UC Berkeley Anthropology Professor James Holston and Public Health immunologist Dr. Josefina Coloma have been awarded a $3.1 million, 5-year grant from the National Institute of Allergy and Infectious Disease of the National Institutes of Health to combate dengue virus in Peru.
The grant will fund “Proyecto Tariki”, a research initiative developed by Professor Holston and Dr. Coloma in collaboration with co-principal investigators Dr. Valerie Paz-Soldan, a social epidemiologist based at Tulane University and in Lima, Peru, and Dr. Amy Morrison, an entomologist based at UC Davis and in Iquitos, Peru. The project seeks to reduce the risk of dengue virus infection and improve health outcomes for dengue fever in the Peruvian Amazonian city of Iquitos.
Dengue virus infection is a devastating public health burden in Latin America, where a recent epidemic coincided with the COVID-19 pandemic. The disruption of health interventions and the challenges posed by community fatigue, changing risk patterns, and the dissemination of false information highlight the urgent need for a new paradigm in public health responses.
Project Tariki proposes such a paradigm change through the use of new digital technologies (the platform DengueChat) and direct democratic assemblies of neighborhood residents. Developed by the Social Apps Lab at UC Berkeley’s Department of Anthropology a decade ago, DengueChat aims to mobilize residents to take preventative and sustainably “green” control measures in their own homes through the identification and elimination of mosquito breeding sites; enhance surveillance of disease vectors; promote the rapid triage and management of febrile cases (with rapid diagnostic tests); improve data exchange; and incorporate implementation science. It has proved to be highly effective in reducing the spread of mosquito-borne diseases, and was deployed successfully to reduce dengue risk in Nicaragua and Paraguay.
DengueChat empowers citizens directly affected by the spread of these diseases by allowing them to self-report both the identification and the elimination of the breeding sites of the mosquito that transmits the disease virus. Their self-reported data instantly populates into the app for all to see. Government health programs in regions affected by dengue virus have generally failed to limit the spread of disease through chemical-based vector control (e.g., fumigation and larvicides). As this failure is a political liability, Holston said, governments also deny epidemics and manipulate data. By contrast, DengueChat is designed to allow citizens to develop and exercise their own agency in reducing the risk of dengue infection without chemicals.
“People in these communities have shown they've got what it takes to lead this project, handling tasks like gathering information, putting protocols into action, and getting rid of the health threat,” he said. “These accomplishments disprove the idea that folks without advanced education can't manage their own health. Allowing residents to take charge in these situations not only breaks down stereotypes but also gives people a sense of power and belief in their ability to control their health – something that's empowering for everyone involved."
For example, Professor Holston explained, neighborhoods that used DengueChat in the Nicaraguan pilot study that Holston and Coloma conducted saw a reduction of approximately 44% in the mosquito vector that transmits the disease. But neighborhoods that did not use DengueChat experienced a 500% increase during one epidemic year.
With the NIH grant, Project Tariki intends to scale up its success from the pilot study to an entire city. It will now be adapted for the new context of Iquitos as an open-source platform available to the Peruvian Ministry of Health. Over the next five years, the project’s focus will be on demonstrating a reduction in the risk of dengue virus infection and improving health outcomes. The UC Berkeley-led research team envisions the project's success leading to its expansion into new cities, with the platform's modules adapted for other infectious diseases. The NIH grant's impact, coupled with the integration of implementation science, positions Project Tariki as a transformative initiative in the realm of public health.