2019 IEEE 32nd International Symposium on Computer-Based Medical Systems (CBMS)
IoT applications to combat Aedes aegypti: a
Systematic Literature Mapping
1st Henrique de Araújo Silva
Instituto de Ciências Matemáticas e de Computação (ICMC) Instituto de Ciências Matemáticas e de Computação (ICMC)
Universidade de São Paulo (USP)
São Carlos, Brazil
henriarasilva@usp.br
Abstract—Dengue, zika and chikungunya are examples of seri-
ous diseases affecting mainly developing countries, such as Brazil.
Data from the World Health Organization (WHO) about these
diseases transmitted by Aedes aegypti mosquito are worrisome,
especially in relation to their possible effects. Considering this
scenario severity, Internet of Things based applications (IoT
applications) are being used to support it. So, this paper aims
to select and organize, through information collection, difficulties
that can be found in the medical use of IoT applications to combat
this mosquito. The objective was to find possible gaps for future
research. A Systematic Literature Mapping was performed to
find possible deficiencies in the methodologies addressed by the
authors of the returned studies. This systematic mapping intends
to list these difficulties, as well methods proposed to improve the
use of IoT in Health (especially combat to Aedes aegypti). In
total, 570 studies were found. When applying the inclusion and
exclusion criteria, 22 studies were selected for a full reading,
which led to rejection of 15, therefore 07 studies were finally
accepted. By analyzing these selected studies, it was possible to
observe monitoring of information is essential in dengue combat
systems. It was also possible to notice the lack of software reuse
initiatives that could make it easier to develop new applications
in this domain.
Index Terms—Internet of Things, IoT Applications, Devel-
opment, Support, Health, Disease, Mosquito, Aedes aegypti,
Outbreak
I. I NTRODUCTION
When the subject is diseases transmitted by the Aedes
aegypti, a crucial aspect is the prevention of mosquito breed-
ing, i.e., finding ways to avoid that mosquitoes lay eggs. In
fact, this is a useful action, since one of the most efficient
prevention methods is to identify and eliminate environments
that accumulate water, which are appropriate for the mosquito
breeding.
In weather conditions terms, IoT technologies that deal
with sensors can be very useful in this regard, since they
can handle information about humidity, water quantity in a
location, temperature, motion detection, among many other
information that can collaborate to combat these mosquitoes.
A. Motivation
In recent years, there has been a considerable increase in
dengue cases, followed by zika outbreaks and chikungunya in
We would like to thank CNPq and CAPES for the financial support
2372-9198/19/$31.00 ©2019 IEEE
DOI 10.1109/CBMS.2019.00141
2nd Rosana Teresinha Vaccare Braga
Universidade de São Paulo (USP)
São Carlos, Brazil
rtvb@icmc.usp.br
Brazil [1]. These diseases have in common the Aedes aegypti
mosquito as a transmitter. This specific mosquito is already
adapted to urban conditions, and its resistance to insecticides
has made current control activities ineffective [2]. In order
to fight it, a joint effort is needed, which means an alliance
between government and citizens [3].
Although there are solutions for that and in some points of
view it may seem obvious and easy to implement, it does not
always occur. Because dengue (and other diseases transmitted
by Aedes aegypti) is very easy to spread – it is enough to
have standing water in the area for the mosquito to reproduce
– fighting it is not a trivial task [3].
Despite the recent increase in funds to control mosquitoes,
dengue remains a real threat. For example, according to
the official website of Brazil Health Ministry, in 2015 the
resources spent by the Federal Government increased by 37%
compared to 2014. There was also a resource increase of 31.89
% spent by the States and Brazilian municipalities. However,
745,957 dengue cases, including 229 deaths, were officially
registered in Brazil only in the first 5 months of 2015. In 2017,
251,711 dengue cases, 185,854 of chikungunya and 17,594
of zika were registered. At this point, it is crucial to find
and unite cost-effective technologies and approaches to detect
Aedes aegypti outbreaks diseases as early as possible, so that
mosquitoes can be efficiently killed.
B. Technology in Health
The use of technologies in Health has increased significantly
in recent years, with the growing concern to modernize med-
ical processes and fight diseases [4]. With such a scenario, IT
professionals had to adapt technologies which already exist
for these purposes [5].
