Beyond the vector - trailer

International Development Research Centre (IDRC)
and LUDO Contenidos
Presents
Because of periodic dengue outbreaks in Cali,
dengue is on the City’s public and research agenda, and the public is also aware of the disease.
The Chaco region as a whole, not just the Bolivian part,
is considered one of the most endemic regions for Chagas disease.
One of the main problems in Peru is malaria.
Rice cultivation occupies an average of around 350,000 hectares
and the type of rice cultivation that uses flooding techniques encourages the breeding of the Anopheles albimanus mosquito.
Chagas disease in the Amazon behaves differently from the disease as it is classically known in the rest of Latin America.
Originally Chagas disease was a zoonosis, a disease from the forest,
but when the forest was destroyed the bug looked for another place to live.
The highest number of malaria cases
occurred in communities that had high rates of deforestation within a radius of 5 kilometres.
There are mega development projects in the area
that will greatly influence what will happen in the rest of the Amazon in the next 10 or 15 years.
BEYOND THE VECTOR Ecosystem approaches and vector borne diseases in Latin America and the Caribbean
Vectorial Reinfestation and Chagas Transmission in Rural Communities
We studied the entire community, not only each person but also the community’s customs and socio-economic factors
Our work was not to fight against the bugs, but rather to work with the local population to understand and resolve a problem.
The bugs are in the wrong place, they are inside the homes,
It is always important to ask, house by house, if there are any more bugs or if they are gone.
The main objective of the project was to find out if this reinfestation process
was due to problems in the application of pesticides and a repopulation of the Triatoma vector in the home
or if the reinfestation was caused by bug populations coming from outside the home and occupying these cracks.
And we have been able to show that reinfestation is more likely in old homes than in new ones.
There are also more bugs in homes that are not plastered.
There is less reinfestation in homes where clothes are kept together in a designated space
compared with homes where people hang their clothes anywhere.
But what surprised us most was how few factors could be associated with the number of bugs
and this has to do with their adaptability.
Since the vector is pesticide resistant it can invade any house
without worrying for example about the type of wall, or the presence of clothing.
An Ecohealth Strategy for the Prevention and Control of Dengue in Cali
Cali is the third largest city in Colombia, and the largest city with a population at risk of contracting dengue.
There are currently 4 serotypes of the virus circulating, and 2 mosquito vectors at work.
The Aedes aegypti is the traditional vector and breeds mainly inside homes
but it has adapted well to breeding grounds in public spaces and non-optimal conditions, such as drains.
The city has 50,000 drains and the Secretary of Health applies larvicides throughout the city every 15 days
in order to prevent and control dengue.
The risk of dengue, therefore, is understood as a complex systematic risk depending on many factors.
It needs to be approached in a transdisciplinary way
The role of the social workers who worked on our project was to clarify what social conditions affect the prevention of dengue
and where it was important to intervene to control it.
After a year of research and uncovering information that provides us with an understanding of dengue transmission in Cali,
we created an intervention strategy.
And this is the site which was a dumping ground for debris and garbage only a few days ago.
This does not end here because I want to keep going and see what other spaces can be recovered, not only those in my area.
There are a lot of degraded spaces and we can advise and help mobilize the community.
In the coming years we have to identify what monitoring strategies can be used during the inter-epidemic periods
in order to be able to anticipate these outbreaks.
We need to identify some factors that provide an early warning in order to prepare the services,
to intensify work with the community and, obviously, to be ready with a quick response when the outbreak begins,
rather than always “putting out fires”.
Rice Irrigation Technique with Intermittent Dry Periods for Malaria Control
Intermittent irrigation, in Peru in particular, is very common in the entire coastal region.
What we have done is add obligatory dry periods into the process
in order to inhibit the development of the mosquito that transmits malaria.
These dry periods also reduce the number of diseases attacking the rice,
especially some specific plagues that strike during the first phase of crop development.
