The role of migration processes in dengue fever occurrence in Colombia : a mixed study approach

• Main Author: Pacheco-Coral, A. D. P.
• Other Authors: Hayward, A.
• Published: University College London (University of London) 2016
• Online Access: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.746059

Background: Dengue is the second most important vector-borne disease in tropical regions largely affecting urban areas. Rural-urban migration increases numbers at risk. In particular, Internally Displaced Populations (IDPs) are forced to migrate through violence, conflict, or natural disasters moving to informal settlements in urban areas. IDPs might represent a pool of susceptible and vulnerable people; because of their cultural, socio-economic, and demographic factors that differ from the local people. Colombia has the third highest number of dengue cases in the Americas and the second largest IDPs number in the world. Aim: To examine the relationship between IDPs and Dengue in Colombia. Methods: A mixed methods approach was used including: policy and literature review; analysis of routinely available national-level data sources; quantitative household surveys of knowledge, attitudes, practices and vector counts in IDPs and host population households; focus group interviews with IDPs and host populations, and interviews with public health authorities and those working with IDPs. Results: A range of policies addresses both dengue and IDPs in Colombia but there is no policy addressing both issues. Analyses of national level data showed that areas with high level of IDPs tended to have high levels of dengue. Household surveys showed that despite IDPs being more economically disadvantaged and having less access to education and health services, knowledge, attitudes, and practices were broadly similar, although IDPs households were more likely to obtain their information from community networking. IDPs households were more likely than host populations to have productive breeding sites for the vector in their households despite emptying and cleaning water containers more frequently. Participants were aware of dengue, but had mistaken knowledge about disease severity, treatment, transmission and effective control measures. Conclusions: Dengue control in IDPs can be strengthened through community networking and integrated policies to increase access to health and education services.