There is a growing interest in the use of new technologies
in Health. This concern has brought adaptations of new
technologies to support Health and several computational tools
have already been created for this purpose, such as those for
calculating diabetes risk, body mass index, etc. The insertion
of these new technologies had impact on health improvement,
as they facilitated management and optimization of several
activities [5].
As an example of this impact it can be mentioned the
mobile application popularization and Web Systems, which
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allow to schedule consultations in clinics and to have access • Q2: What were the benefits/contributions that the use of
to exams results without leaving home. The medical system IoT technologies brought to combat Aedes aegypti?
modernization helped to make the service queues shorter and, Q2.1: Which type of contribution (System, Archi-
consequently, people can have a better life quality. tecture, etc.) was given?
Although the usage of IoT in health applications, in special Q2.2: Was the contribution focused on the control,
for helping detecting conditions for mosquitoes proliferation, prevention or combat of diseases transmitted by Aedes
is highly justified, we could not find secondary studies that aegypti?
identify the state of the art concerning how IoT has been used A. Databases and inclusion/exclusion criteria
in this kind of application. This has motivated the realization
of the research presented in this paper. The search string was formed by keywords considered
relevant to execute this mapping. It was executed through the
C. Objectives following search engines: IEEE Xplore, Engineering Village,
This paper aims to select and organize difficulties in medical Scopus, Web of Science, ACM Digital Library and Science
use of IoT applications to combat the Aedes aegypti mosquito, Direct. Similar terms were considered for the string construc-
by performing a collection of information in studies published tion, as specified in Table I.
in the literature. The goal was to identify the current state of
TABLE I
the art and to find possible shortcomings for future research. T ERMS TO BE SOUGHT
To achieve that, a Systematic Literature Mapping was
carried out to determine possible shortcomings in the method- Term
ID Main Term Similar Terms
ologies addressed by the authors of the studies. This system- IoT
atic mapping aims to list these difficulties and the methods RFID
proposed to improve the use of this technology in Health, 1 Internet of Things WSN
particularly in the fight against Aedes aegypti. Wireless Sensor Network
Sensor
2 mosquito mosquitoes
II. S YSTEMATIC L ITERATURE M APPING 3 epidemics outbreaks
According to Peter and others [6], a Systematic Literature dengue
Mapping (SLM) is a method that involves research in the 4 diseases zika
chikungunya
literature to estimate the extent and papers quantity published
in a domain area. It is possible to select and categorize primary Table II represents the web addresses of the chosen search
studies, thus allowing an overview of this area. In order to engines to allow the reproduction of this SLM. Table III
be able to better understand what has been researched in the enumerates the inclusion (I) and exclusion (E) criteria used
interest area and identify gaps and research opportunities that to filter the studies in the subsequent phases.
will be used in this work, a SLM was performed following
the protocol established by [6]. TABLE II
The mapping was divided according to the four steps S ELECTED E NGINES
established by [6]: research questions definition; conducting Engine Address
research through relevant primary studies; extraction and data IEEEXplore http://ieeexplore.ieee.org
synthesis; and data analysis. ACM DigitalLibrary http://dl.acm.org
Scopus http://www.scopus.com
III. P LANNING
Web of Science http://apps.webofknowledge.com
It was agreed by the authors that the objective of the Science Direct http://www.sciencedirect.com
SLM was to identify the state-of-the-art regarding how IoT Engineering Village https://www.engineeringvillage.com
application concepts are used in Health, specifically in the fight
against Aedes aegypti. This served to map the contributions
made to that purpose. TABLE III
I NCLUSION AND E XCLUSION C RITERIA
Firstly, the research questions were defined, which served
as the north for most relevant studies selection, as well as the Criteria I/E
data to be collected from each study. The following research Studies which use IoT technologies applied in the fight against
diseases transmitted by mosquitoes I
questions have been proposed: Studies that are not fully available on the Web E
• Q1: Which were the strategies adopted for the imple- Redundant Studies of the same author (duplicates) E
mentation of IoT technologies in the fight against Aedes Studies that do not present approaches based on IoT technologies
applied in the fight against diseases transmitted by mosquitoes. E
aegypti? Absence of verification / validation methods E
Q1.1: What was the application environment?
