3. A comprehensive approach for engaging society

reduce PBRPs with difficult access [28], for example, encouraging architects to eliminate open gutters that are hard to access [29]. However, the inevitable existence of those PBRPs almost ubiquitously demand interventions that are applied in a "diffuse way", such as "peri-focal" interventions with residual insecticides [1], release of sterile adult mosquitoes or strategies

The Mosquito Drain is based on the idea of attracting females to ubiquitous oviposition places where larvae can be eliminated (e.g. domestic breeding traps, see Box 1) rather than natural, but inaccessible sites thereby eliminating the next generation of mosquitoes.

In an urban environment, some breeding and resting sites are likely to be inaccessible for cleaning and control (e.g., roofs, crevices, tree holes, etc.; Figure 1). However, not all potential breeding places are equally attractive to laying mosquitoes and "compete" for females' preference. Removal of accessible breeding sites would have the following

2. impel females to over-disperse [30, 31] (so infected mosquitoes will cover an area

3. reduce the quality of potential breeding places sought by females (potential reduc-

Because "egg-laying females were most attracted to sites containing other immature Aedes, rather than to sites containing the most food" [9], home traps could become especially attractive to gravid females, and therefore be disproportionally important in reducing the mosquito population. Alternatively, attractants can be added to encourage mosquitoes to preferentially use lethal ovitraps that can be managed or left to biodegrade rather than inaccessible natural PBRPs [32–34]. The Mosquito Drain posits that it is not necessary to eliminate all breeding sites to cause the population to crash, which would not be practicable anyway, but that by (i) removing manageable breeding sites (e.g. putting lids on water containers), (ii) providing alternative attractive breeding sites that are easily managed (e.g. 'lure' breeding adults with a suitable trap) and that (iii) kill future generations of mosquitoes (e.g. adding larvicide to ovitraps) would eliminate sufficient reproductive capability of the mosquito population as to drive the population to extinction or at least pushing the biting population below levels at which virus

This is a societal effort that depends on collaboration between (many) individuals and government agencies: individuals would be in charge of eliminating any larvae, pupae and/or eggs that could have been accumulated in domestic breeding places (like plant pots and fountains) whilst governments should broadcast a reminder and coordinate that effort. Government agencies would then be freed to tackle hard to access and public spaces.

involving multiple traps ("Mosquito Drain"; Box 2).

84 Dengue Fever - a Resilient Threat in the Face of Innovation

effects on female mosquitoes in search for oviposition sites:

tion -but not elimination- of viable broods).

1. impel females to search for alternative potential breeding places;

Box 2. Mosquito drain.

quicker)

circulation is sustained.

Mosquito control depends on human actions, yet those actions are often at the mercy of legal and physical constraints. Dissecting the legal and physical complexity of contemporary urban ecosystems results in a categorization that can assist the effective implementation of interventions. These categories – based on the diversity of putative oviposition and resting sites – can be easily integrated into existing habitat management behaviors, and can be readily integrated into GIS mapping technologies to generate actionable information to tackle endemic infestations and unfolding outbreaks [29, 38].

One principle reason for successful control in the past century was the implementation of aggressive top-down measures [8, 12, 39]. The erosion of governmental capabilities to interfere with individual liberties does not necessarily impede mosquito control, as that "loss" may be compensated by an increasingly technologically-savvy, knowledge-avid and social media linked population can be mobilized to combat mosquito populations [40–42]. The proposed framework assumes that it is possible to effectively engage the local population [7], not only by suppressing areas of infection where they can easily act (e.g. their properties), but also by collaborating in a forcing a "Mosquito Drain" (Box 2) to reach beyond their immediate domain of direct impact.

Prioritizing citizens' actions has several potential benefits: (a) reduced strain on limited public resources that are stretched during public health crises (e.g. epidemics); (b) individuals can act on more targeted and sustained activities [43]; (c) reduction of harmful interventions (e.g. use of fogging in urban spaces that can be practically managed by community initiatives). The local population is also most likely to recognize hotspots of mosquitoes [41, 44, 45] and appreciate local conditions of epidemiological importance [18]. Although evidence for effectiveness of individual community-based interventions is sparse [37], it appears that integrating community participation into schemes reduces costs and increases effectiveness [46–48].

and regular reminders [39, 51]–for example to clean out water containers, mosquito traps or remove refuse each week [17]. Over reliance on past success risks mosquito populations rebounding, for example because surveillance priorities shift and vigilance suffers [35].

