BackgroundChagas disease transmission by Triatoma dimidiata persists in Guatemala and elsewhere in Central America under undefined ecological, biological and social (eco-bio-social) conditions.MethodologyEco-bio-social risk factors associated with persistent domiciliary infestation were identified by a cross-sectional survey and qualitative participatory methods. Quantitative and qualitative data were generated regarding Trypanosoma cruzi reservoirs and triatomine hosts. Blood meal analysis and infection of insects, dogs and rodents were determined. Based on these data, multimodel inference was used to identify risk factors for domestic infestation with the greatest relative importance (>0.75).Principal FindingsBlood meal analysis showed that 64% of 36 bugs fed on chickens, 50% on humans, 17% on dogs; 24% of 34 bugs fed on Rattus rattus and 21% on Mus musculus. Seroprevalence among 80 dogs was 37%. Eight (17%) of 46 M. musculus and three (43%) of seven R. rattus from households with infected triatomines were infected with T. cruzi Distinct Typing Unit I. Results from interviews and participatory meetings indicated that vector control personnel and some householders perceived chickens roosting and laying eggs in the house as bug infestation risk factors. House construction practices were seen as a risk factor for bug and rodent infestation, with rodents being perceived as a pest by study participants. Multimodel inference showed that house infestation risk factors of high relative importance are dog density, mouse presence, interior wall plaster condition, dirt floor, tile roofing and coffee tree presence.Conclusions/SignificancePersistent house infestation is closely related to eco-bio-social factors that maintain productive T. dimidiata habitats associated with dogs, chickens and rodents. Triatomine, dog and rodent infections indicate active T. cruzi transmission. Integrated vector control methods should include actions that consider the role of peridomestic animals in transmission and community memberś level of knowledge, attitudes and practices associated with the disease and transmission process.

BackgroundIntegrated vector management strategies depend on local eco-bio-social conditions, community participation, political will and inter-sectorial partnership. Previously identified risk factors for persistent Triatoma dimidiata infestation include the presence of rodents and chickens, tiled roofs, dirt floors, partial wall plastering and dog density.MethodsA community-based intervention was developed and implemented based on cyclical stakeholder and situational analyses. Intervention implementation and evaluation combined participatory action research and cluster randomized pre-test post-test experimental designs. The intervention included modified insecticide application, education regarding Chagas disease and risk factors, and participatory rodent control.ResultsAt final evaluation there was no significant difference in post-test triatomine infestation between intervention and control, keeping pre-test rodent and triatomine infestations constant. Knowledge levels regarding Chagas disease and prevention practices including rodent control, chicken management and health service access increased significantly only in intervention communities. The odds of nymph infection and rat infestation were 8.3 and 1.9-fold higher in control compared to intervention communities, respectively.ConclusionVector control measures without reservoir control are insufficient to reduce transmission risk in areas with persistent triatomine infestation. This integrated vector management program can complement house improvement initiatives by prioritizing households with risk factors such as tiled roofs. Requirement for active participation and multi-sectorial coordination poses implementation challenges.

Tourism is an important industry to many regions around the world and has the potential to substantially impact local communities. Climate change is expected to influence tourism since weather patterns help determine where and when people travel. In this analysis, the effect of weather conditions on tourism-related spending at three geographically distinct locations in Maine, United States, was evaluated. A nonparametric method (boosted regression trees) was used to first identify the relative influence of twenty-two weather variables as predictors of tourism spending. Following this, a parametric model was constructed to statistically evaluate tourism spending across different measures and predict potential spending changes due to a warming climate. Results indicated that warmer temperatures increased tourism spending in the summer and fall, but had more varying results in the winter. Findings suggest tourism businesses in Maine and other relatively colder destinations could capitalize on potential gains in warmer months.