Q1.2: Which were the IoT technologies used? The search was based on domain research keywords, to-
Q1.3: Which institutions involved in the use of gether with corresponding synonyms and/or plurals. As a result
Health resources were used? of the terms union, the resulting search string was:

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 (“internet of things” OR iot OR rfid OR wsn OR “wireless Fig. 2. Studies distributed by years
sensor network” OR sensor) AND (mosquito OR mosquitoes)
AND (epidemics OR outbreaks OR diseases OR dengue OR
zika OR chikungunya)
B. Conduction
The studies selection occurred in three steps, all of them
performed on May, 2018. In the first step, the search string was
applied in the search engines and 570 studies were obtained,
although without applying the inclusion and exclusion criteria.
In the second step, the search string was applied, and the
title and abstract were also read, in order to find studies that
were strongly related to the subject in question, resulting in
22 studies. In the third and last stage, all 22 studies were
completely (thoroughly) read and the inclusion and exclusion
criteria were applied again, resulting in 07 selected studies may have been due to dengue outbreaks in 2016 and mobile
in total that are compliant with our systematic mapping goal. technologies popularization, which includes IoT and the large
Figure 1 illustrates the three steps performed during the SLM. use of Smartphones.

Fig.
g 1. Study
y Selection Stages
g
B. Country
During the studies evaluation according to their origin
countries, it was possible to highlight the developing countries,
where more studies about the research subject were published,
corresponding to 87.5% of the studies (Brazil, India, Malaysia,
Iraq and Sri Lanka). It can be seen that the countries with
more published studies are Brazil and India. The United
States, Malaysia, Iraq, and Sri Lanka each represent 12.5%
of the studies, as well as all other (except Brazil) developing
countries which have studies in Asia (62.5%). They are
countries that suffer from simple problems, including basic
sanitation, which make them more susceptible to dengue. It is
still possible to highlight the participation of a major world
power, the USA, which has the first study published [7], whose
focus was the identification of outbreaks with the help of
Smartphones and social networks. The analyzed data can be
verified in Figure 3.

IV. R ESULTS
Fig. 3. Studies distributed by countries
In this section, we present data collected and evaluated
from the 07 selected studies, in order to answer the research
questions, as well as to gather other data relevant to this SLM.
A. Year
When evaluating the selected studies according to the
publication year, studies were identified for the years 2012
[7], 2016 [8], [9], 2017 [2], [10] and 2018 [2]. The most
significant volume is related to the years 2016 and 2017, in
which more works were produced. These numbers indicate that
the research problem investigated is recent, and that there is
much to explore from the subject in the use of IoT applications
to combat Aedes aegypti. Figure 2 represents the use of IoT
technologies to combat dengue over the years.
One fact which shows the subject is a recent concern C. Type of Disease and Motivation
is that 85.7% of studies have been published in the last 3
years (2016, 2017 and 2018). A significant increase in the The authors mentioned in this SLM defend several points
number of studies published since 2016 is noteworthy. This about the importance of carrying out their studies. Mostly,

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they are closely related to the prevention, control or combat Fig. 5. Studies according to the motivation
of diseases transmitted by Aedes aegypti.
Most studies (66.6%) highlight the serious consequences
that these diseases (dengue, zika and chickungunya) can bring.
For example, to [11], these diseases are still a challenge for
governments and health services. Thus, a Public Health System
based on Information Technology (IT) is strongly needed to
prevent the dissemination of the Zika Virus (ZIKV). The idea
of building a cloud-based infectious disease monitoring system
that is accessed by mobile devices to monitor and detect Zika
infected patients in real time can be an effective solution.
In addition, the detection and remote monitoring of serious
disease outbreaks in real time is strongly required to con-
trol the outbreak. Sareen and others [11] argues that recent
advances in IT, such as cloud computing, IoT, Smartphones
and Geographic Information Systems, can be used to improve fever (DHF). These factors have led to huge economic losses
Health Services quality by providing users with a wide variety and health complications [2]. Another worrying factor is that
of computing services. There is a trend in the use of real Aedes aegypti females can use any sites with standing water
time systems to control the diseases, since they spread rapidly. for breeding, especially places with water stagnation that
Figure 4 shows data on diseases transmitted by Aedes aegypti. people cannot readily reach or identify (i.e., roof gutters, water
tanks, inaccessible roofs and materials that are capable of
holding water). Due to the impact of water retention over a
Fig. 4. Studies according to type of disease (or mosquito) long period of time, these areas are conducive to reproduction
of the Aedes aegypti [10].
D. Contribution type
The studies presented several contributions with different
types of results. However, many of these results present similar
solutions to each other. In general, development of systems,
mobile applications and sensor approaches were carried out.
