Interruption of vector transmission by native vectors and “the art of the possible”

Abstract

In a recent article in the Reader’s Opinion, advantages and disadvantages of the certification processes of interrupted Chagas disease transmission (American trypanosomiasis) by native vector were discussed. Such concept, accepted by those authors for the case of endemic situations with introduced vectors, has been built on a long and laborious process by endemic countries and Subregional Initiatives for Prevention, Control and Treatment of Chagas, with Technical Secretariat of the Pan American Health Organization/World Health Organization, to create a horizon target and goal to concentrate priorities and resource allocation and actions. With varying degrees of sucess, which are not replaceable for a certificate of good practice, has allowed during 23 years to safeguard the effective control of transmission of Trypanosoma cruzi not to hundreds of thousands, but millions of people at risk conditions, truly “the art of the possible.”

2 nd Brazilian Consensus on Chagas Disease, 2015

“…Furthermore, additional studies and analyses have sought to evaluate further the operational processes involved in different strategies to control/eliminate of indigenous vector transmission, including the certification model and potential alternatives (69) (70) (71) (72) . (55) .…”

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“…The elimination depends on an installed, sustainable and feasible surveillance that adapts to the needs of every epidemiologic scenery for a periodical registration. The surveillance system is the guide for the control programs in the process of making decisions and adjustments necessary for more effective actions (3).…”

“…This debate is still open, the PAHO/WHO think that the proposal of scientists could contribute to improve the conceptual framework and the field work, which is undoubtedly perfectible and making it public to all the sub-regional Initiatives. However, the PAHO/WHO consider that it is not an alternative to the evaluation of the impact of the work developed by the countries which are fighting to interrupt vector transmission, which currently is the best available option to measure the progress made in a public health scale (3).…”

“…Considera que la mejor estrategia sería certificar la "buena práctica" en lugar de los hechos no verificables sobre la no ocurrencia de la transmisión (5). Este debate aún sigue abierto, la OPS/OMS considera que la propuesta de estos investigadores podría contribuir a mejorar el marco conceptual y el trabajo de campo, que es sin dudas perfectible y darse a conocer a todas las Iniciativas Subregionales, pero que no constituye una alternativa a la evaluación de impacto del trabajo desarrollado por los países que están luchando por llegar a interrumpir la transmisión del vector, y que en la actualidad es la mejor opción disponible para medir el progreso realizado en una escala de salud pública (3).…”

A methodology based on insecticide impregnated filter paper for monitoring resistance to deltamethrin in Triatoma infestans field populations

“…As no effective treatment is available for the chronic forms of the disease, vector chemical control represents the best way to reduce the incidence of disease (Zerba, ). After application of pyrethroids insecticides in dwellings and peri‐domiciliary areas, intergovernmental control programmes reduced the geographic range and infestation prevalence of major triatomine vectors leading to the interruption of transmission mediated by Triatoma infestans in some countries of the Southern Cone (Brazil, Chile, Uruguay and provinces/departments from Argentina, Paraguay, Bolivia, and Peru), as well as decreasing infestations with T. dimidiate and the distribution of Rhodnius prolixus in Central America (Schofield et al ., ; Gürtler, ; Salvatella et al ., ). However, the domiciliary presence of T. infestans after control interventions has repeatedly been reported in recent years (Mougabure‐Cueto & Picollo, ).…”