Aedes ægypti control in urban areas: A systemic approach to a complex dynamic

PLoS Negl Trop Dis. 2017 Jul 27;11(7):e0005632. doi: 10.1371/journal.pntd.0005632. eCollection 2017 Jul.

Abstract

The available strategy for controlling the diseases transmitted by Aedes ægypti (dengue fever, Zika, and chikungunya) relies on continued community participation. Despite slogans emphasizing how easy it should be, no country has achieved it since the seventies. To better investigate potentially sustainable interventions, we developed a systemic model based on a multidisciplinary approach, integrating as deeply as possible specialized knowledge and field experience. The resulting model is composed of 4 external and 8 internal subsystems and 31 relationships, consistent with the literature and checked over multiple iterations with specialists of the many areas. We analyzed the model and the main feedback loops responsible for the system's stability, searching for possible interventions that could shift the existing balance. We suggest the introduction of 1 more player, the local primary health care structure, with the potential to change the undesired equilibrium. The health agents in the areas are the first to detect disease cases, and they could stimulate individuals to inform about potential mosquitoes' breeding sites and bring timely information to the vector-control program. Triggering such an action could introduce changes in people's attitude through a positive feedback loop in the desired direction.

Publication types

  • Review

MeSH terms

  • Aedes / growth & development*
  • Animals
  • Cities*
  • Community Participation / methods*
  • Humans
  • Mosquito Control / methods*
  • Mosquito Control / organization & administration*
  • Mosquito Vectors / growth & development*

Grants and funding

MSC is funded by the Conselho Nacional de Desenvolvimento Científico e Tecnológico (http://www.cnpq.br/, grant # 200716/2015-8) and Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (http://www.faperj.br/, grant # E-26/2014-203577). NAH is funded by the Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (http://www.faperj.br/, grant # E-26/102.241/2013 and E-26/010.001610/2016) and received a scholarship from the Conselho Nacional de Desenvolvimento Científico e Tecnológico (http://www.cnpq.br/, grant # 206402/2014-7). LMTG receives a postdoctoral scholarship from the Conselho Nacional de Desenvolvimento Científico e Tecnológico (http://www.cnpq.br/, grant # 150213/2016-6). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.