Figure 6 shows the studies contribution type.
In the study of Saren and others [11], Bayesian Naive
Networks were used to diagnose possibly infected users,
and the Google Maps service was used to provide Global
Positioning System (GPS) based risk assessment to prevent
outbreaks. The proposed system, based on cloud-computing,
contributed to a precise classification, as well as for the precise
According Rani and others to [12], chikungunya is a disease
identification of areas prone to the risk of having outbreaks,
transmitted by the rapidly spreading of Aedes aegypti. Ac-
doing a mapping with Google Maps.
cording to the author, a measure of awareness and prevention
of this disease, a new paradigm of intelligent health, needs
Fig. 6. Studies in relation to the contribution type
to be planned/implemented. The evolution perspective of IoT
applications for interconnected heterogeneous devices and
objects has played a vital role in health care systems for
patients with chikungunya. Therefore, there is still a need
for real time health monitoring to analyze patients to take
preventive measures and precautions for a healthy life.
The studies emphasize the importance of having localization
mechanisms to find breeding sites for Aedes aegypti. As stated
by Andrade and others [9], it is very important to locate and
eliminate the causative elements (vases, pet bottles and other
objects that can keep still water) quickly and immediately, a
very important preventive measure.
Figure 5 provides a view of the primary motivation for the
studies to be carried out, i.e., combat, prevention, or control.
In addition to increasing dengue cases in the last decade, The study of Rani and others [12] presents an IoT model
there has been an increase in cases of dengue hemorrhagic in which data collected from sensors, objects and people

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are gathered in the cloud, enabling health professionals to
perform preventive actions. Precautionary measures are taken
by collecting information about the causes of Aedes aegypti
growth. The appropriateness of the approach is validated in
the IoT base layer and the data is transmitted to the cloud
with the help of edge nodes.
In the study of Mathew and others [7], PowerSense was
developed, which is an extensible module for mobile appli-
cations. It has functions that help the mapping of specific
places to detect dengue, and proactively facilitates the pro-
cesses management for mobile applications assisted by web
services. PowerSense uses power consumption measurements
and processing delay for Smartphone devices. This allows
the users to dispatch image processing jobs either locally or
remotely to the Web service at run time.
The published studies, in general, have an emphasis on
two areas: Information Systems (IS) and Robotics. IS refers
to mobile systems and applications [7], [9], [11], [12]. In
Robotics, the focus of the development is on sensors and other
auxiliary electronics [2], [8], [10].
In the study of Andrade and others [9], it is presented
DeuZikaChico, a system which makes use of Geographic
Information Systems technologies, mobile platforms, crowd-
sourcing and social networks, with the objective of providing
public managers with better monitoring of epidemics with the
support of society. The system maps disease cases.
Another study worth mentioning [10] presents a new ap-
proach to identify areas of Aedes aegypti reproduction through
drone images of the distinct staining found in these areas, by
applying the Oriented Gradient Histogram algorithm. Using
this algorithm, potential areas of water retention were detected.
Salim and others [2] state that their study is the first to report
the detection of Aedes aegypti female in human dwellings
using a surface acoustic wave sensor. The viability of an
acoustic-based device recording differences in signal and noise
levels of different mosquito species was demonstrated by
instructing frequency differences to detect female mosquitoes.
E. Institutions involved
Figure 7 presents the main institutions involved in the use of
health resources. It is important to identify these institutions,
as they are relevant stakeholders that need to be contacted in
the scenario of studies of this SLM. A health resource can
be defined as a resource used in the medical area, such as
medical equipment or exam materials or results. The studies
presented different final interests and applicability as well.
There was a variation of institutions and they could have
different names in different contexts, so a standardization was
important. For example, Hospitals, Disease Control Centers,
Health Centers and Health Inspectors are used to denote the
institution or person that should receive alerts from the system
or be assigned as a supervisor (a person who is responsible
for triggering actions to combat or prevent an outbreak).
A possible scenario involves the Public Health Inspectors,
who have the task of detecting and eliminating areas where
there is still water. However, they face the problem of detecting
700
Fig. 7. Studies according to the institutions involved in the use of Health
resources
potential Aedes aegypti breeding sites in difficult access areas
(supervisory activities).
