Community involvement in a dengue prevention project in Marilia, Sao Paulo State, Brazil

Since dengue fever has only recently appeared in the city of Marilia, Sao Paulo State, Brazil, and no severe and fata cases of the disease have yet to occur, dengue prevention is not a local priority. A dengue prevention program in one neighborhood made the tires, cans, and bottles where mosquitoes breed its focus, and conducted an 'ethnography of refuse,' including local classification of materials as useful or disposable in preparation for an educational intervention. The initial assumption was that patterns of refuse disposal are an individual choice, influenced by relatively static cultural definitions of what constitutes refuse. This gave way over the course of the project to a new, more dynamic and contextualized view, allowing for the influence of various stakeholders, including municipal and informal refuse collectors, on patterns of refuse management. The end result was the establishment of a system of selective refuse collection with participation of both householders and informal refuse collectors. The implications of the findings for programs to control other emerging infectious diseases are discussed.