Urban Ecology and the Effectiveness of *Aedes* Control http://dx.doi.org/10.5772/intechopen.78688 87

The key challenge in community participation is sustaining interest. As an example of citizen engagement in action, in two Cuban cities house blocks were randomly enrolled in a trial to control PBRPs (2000–2002), resulting in 75% reduction in Aedes populations through adding lids to water containers (i.e. monitoring accessible and accountable), repairing drains and transforming areas of garbage into (maintained) flowerbeds (i.e. accessible but not necessarily accountable) [53]. Importantly, these neighborhood task forces were still in operation 5 years later when there was an outbreak of dengue and proved cost and health effective [43, 47, 48]. However this sustainability may be unusual with evidence from other studies suggest that success may lead to changes in focus that risk lapses in effort [35], volunteers lose enthusiasm [22] and that adherence to control measures diminishes over time (though still out-perform no activity) [54, 55], more so if initiatives (and official cajoling) end [21]. Evidence of citizen science mosquito surveillance suggests good initial participation that rapidly decreased [41], and the few studies that evaluate the effectiveness of community interventions, whilst generally positive for vector control, lasted a year of less [55, 56]. Encouraging appropriate community participation in control measures is likely to be easier in the midst of epidemics when the benefits are visible, but it remains unclear whether this is sustainable in the longer-term in between episodes of, for example, dengue. That is why it is so important that control measures

are "cross-cutting" within the context of a community, as we will see below.

livability

unavailable, disrupted or fails.

4. Transforming cities in a large mosquito trap while improving their

depressed or unplanned urban areas, thereby improving living conditions [59–61].

Aedes-transmitted diseases are, largely, diseases emanating from neglected private and social spaces [57]. In backyards, buildings, vacant lands and empty lots, trash and untended structures provide perfect breeding places not only for Aedes mosquitoes, but also for many other urban and domestic pests. These neglected places have a negative impact on the environment and quality of life of the community, as well as on their economic development and safety [58]. Therefore, a campaign to remove mosquito breeding places is also a campaign to reinvigorate

It is important to highlight that mosquito control has to be integrated into "cross-cutting" solutions for public health, turning societal vulnerabilities into resilience [61, 62] – i.e. what is good for elimination of Aedes, should also be beneficial on other societal fronts. For instance, environmental management of Aedes might discourage traditional ad hoc water storage practices such as private water-storage systems [16, 28]. But resilience to crises and catastrophes are enhanced through decentralized and resource-autonomous societies [63], for example potable water that is locally collected, treated [64] and appropriately stored (so that it is inaccessible to mosquitoes) would still be available even if the water supply from a centralized provider is

Engaging populations need not be costly (in time or money) given new communication technologies [40] (Figure 3) and, by stimulating and coordinating positive bottom-up initiatives, health agencies can co-opt allies in collective health emergencies [49]. In contrast, topdown approaches to combat Aedes risk treating citizens like irresponsible actors (for example threatening fines [35, 39]) fail to realize the emergent benefits of community participation. Emphasizing the power of bottom-up initiatives is not meant to marginalize the role of topdown activities [7, 8, 12]: as shown in our categorization (Figure 1), even the most engaged community will not be able to manage all putative mosquitoes breeding sites. Public authorities have an immense role to play, but are perhaps more efficient exercising their mandate in the expensive activities of avoiding a state of neglect in public spaces that risks them becoming the foci of urban pests and then efficiently using a smaller budget to encourage and support societal initiatives (e.g. nudging behavioral change [52]) to address readily accessible environments that would otherwise rapidly drain central resources.

