[Chagas' disease: triatomines notification of the São Paulo State during the 1990s]. / Doença de Chagas: notificação de triatomíneos no Estado de São Paulo na década de 1990.

The objective of this study was to analyze the surveillance of Chagas' disease in São Paulo State through notifications registered from 1990 to 1999. The information originated when notification of triatomines was announced by inhabitants and the established control program was followed. 20,563 triatomine notifications were received, showing a decrease over the years, with more accentuated decreases in the area of greatest frequency of Panstrongylus megistus. Each notification corresponded to an average of 1.3 examples of captured triatomines (median = 1), predominantly in the intradomicile area, while during attendance, the mean number of collected insects was 3.6 (median = 2), mostly present in the peridomicile area. The notification distribution permitted the demarcation of three different areas in the state: area 1, comprising the areas of São José do Rio Preto, Araçatuba and part of Presidente Prudente; area 2, São Vicente and Sorocaba; area 3, municipalities located to the northeast of the Campinas region. Analysis showed that entomological surveillance through triatomine notification, despite the fall in the same, has not detected intradomiciliary colonies associated with Trypanosoma cruzi which could give rise to vectorial transmission of Chagas' disease.

Doença de Chagas: notificação de triatomíneos no Estado de São Paulo na década de 1990 / Chagas' disease: triatomines notification of the São Paulo State during the 1990s

O objetivo deste estudo foi analisar a vigilância da doença de Chagas no Estado de São Paulo, através da notificação, na década de 1990. As informações foram originadas quando da notificação de triatomíneos pelos moradores e seguiram o normatizado pelo Programa de Controle. Foram recebidas 20.563 notificações de triatomíneos com queda ao longo dos anos, sendo esta mais acentuada na região que compreende a área de maior freqüência de encontro de Panstrongylus megistus. Cada notificação correspondeu em média a 1,3 exemplares de triatomíneos capturados (mediana=1), predominantemente no intradomicílio, enquanto nos atendimentos a média de insetos coletados foi de 3,6 (mediana=2), presentes na maioria no peridomicílio. A distribuição das notificações permitiu demarcar três áreas distintas do Estado: área 1- compreendida pelas regiões de São José do Rio Preto, Araçatuba e parte de Presidente Prudente; área 2- São Vicente e Sorocaba; área 3- municípios situados a nordeste da região de Campinas. A análise mostrou que a vigilância entomológica através da notificação de triatomíneos, a despeito da queda das mesmas, não tem detectado colônias intradomiciliares associadas a infecção por Trypanosoma cruzi que possam dar origem à transmissão vetorial da doença de Chagas humana.

The objective of this study was to analyze the surveillance of Chagas' disease in São Paulo State through notifications registered from 1990 to 1999. The information originated when notification of triatomines was announced by inhabitants and the established control program was followed. 20,563 triatomine notifications were received, showing a decrease over the years, with more accentuated decreases in the area of greatest frequency of Panstrongylus megistus. Each notification corresponded to an average of 1.3 examples of captured triatomines (median = 1), predominantly in the intradomicile area, while during attendance, the mean number of collected insects was 3.6 (median = 2), mostly present in the peridomicile area. The notification distribution permitted the demarcation of three different areas in the state: area 1, comprising the areas of São José do Rio Preto, Araçatuba and part of Presidente Prudente; area 2, São Vicente and Sorocaba; area 3, municipalities located to the northeast of the Campinas region. Analysis showed that entomological surveillance through triatomine notification, despite the fall in the same, has not detected intradomiciliary colonies associated with Trypanosoma cruzi which could give rise to vectorial transmission of Chagas' disease.

Representações dos agentes de combate ao Aedes aegypti sobre a estratégia de retirada do inseticida nas ações de controle do vetor / Views of the agents that fight Aedes aegypti on the strategy of eliminating insecticide in vector control action

Estudos realizados pela Superintendência de Controle de Endemias-SUCEN sobre a suscetibilidade do Aedes aegypti a inseticidas utilizados rotineiramente no seu controle demonstraram que o principal problema identificado dizia respeito ao uso excessivo do controle químico, em detrimento da melhoria das condições de saneamento do meio e das ações educativas. Verificou-se também que este uso inadequado do inseticida, se mantido ao longo do tempo, viria a comprometer a sustentabilidade das ações anti-Aedes. A presente pesquisa pretende investigar a percepção de profissionais da Saúde das esferas estadual e municipal que atuam no controle do Aedes aegypti frente à proposta técnica da SUCEN, que, em função desses estudos, decidiu pela retirada do inseticida usado rotineiramente no controle do vetor. A investigação quali-quantitativa foi feita em 5 municípios do Estado de São Paulo, tendo sido utilizado o método do Discurso do Sujeito Coletivo. Chegou-se à conclusão de que as idéias e valores que presidiram a adoção pela SUCEN da política de retirada do inseticida do casa a casa fazem parte do imaginário dos técnicos entrevistados, estando presentes as idéias de toxidade do veneno, do prejuízo à ecologia e à saúde do funcionário, da revalorização do controle mecânico do vetor e da necessidade de reforço da atuação no plano educativo junto à população. Estão também presentes idéias que confrontam com esta política e que dizem respeito à forte crença no uso do inseticida e também a uma visão céptica da atividade educativa a ser desenvolvida junto à população.

Community Involvement in a Dengue Prevention Project in Malaria, Sao Paulo, State, Brazil

Since dengue fever has only recently appeared in the city of Marília, São Paulo, State, Brazil, and no fatal 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 and educational intervention. The initial assumption was that patterns of refuse disposal are and 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 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.

Disposable containers a larval habitats for Aedes aegypti in city with regular refuse collection: a study in Marília, São Paulo State, Brazil

In Marilia, Brazil, refuse ins collected at least every other day, yet non-useful, non- returnable containers such as cans, plastic bottles and tires account for almost half of the container habitats found positive for the Aedes aegypti mosquito. A study was therefore conducted to investigate why these containers exist despite regular refuse collection and a high level of awareness of dengue prevention, and how the control program could most effectively respond. Differing community perceptions as to what constitutes refuse were found to lead people to store a variety of containers in their yard. Other dimensions of the problem include the presence of informal refuse collectors in search of saleable materials, and dumping of refuse in vacant lots and along roads. An intervention based on these data will involve the informal refuse collectors in implementation of a community-base recycling project.

Newsletters as a Chanel for communication in a community-based aedes aegypti control program in Marília, Brazil

In Marilia, Brazil, community newsletters were established in a pilot project on community-based Aedes aegypti control. The newsletters were an excellent way of promoting communication between community members and project personnel, Wile people might not have attended a dengue meeting, and they did turn up at meetings to plan the newsletters. During these meetings project that targeted many Aedes aegypti larval habitats. The newsletters were not an appropriate channel for transmitting information about dengue prevention and mosquito control.