F. Studies Overview
According to Table IV, it is possible to notice that most
of the selected studies are concerned with the disease control
(5 out of 7), followed by prevention (4 out of 7) and combat
(2 out of 7). This highlights the fact that the control of the
disease is a priority, i.e., once the disease is controlled, less
investment is needed to prevent and combat it.
Regarding technologies used for implementing IoT appli-
cations in the diseases control domain, we can observe on
Table IV that, among the variety of IoT devices that are
available nowadays, the most commonly used in the studies
were sensors embedded in smart phones, such as GPS, and
other conventional sensors for humidity and temperature. A
specific kind of sensor to detect the mosquito itself was also
identified.
It is worth to mention that the use of drones has been
explored in only one of the studies. This can be an opportunity
to researchers, since the analysis of images captured by drones
in areas of difficult access can help to identify and combat the
mosquito proliferation. This brings us another aspect presented
in the comparison table: the environments of application
identified in the studies are mostly concerned with propitious
areas for Aedes aegypti procreation.
It would be desirable to improve software reuse during the
development of specific applications to control/combat/prevent
diseases. For example, a public health department might
be interested in developing a customized application that
allows users to collaborate with updated information about
mosquitoes and people suffering from the diseases in each
region of the city. Applications for the Health area present so-
lutions for similar problems, so reusing existing components,
services or software classes could help improving productivity
and quality. However, if we observe the Technology/Services
column of the table, it is not explicit that reuse initiatives are
being applied during development.
V. T HREATS TO VALIDITY
Possible threats to the validity of this SLM include, mainly:
 TABLE IV
S UMMARY OF C HARACTERISTICS OF THE SELECTED STUDIES
Technology/ Control/
Contribution Institutions Environment of
Study Motivation Country Services Prevention/
type Involved Application
used Combat
Smartphone,
Propitious areas
Image, Control,
[11] System Zika India Hospital for Aedes aegypti
Cloud, Prevention
procreation
GPS, Sensor
Dengue focuses
and Hospitals
Image,
Control, (People
[12] System Chickungunya India Cloud, Hospital
Combat information
GPS, Sensor
and mosquito
sensors)
Smartphone,
In people,
Web Services, Diseases
Mobile to know if
[7] Dengue EUA Web Page, Control Control
App they have
Image, Center
dengue mark
GPS, Sensor
Social
Digital Media
Dengue, Networks,
Health Control, and Propitious areas
[9] System Zika, Brazil Mobile
Centers Prevention for Aedes aegypti
Chikungunya Platforms,
procreation
GPS
Approach with Malaysia, Sensor Prevention,
[2] Dengue None Any environment
sensor(s) Iraq GPS Combat
Approach with Sensor,
[8] Aedes aegypti Brazil None Control Any environment
sensor(s) GPS
Approach with Image, Health
[10] Aedes aegypti Sri Lanka Prevention Any environment
sensor(s) Drone Inspectors

• Selection Bias: In order to narrow the scope of the study
and select only papers relevant to the subject, inclusion
and exclusion criteria based on our understanding have
been applied, so that some studies may have not been
included or misclassified. To avoid this possible threat,
the review protocol was discussed until a common sense
was reached among researchers.
• Search String Construction and Data Extraction: As
for the subject of the mapping discussed there are several
possible search string constructs. In this way, researchers
could have built a string with words that were not
appropriate. This might have resulted in a set of studies
that does not represent the universe of possible studies.
VI. C ONCLUSION
The presented Systematic Literature Mapping resulted in the
selection of seven studies in which IoT applications are used
to control/combat/prevent Aedes aegypti.
Supporting systems that use sensors (such as Arduino
boards) and mobile applications are recurrent, which shows
that it is possible to combat Aedes aegypti by benefiting from
IoT without high expenses to build effective applications.
Considering the basic mechanisms for IoT application de-
velopment, e.g. RFID, WSN, middleware, cloud computing
and the IoT application itself, the studies presented a series of
resources using these mechanisms. Opportunities for software
reuse have also been identified. For example, Google Maps
Web service was used to detect infection spread at high
mosquito-dense sites [11] and was also used in an application
to identify and highlight recently affected regions [7]. How-
ever, the studies did not make explicit their reuse initiatives.
Finally, it was possible to observe that monitoring of infor-
mation is essential in dengue combat systems, and IoT plays an
essential role to support this. We believe that the present SLM
can be useful for researchers interested in developing solutions
for diseases control, combat and prevention. They can benefit
from the studies found in the literature that resulted from this
SLM.
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