Climate change poses many risks for nature-based recreation and tourism, especially in protected areas and parks. This paper discusses visitor risk perceptions of climate change and its impacts, and their potential consequences for nature-based tourism destinations such as national parks. An online survey was used to assess visitor risk perception on the likelihood of climate change impacts to affect Mount Desert Island (MDI)-Acadia National Park in the next 10 years, and potential risks those impacts could pose to visitors. Environmental impacts such as extreme weather (75%) and sea level rise (66%) were perceived by respondents as the most likely effects of climate change to MDI in the next 10 years. Conversely, respondents' risk perceptions of climate change impacts as threats to visitors showed an increased importance of other environmental impacts such as increased presence of mosquitoes (60%) and ticks (58%); with extreme events as the key risk to visitors (68%). However, perceptions that pose potential personal risk to visitors gained in significance when considering their influence on travel behavior, including impacts such as disease outbreak and water scarcity. Factor analyses with varimax rotation identified four climate change impact factors associated with perceived vulnerability, perceptions of risk, and influence on future travel to MDI; the four factors generated were: weather patterns, impacts on wildlife, access and health, and physiological and safety needs. Results from cluster analysis yielded three segments: Skeptics, Believers, and Cautious. Segments were significantly different in how they perceived the vulnerability of the area, perceived risks, and factors that may influence travel behavior.

Abstract:With recently announced federal funding and subsidies to redevelop vacant mills and the communities they were in, the forest products industry in Maine is poised to gain its momentum once again. One of the important components influencing the cost of delivered forest products is transportation. A recent study in the region has shown that the location and availability of markets along with lack of skilled labor force are the major challenges faced by the forest products transportation sector in Maine. This study was focused on developing a management guideline which included various field level options for improving trucking enterprises in Maine. For this, a qualitative research approach utilizing a case study research tradition was employed, with in-depth semi-structured interviews with professionals directly related to the forest products transportation sector used for data generation. Thirteen semi-structured interviews were conducted, with each being audio recorded and later transcribed verbatim. Interview transcriptions were analyzed using NVivo 11. Suggestions, like increasing benefits to drivers and providing training, were proposed for challenges related to manpower shortage, while the marketing of new forest products and adjustment in some state-level policies were proposed for challenges related to the forest products market condition of the state.

Chagas disease is a neglected tropical disease that continues to affect populations living in extreme poverty in Latin America. After successful vector control programs, congenital transmission remains as a challenge to disease elimination. We used the PRECEDE-PROCEED planning model to develop strategies for neonatal screening of congenital Chagas disease in rural communities of Guatemala. These communities have persistent high triatomine infestations and low access to healthcare. We used mixed methods with multiple stakeholders to identify and address maternal-infant health behaviors through semi-structured interviews, participatory group meetings, archival reviews and a cross-sectional survey in high risk communities. From December 2015 to April 2016, we jointly developed a strategy to illustratively advertise newborn screening at the Health Center. The strategy included socioculturally appropriate promotional and educational material, in collaboration with midwives, nurses and nongovernmental organizations. By March 2016, eight of 228 (3.9%) pregnant women had been diagnosed with T. cruzi at the Health Center. Up to this date, no neonatal screening had been performed. By August 2016, seven of eight newborns born to Chagas seropositive women had been parasitologically screened at the Health Center, according to international standards. Thus, we implemented a successful community-based neonatal screening strategy to promote congenital Chagas disease healthcare in a rural setting. The success of the health promotion strategies developed will depend on local access to maternal-infant services, integration with detection of other congenital diseases and reliance on community participation in problem and solution definition.

No abstract

National parks are unique and significant vector-borne pathogen transmission settings, engaging over 300 million people in outdoor recreation per year. In this study, we integrated vector surveys and ecological habitat feature data in spatial models to characterize tick-borne disease exposure risk in Acadia National Park (ANP), Maine. To determine the broad-scale patterns of blacklegged tick Ixodes scapularis Say (Acari: Ixodidae) densities in ANP, we conducted host-seeking tick collections at 114 sites across the park over two years. Using these tick survey data and geospatial landscape feature data (i.e., land cover, elevation, forest patch size, and aspect) we developed a random forest model of nymphal tick density. We found that host-seeking tick density varies significantly across the park and is particularly high in areas characterized by deciduous forest cover and relatively low elevation. To explore potential fine-scale ecological drivers of tick density spatial patterns, we quantified microclimate conditions, host activity, and vegetation characteristics at a subset of 19 sites. We identified significant differences in microclimate conditions but not host activity or vegetation metrics across broad-scale landscape feature classes. Mean temperature and mean humidity were correlated to nymphal densities and therefore may provide a mechanistic link between landscape features and blacklegged tick densities. Finally, we detected multiple tick-borne pathogens in both ticks and small mammals sampled in ANP, including Borrelia burgdorferi, Babesia microti, and Anaplasma phagocytophilum. Our findings demonstrate the value of using ecological metrics to estimate vector-borne disease exposure risk and provide insight into habitat characteristics that may drive tick-borne disease exposure risk.