In 2023, the Americas has seen the highest number of dengue cases in its history, with climate change being a potential contributor. Actions to reduce the population of mosquitoes that transmit the disease are essential to prevent and control dengue.
— Asunción, Paraguay, November 2023 —
Silveira Rodriguez is a devout Catholic. In the courtyard of her home in the Jara neighborhood of Asunción, Paraguay, there is an altar covered with virgins and saints to whom she lights candles and offers flowers. Silveira no longer uses vases with water but replaced them with floral sponges to avoid creating breeding grounds for the mosquitoes that transmit dengue fever, a disease on the rise in the capital city of this South American country.
It is a hot November Saturday in Asunción. Crews from the National Malaria Eradication Service (SENEPA) and partner organizations travel across the neighborhood, from house to house, including Silveira's, to clean, raise awareness and eliminate possible breeding sites for Aedes aegypti, the mosquito that transmits dengue, chikungunya, Zika and other diseases. This type of initiative is called a “minga”.
"I love that they come to the houses because it helps the government in trying to prevent this (dengue) from spreading because, as the mosquito bites everyone, once it gets to one person in the community it gets to us all," she says, noting that her "husband caught chikungunya and then dengue" this year.
With the permission of neighbors, SENEPA crews go through houses and yards, collect unused objects, turn over bottles and give advice on how to recognize breeding sites and take action to prevent them from becoming active, such as cleaning pet water bowls thoroughly with a brush and soap every time the water is changed. They also treat household gutters with chemicals to kill larvae before they become mosquitoes.
Biologist Mara Muñoz, technical director of SENEPA, points out that the dengue epidemic period has already begun in Paraguay and there is viral circulation in the Jara neighborhood, which is why she considers it essential to ensure that houses and their surroundings are free of breeding sites.
So far this year, until the first half of November, Paraguay reported around 9500 cases of dengue fever and 18 deaths from the disease. From October 2022 to mid-2023, the country also experienced an outbreak of chikungunya, another disease transmitted by the bite of an infected mosquito, which caused around 115,000 cases and more than 330 deaths in the country.
Regionally, in 2003 the Americas has recorded the highest number of cases so far, with more than 4 million people affected by dengue. This surpasses the more than 3 million cases reported in 2019. Climate change has been identified as a potential driver for the increase in vector-borne diseases. Not only do higher temperatures enable mosquitoes to thrive, but these temperatures have also facilitated their expansion into previously cooler areas. Reducing mosquito population density by eliminating breeding sites is key to preventing and controlling dengue.
Cleaning and awareness-raising “mingas” are one of the strategies used by SENEPA to reduce the risk of diseases transmitted by Aedes aegypti. To help guide these initiatives, SENEPA uses a manual developed by the Pan American Health Organization (PAHO), which provides information on how to organize the community to control the vector.
For Lourdes Ocampo "there are a lot of" mosquitoes in the neighborhood. This is why the SENEPA visit was "very important because they teach us things we don't know". During the tour, the Service's technicians identified a glass vase with water inside the house, a potential breeding site for mosquitoes. After treating it with a chemical, they advised Lourdes to plant the flower outside.
According to the SENEPA technical director, most of the breeding sites found in Asuncion are unused objects: products that can be discarded, such as bottles, cans, and old car tires, “that people have not removed from their homes.”
To encourage people to get rid of old car tires, a “tire marathon” was held during the minga, promoted by the Municipality of Asunción to mobilize neighbors to dispose of these potential mosquito breeding sites.
Muñoz hopes that these actions will have an impact on reducing the number of dengue cases and empower the community to keep their homes, yards and neighborhoods free of breeding sites. "If the epidemic is going to come, we need to delay its onset as much as possible and when it starts, we need to ensure it’s of lesser magnitude," he says.
Addressing factors related to human behavior and environmental hygiene is crucial to addressing dengue in the community.
Jacinta Agüero, another resident of the Jara neighborhood, proudly shows off her patio and assures that she and her daughter clean it every day and throw away any unused containers that could accumulate water and serve as mosquito breeding grounds.
However, one clean yard alone is not enough to fight dengue. "I ask people to get up and clean, to get involved in a campaign with their families and clean their homes and yards". If everyone gets involved and takes action in their homes, yards and environment, a healthier community, with less mosquitoes and less dengue is possible.
— Dengue cases in the Americas (in Spanish)