The challenge is also to effectively manage activities, whether top-down or bottom-up that risk being popular, but ill conceived. The WHO emphasizes detailed planning to achieve successful behavioral change and recommend a series of steps to capitalize on public engagement to avoid what they consider the two greatest barriers of doing nothing or, perhaps worse, doing the wrong thing (hence putting people off further interventions if their efforts fail) [50]. In addition to combating lack of knowledge or misinformation, governmental activities need to manage social engagement campaigns beyond planning and into co-ordination since such campaigns to change behaviors have been most successful when combined with feedback

Figure 3. Interface from a citizen-science mosquito identification and reporting application used in Spain to assist in the surveillance efforts. Provided by mosquito alert CC-BY [41].

and regular reminders [39, 51]–for example to clean out water containers, mosquito traps or remove refuse each week [17]. Over reliance on past success risks mosquito populations rebounding, for example because surveillance priorities shift and vigilance suffers [35].

Prioritizing citizens' actions has several potential benefits: (a) reduced strain on limited public resources that are stretched during public health crises (e.g. epidemics); (b) individuals can act on more targeted and sustained activities [43]; (c) reduction of harmful interventions (e.g. use of fogging in urban spaces that can be practically managed by community initiatives). The local population is also most likely to recognize hotspots of mosquitoes [41, 44, 45] and appreciate local conditions of epidemiological importance [18]. Although evidence for effectiveness of individual community-based interventions is sparse [37], it appears that integrating community participation into schemes reduces costs and increases effectiveness [46–48].

Engaging populations need not be costly (in time or money) given new communication technologies [40] (Figure 3) and, by stimulating and coordinating positive bottom-up initiatives, health agencies can co-opt allies in collective health emergencies [49]. In contrast, topdown approaches to combat Aedes risk treating citizens like irresponsible actors (for example threatening fines [35, 39]) fail to realize the emergent benefits of community participation. Emphasizing the power of bottom-up initiatives is not meant to marginalize the role of topdown activities [7, 8, 12]: as shown in our categorization (Figure 1), even the most engaged community will not be able to manage all putative mosquitoes breeding sites. Public authorities have an immense role to play, but are perhaps more efficient exercising their mandate in the expensive activities of avoiding a state of neglect in public spaces that risks them becoming the foci of urban pests and then efficiently using a smaller budget to encourage and support societal initiatives (e.g. nudging behavioral change [52]) to address readily accessible environ-

The challenge is also to effectively manage activities, whether top-down or bottom-up that risk being popular, but ill conceived. The WHO emphasizes detailed planning to achieve successful behavioral change and recommend a series of steps to capitalize on public engagement to avoid what they consider the two greatest barriers of doing nothing or, perhaps worse, doing the wrong thing (hence putting people off further interventions if their efforts fail) [50]. In addition to combating lack of knowledge or misinformation, governmental activities need to manage social engagement campaigns beyond planning and into co-ordination since such campaigns to change behaviors have been most successful when combined with feedback

Figure 3. Interface from a citizen-science mosquito identification and reporting application used in Spain to assist in the

ments that would otherwise rapidly drain central resources.

86 Dengue Fever - a Resilient Threat in the Face of Innovation

surveillance efforts. Provided by mosquito alert CC-BY [41].

The key challenge in community participation is sustaining interest. As an example of citizen engagement in action, in two Cuban cities house blocks were randomly enrolled in a trial to control PBRPs (2000–2002), resulting in 75% reduction in Aedes populations through adding lids to water containers (i.e. monitoring accessible and accountable), repairing drains and transforming areas of garbage into (maintained) flowerbeds (i.e. accessible but not necessarily accountable) [53]. Importantly, these neighborhood task forces were still in operation 5 years later when there was an outbreak of dengue and proved cost and health effective [43, 47, 48]. However this sustainability may be unusual with evidence from other studies suggest that success may lead to changes in focus that risk lapses in effort [35], volunteers lose enthusiasm [22] and that adherence to control measures diminishes over time (though still out-perform no activity) [54, 55], more so if initiatives (and official cajoling) end [21]. Evidence of citizen science mosquito surveillance suggests good initial participation that rapidly decreased [41], and the few studies that evaluate the effectiveness of community interventions, whilst generally positive for vector control, lasted a year of less [55, 56]. Encouraging appropriate community participation in control measures is likely to be easier in the midst of epidemics when the benefits are visible, but it remains unclear whether this is sustainable in the longer-term in between episodes of, for example, dengue. That is why it is so important that control measures are "cross-cutting" within the context of a community, as we will see below.
