Dengue, product and marker of urban inequalities : The case of Santa Cruz de la Sierra (Bolivia)

Dengue is a major public health problem linked to urbanization and globalization. Dengue is endemic in Bolivia's lowlands, in particular in the Santa Cruz de la Sierra region, where the head town is now considered to be the... [ view full abstract ]

Dengue is a major public health problem linked to urbanization and globalization. Dengue is endemic in Bolivia's lowlands, in particular in the Santa Cruz de la Sierra region, where the head town is now considered to be the epicenter of the disease in the country. The town of Santa Cruz de la Sierra has roughly 1.5 million inhabitants and is characterized by significant spatial and demographic growth since the middle of the 20th century. This growth produced heterogeneous urban sub-spaces and diverse conditions for the circulation and transmission of the dengue virus.
This paper presents findings from a study of household and neighborhood vulnerability to dengue in the town of Santa Cruz. We pursued a spatial analysis of diagnosed cases of dengue and census data to identify diagnosed dengue heterogeneity, which is often confused with spaces at risk heterogeneity. To analyze the real conditions of virus circulation at household and neighborhood level, the same data were collected during a multidisciplinary field survey from a 100 cluster random sample at the town level. Our findings reveal the social and spatial variability of dengue morbidity, and that different spaces of risk are produced by neighborhood-level disparities . Comparing these results with other urban health research (Santinelles research program) allows us then to propose a new analysis of the health consequences of urban development, planning and management.