And at the same time, the use of smaller layers of water promotes greater clustering from the rice crop
which translates into increased yield.
I operate 24 hectares
we saved in terms of water, fumigations and fertilizers, and production improved by 15%,
while 70% of the mosquito plague was eliminated.
We have seen farmers who are not involved in the project
applying the technique after seeing the success of their neighbours.
We would like this technique to be promoted in other rice regions in our country, and not only in our country
but also in other rice producing countries so they can learn about the results we have achieved.
The Ecosystem Approach and Chagas Disease Transmission in Ecuador's Amazon Region
In historically endemic regions, Chagas disease is related to the domestication of a vector
which systematically transmits the parasite within the home.
In the Amazon, we do not have vectors in the home,
but rather wild vectors which invade the home without colonizing it, but which produce continual transmission.
The most deforested areas are also the hottest and driest,
and these are the areas which have much more frequent transmission.
Transmission rate is higher and there is a greater number of cases in the areas with greater landscape degradation.
The community is gathered together to learn first what it is that the project will do and the expected results.
We are here to inform you a little about Chagas disease.
We have been able to show that the transmission of Trypanosoma Cruzi intensified
after petroleum industry activities started in the region.
This shows that the emergence of the disease is linked to the spatial occupation of the Amazon.
Malaria and Natural Resource Management in Ecuador's Amazon Region
Health policy in the region was defined at desks,
in the Ministry of Health in Quito, with models that are applied in all parts of the country.
Therefore, we monitored 3 communities for a year.
We found that the 3 communities have different transmission models, with different species and different circumstances.
This reinforces the idea that we need to know about these realities
in order to build different control models for the different communities and realities.
Malaria, Deforestation and Land Use Changes in the Guayana
In April, in one week there were more than 1000 cases of malaria compared to an annual average of 250 cases.
This was because a new mining operation started in the area,
one of the last and most pristine corners of Venezuela, a practically untouched ecosystem.
People come from other malaria infected areas, such as Brazil and other mining areas in Venezuela.
They brought along the seeds for malaria to a place that had little or no malaria.
Malaria is a perfectly preventable and controllable disease,
but achieving its elimination, will be very difficult in these remote areas.
We have the tools but we lack knowledge transfer and sufficient resources
to reach these poor, isolated and forgotten communities in very remote areas.
Vector Reinfestation Risk Management and Prevention of Chagas Disease
Guatemala was the first country to be declared free from Chagas transmitted by one of the vectors, Rodnius prolixus.
It has been very difficult for countries to eliminate this species.
Still, it can be eliminated with insecticides because it doesn’t live in the forest.
But our bug (Triatoma dimidiata) lives in the forest, it lives in caves and under rocks,
and every year it migrates to houses, attracted by the lights, and if conditions are adequate it reproduces there.
This means that if we continue spraying, we need to spray every year, and this is not what we want.
We want to prevent the bug from reproducing in the houses, even if it gets in.
The engineers, who formed part of our multi-disciplinary group,
found that by mixing soil with sand in a certain proportion for plastering the wall, cracks can be avoided.
This is the most effective intervention because we know that spraying a house involves investing human resources, logistics,
and insecticides at a cost of approximately 1000 Quetzales per house.
Meanwhile a house improved like the one behind me, is an investment of roughly 250 Quetzales.
The community itself does the work, and their job is to rework the walls and improve the floor.
What we do in collaboration with the Municipality is to find local materials and transport them to the communities.
As President of the community development council, in order to provide an example, I am doing my house over there,
in order to be an example for the community so that other people follow my lead.
We are going to make the plaster, we are going to make 2 tins, and we are going to add one in of soil.
The engineers were in charge of studying the local materials in order to prepare a suitable formula to be used.
Then they taught the whole project team, the Ministry of Health representatives, the vector control specialists
and finally the community.
When we came to this village there was a 35% rate of intra-domicile infestation and this rate has now dropped to 5%.
We want people to live better. This is the holistic approach, development for health.