Health, the objective of the plan is to minimize the presence of the mosquito and eliminate possible sites where it can nest and become a breeding ground. The weekly fumigation route is defined based on the information recorded in the Health portfolio. They put together a list with the places where confirmed cases of dengue are detected and there it is reinforced. The operations, in turn, are accompanied by hydro-washing cleaning tasks, both inside the buildings and in the neighborhoods. We brought together three neighborhood cooperatives that clean the streets, sidewalks and facades of houses with water and chlorine, and disinfect common spaces, ”says the General Manager of the City’s Housing Institute (IVC) Gabriel Mraida.

A Mundo Sano volunteer checks elements that can store rainwater, where the 'Aedes aegypti' mosquito lays its eggs.
A Mundo Sano volunteer checks elements that can store rainwater, where the ‘Aedes aegypti’ mosquito lays its eggs.Provided by Mundo Sano

The official tells that all the actions of the IVC go through neighborhood participatory tables. “There they agree from the most macro issues such as the allocation of a home to awareness campaigns about the discard. All this is put in common at the tables, where neighbors and referents of the neighborhood participate ”, says Mraida.

Every August, the Ministry of Human Development and Habitat and the IVC make a team available to work on disinfection,discardand concrete awareness-raising actions in poor neighborhoods to anticipate spring. “Prevention is very important so that mosquito larvae are not cultured. Broadcasts were made via WhatsApp, brochures were distributed and posters were put together to put the issue on the agenda, ”says Mraida. And Agega: “Although the covid-19 monopolized health policy care, dengue is also a sensitive issue that has to be on the political and neighborhood agenda.”

Another organization that works all year round to prevent mosquito-borne diseases is the Mundo Sano Foundation, which put at the service of the municipalities tools to monitor the activity of this mosquito through the installation of ovitrap networks, to determine their spatial distribution. measure the seasonal fluctuation of its proliferation and effectively manage resources for its control. Already 12 municipalities are part of the Ovitramp Network and carry out weekly monitoring of oviposition activity ofAedes aegypti .

On the other hand, every year, Mundo Sano implements the program Prevention in Action: Pedagogical Resources for a Healthy World, a project through which the Foundation visits primary, public and private schools and —through recreational activities— teaches children the characteristics and stages of development of the dengue-transmitting mosquito, the larval habitat (natural and artificial hatcheries ), the mode of transmission, symptoms, and prevention methods. In 2020, the program was not suspended and was developed under the virtual modality. Although so far the circulation of the virus is low, it is important to know that the mosquitoAedes aegyptiIt is present in more than 60% of the Argentine territory. That is why you always have to be vigilant and insist on preventive measures to avoid breeding sites.

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