Modelo multidimensional para o controle da dengue: uma proposta com base na reprodução social e situações de riscos / Multidimensional model for dengue control: a proposal based on social reproduction and risk situations

O objetivo do artigo consiste em apresentar e discutir um modelo compreensivo/explicativo, de caráter ecossistêmico, sobre o processo de transmissão da dengue nos níveis de micro e macrocontexto, a partir da identificação das situações de riscos envolvidas. Considerou-se a dengue como doença infecciosa viral de transmissão vetorial que traz, na sua dinâmica de transmissão, elementos das dimensões biológicas, de conduta, ecológicas, políticas e econômicas, o que a caracteriza como um problema complexo e exige um enfoque sistêmico para seu controle. Assim, para a construção da modelagem, utilizaram-se o enfoque teórico da reprodução social de Juan Samaja e seus condicionantes de macro e microcontexto, e o enfoque operativo ecossistêmico, que buscou responder à pergunta condutora desta construção: quais são as situações de risco para transmissão da dengue, considerando as diversas dimensões da "reprodução social da saúde" no nível local? A visão ampliada das inter-relações entre as diversas situações de risco envolvidas na determinação multidimensional da dengue poderá servir como eixo direcionador para uma gestão integrada das ações do programa de controle da doença, articuladas entre os diversos setores envolvidos.

This paper aims to present and discuss a comprehensive / explanatory model, of ecosystem approach, on the process of transmission of dengue in the levels of micro and macro context, from the identification of the risks involved. Dengue was considered a viral infectious disease of vectorial transmission that carries on its transmission dynamics, elements of the biological, behavioral, ecological, political and economic dimensions, that make it a complex problem and require a systemic approach to its control. Thus, for the construction of modeling, we used the theoretical framework of social reproduction of Juan Samaja and its conditions of macro and micro-context, and the operating ecosystem approach, which sought to answer the question driving this construction: what are the risk situations for the transmission of dengue, considering the different dimensions of "social reproduction of health" at the local level? The enlarged view of the interrelationships among the various risk situations involved in determining multidimensional dengue could guide the integrated management of actions of a disease control program, coordinated by the several sectors involved.

The advantages of mosquito biocontrol by stocking edible fish in rice paddies.

Edible fish stocked in rice fields at a density of 600-800 fry per mu (1 mu = 1/15 hectare) for 150-170 days may act as an effective mosquito biocontrol agent. Common carp (Cyprinus carpio), grass carp Ctenopharyngodon idella) and Tilopia spp. killed late stage larvae and pupae of Anopheles sinensis and Culex tritaeniorrhyncus in laboratory and field trials. Stocking of fish in experimental rice fields decreased larval numbers significantly in comparison with control areas. Expansion of fish stocking in rice fields on a large scale over several years correlated with a marked decrease in malaria transmission. The addition of fish to the rice fields also resulted in increased yields. A ditch-ridge system of field arrangements is described for optimization of fish handling. Preliminary cost-benefit analysis indicates that this approach to mosquito control conveys considerable economic advantage and thus provides incentive to the community to participate in vector control programs. Farmers' experience in Guangxi over a number of years indicates that the use of edible fish for this purpose can be carried on a large, commercially viable scale.