ABSTRACT
BACKGROUND: This study intended to implement a novel intervention strategy, in Brazil, using an ecohealth approach and analyse its effectiveness and costs in reducing Aedes aegypti vector density as well as its acceptance, feasibility and sustainability. The intervention was conducted from 2012 to 2013 in the municipality of Fortaleza, northeast Brazil. METHODOLOGY: A cluster randomized controlled trial was designed by comparing ten intervention clusters with ten control clusters where routine vector control activities were conducted. The intervention included: community workshops; community involvement in clean-up campaigns; covering the elevated containers and in-house rubbish disposal without larviciding; mobilization of schoolchildren and senior inhabitants; and distribution of information, education and communication (IEC) materials in the community. RESULTS: Differences in terms of social participation, commitment and leadership were present in the clusters. The results showed the effectiveness of the intervention package in comparison with the routine control programme. Differences regarding the costs of the intervention were reasonable and could be adopted by public health services. CONCLUSIONS: Embedding social participation and environmental management for improved dengue vector control was feasible and significantly reduced vector densities. Such a participatory ecohealth approach offers a promising alternative to routine vector control measures.
Subject(s)
Community Health Services/organization & administration , Dengue/prevention & control , Disease Reservoirs/parasitology , Mosquito Control/organization & administration , Aedes/parasitology , Animals , Attitude to Health , Brazil/epidemiology , Cluster Analysis , Ecosystem , Entomology , Feasibility Studies , Health Knowledge, Attitudes, Practice , Health Promotion/organization & administration , Housing , Humans , Insect Vectors/pathogenicity , Social ParticipationABSTRACT
Analisar a percepção de atores sociais responsáveis pela gestão de resíduos sólidos no município de Fortaleza-CE, Brasil, no contexto da dengue. Métodos: Trata-se de umapesquisa inserida em um estudo multicêntrico, descritiva, exploratória e qualitativa, realizada no período de outubro a novembro de 2010. Coletaram-se os dados por meio de entrevistas abertas com os representantes da Secretaria Municipal do Meio Ambiente e Controle Urbano, as quais receberam análise de conteúdo. Resultados: Evidenciaram-se as seguintes categorias: características das instituições; hábito do mau acondicionamento; importância damultidisciplinaridade; possíveis soluções. Há uma complexidade sociocultural relacionada ao mau acondicionamento do lixo, sendo necessário maior envolvimento multidisciplinar. Conclusão: As percepções desses atores refletem que a população, independentemente dofator econômico, possui o hábito de descarte inadequado do lixo, com o agravamento da falta de estrutura para trânsito dos caminhões de coleta, sendo possível verificar a complexa relação entre dengue e lixo, a qual depende de mudança de hábitos, educação e investimentos governamentais...
To analyze the perception of social actors responsible for managing solid waste in the city of Fortaleza-CE, Brazil, in the context of dengue.Methods: The research, comprisedin a multicenter study, is descriptive, exploratory and qualitative, performed in October and November 2010. Data was collected through open interviews with representatives of theMunicipal Secretariat for the Environment and Urban Control (Secretaria Municipal do Meio Ambiente e Controle Urbano), that were submitted to the content analysis.Results: The following categories were evidenced: characteristics of institutions; habit of poor wasteconditioning; important role of multidisciplinarity; possible solutions. There is a socio- cultural complexity related to poor waste conditioning, requiring greater multidisciplinaryinvolvement. Conclusion: Perceptions of these actors reflect that the population has the habit of improper refuse disposal, regardless of economic features and worsened by the lackof infrastructure for the transit of collection trucks, also being possible to verify the complex relationship between dengue and garbage, which depends on changes in habits, education and government investments...
Analizar la percepción de los actores sociales responsables de la gestión de residuos sólidos en el municipio de Fortaleza-CE, Brasil, en el contexto de la dengue. Métodos:Se trata de una investigación de un estudio multicéntrico, es descriptiva, exploratoria y cualitativa, realizada en el período de octubre a noviembre de 2010. Se recogieron los datosa través de entrevistas abiertas con los representantes de la Secretaria Municipal del Medio Ambiente y Control Urbano en las cuales se realizó el análisis de contenido. Resultados Se evidenció las siguientes categorías: características de las instituciones; hábito del mal acondicionamiento; la importancia de la multidisciplinaridad; posibles soluciones. Hay una complejidad sociocultural relacionada al mal acondicionamiento de la basura, siendo necesario más implicación multidisciplinar. Conclusión:Las percepciones de esos actores reflejan que la población, independientemente del factor económico, posee el hábito de tirar la basura de manera inadecuada asociado al agravo de la falta de estructura para el tráfico de camiones de recogida, siendo posible verificar la compleja relación entre el dengue y la basura, la cual depende de cambios de hábitos,educación e inversiones del gobierno...
