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 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 bott les where mosquitoes breed its focus, and conducted an ''ethnography o f refuse,'' including local classification of materials as useful or d isposable in preparation for an educational intervention. The initial assumption was that patterns of refuse disposal are an individual choi ce, influenced by relatively static cultural definitions of what const itutes refuse. This gave way over the course of the project to a new, more dynamic and contextualized view, allowing for the influence of va rious stakeholders, including municipal and informal refuse collectors , on patterns of refuse management. The end result was the establishme nt of a system of selective refuse collection with participation of bo th householders and informal refuse collectors. The implications of th e findings for programs to control other emerging infectious diseases are discussed.