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Volume 1 Number 2 2025
Dengue prevention: a vector-focused strategy

by Porfirio Felipe Hernández Bautista*

*Coordinación de Calidad de Insumos y Laboratorios Especializados, Instituto Mexicano del Seguro Social, Ciudad de México 07760, México.



During the 20th century, significant technological advances occurred, which had a major impact on human demographic development. Never had the population changed so rapidly and radically in its behavior. There were massive migrations of capital, resources, and people, leading to rampant urbanization.

All of this has had various repercussions, some of which have become problems affecting humanity. One example is the ease with which diseases spread, through the introduction of new biological species, either intentionally or unintentionally. Considering that this type of phenomenon has always existed but now occurs on a much larger scale in terms of time and space, it should not be surprising that a virus can, at any time, get out of control worldwide. Obviously, many factors that cause this situation are still unknown, which makes it unpredictable when and where a pandemic will emerge, thus hindering the implementation of effective preventive measures. However, in other types of diseases, this uncertainty is related to the knowledge of another factor in the transmission chain, such as vector-borne diseases. In this case, the most important factor will be controlling the vector. Therefore, the Aedes mosquito is of utmost importance for controlling diseases such as dengue, chikungunya, and yellow fever, especially in urban areas.

Despite the recognition by international health organizations, such as the World Health Organization, of the importance of eliminating the Aedes mosquito since the mid-20th century, sustained efforts to eradicate it have not been made. On the contrary, there has been a constant increase in cases of diseases like dengue worldwide, especially in the last two decades. Furthermore, other diseases such as chikungunya and Zika have appeared in countries where they had not been previously recorded, and yellow fever remains latent in the Amazon.

Therefore, it is necessary to reconsider the factors that have caused preventive measures for controlling the Aedes mosquito to be ineffective. These factors can be listed as follows: 1) Greater importance has been given to treating diseases than to preventive measures, as a consequence of a persistent curative paradigm. 2) The elimination of the mosquito has become solely the responsibility of the vector control departments under the authority of the ministries of health. This has resulted in a lack of shared social responsibility, which the vector has exploited effectively. It is worth remembering that Aedes aegypti is a completely domestic species, and this is probably the key factor in its success as a species. Therefore, it is necessary for humans to act as predators, since otherwise, there will be no competition in the domestic environment to limit its growth. Now, how can we transform two species into enemies? Undoubtedly, the answer for humans lies in education. However, here, education must be understood as a basic process of socialization, from which we expect behaviors that promote the elimination of the vector. This has probably already been understood by those responsible for vector-borne disease control at the WHO, as well as the ministries of health in each country, as evidenced by the efforts to create educational materials and the recommendations in dengue control operational plans, which include education as a strategy. Unfortunately, when it comes to implementing these educational plans, they often end up being merely informational or are not implemented at all. The reasons are varied, ranging from a lack of human resources to the perception that they are unnecessary because control of insecticides is already being carried out. This usually ends up being a mistake because, within 5 or 10 years, the situation returns to square one with a dengue outbreak, and the informational and educational process begins again, without achieving any long-term impact.

Due to these reasons, it is necessary to rethink educational techniques for controlling the Aedes mosquito to make them more effective and achieve their objective. Within this context, an educational strategy should be developed that fosters community participation, and which should be an economic and safe option for eradicating the Aedes mosquito.

To achieve this goal, various forms of information should be used, as well as educational games that reinforce the most effective actions to combat the vector. An important component should be self-evaluation, such as a reporting platform for Aedes mosquito sightings, which would encourage greater participation.

Although the strategy would be directed at schools, universities, businesses, churches, etc., individuals can also participate by joining special groups focused on vector control; in fact, the participation of the entire population is essential.

This method should not, in any way, be intended to replace the activities carried out by health ministries, but rather to serve as a complement to a common goal: the elimination of the Aedes mosquito.

It is necessary to reevaluate the current approaches to combat dengue, chikungunya, and other vector-borne diseases, and to focus more on eradicating the vector itself. Community participation will undoubtedly be very helpful, but it is important to have a multi-pronged approach against the vector, which opens the possibility of conducting more research on safe mosquito control devices for use in environments where human intervention is not possible, especially for Aedes albopictus. It will also be essential to continue exploring various teaching methods that can influence public behavior.

Finally, we must look to the future, where we can make decisions about the existence of certain species, which must be done with the utmost objectivity, since any mistake could also affect us, and ultimately, what we seek is the survival of the human species.



You can consult:


1. Pan American Health Organization. Addressing environmental determinants of health in vector surveillance and control strategies: guidelines for promoting key interventions. Washington, D.C.: PAHO/WHO. 2019. Available at: https://iris.paho.org/handle/10665.2/515 63.

2. Al-Muhandis N, Hunter PR (2011) The Value of Educational Messages Embedded in a Community-Based Approach to Combat Dengue Fever: A Systematic Review and Meta Regression Analysis. PLoS Negl Trop Dis 5(8): e1278. doi:10.1371/journal.pntd.0001278

3. Ballenger-Browning KK, Elder JP, Multi-modal Aedes aegypti mosquito reduction interventions and dengue fever prevention., Tropical Medicine and International Health volume 14 no 12 pp 1542–1551 december 2009



Citation

Hernández-Bautista PF, Dengue prevention: a vector-focused strategy, ERSJ 2025,1(2) 45-48.