Dengue proposal. Considerations for design of the phase II follow up. Background. DPSEEA was used to introduce the notion of urban ecosystem health. The framework was applied to chronic aspect of urban conditions in Cayo Hueso. Participatory approaches were used to define key indicators.
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Considerations for design of the phase II follow up
The challenge of sustainability in the absence of a signal
The opportunity for sustainability through indirect benefits
The scientific input
Goals and values
The ecologically possible
The socially preferred
Whatoutcome to encourage and when
when to act?
what to do?
Find best system
Weakly active network until trigger
Adaptive hotspot monitoring
The iterative cycles of monitoring and intervention. E.g.:
The rule for when to stop is determined by the whole human-vector-virus ecology. For a disease that is hard to transmit, we can stop at the level of the first risk factors. For a disease that is easily transmitted we need to go to understanding and controlling smaller and smaller risk factors.
May be too late for prevention epidemic
Loss of privacy
Screening for other diseases & behavioural changeC&B of Interventions:monitoring blood samples
High labour input
Cleaner environmentC&B of Interventions:destruction of habitat
Loss of work
Good to have a restC&B of Interventions:quarantine
Needs coordination of episodic effort & opportunity cost of labour and material input
Contamination of environment
Loss of ecosystem integrity
Human health effects
Destruction of mosquitoesC&B of Interventions:fumigation & spraying
High investment costs
Only part of the solution
Eliminates major habitats at home
Reduced water-borne epidemics
Reduces injuryC&B of Interventions:reliable domestic water supply