A multidisciplinary, collaborative, inter-agency and comprehensive approach for the control of Chagas Disease as a public health problem in Guatemala

Abstract

Background : Central America is considered a hotspot for Chagas disease transmission and the most important vector in the northern region is Triatoma dimidiata; a native vector adapted to multiple environments, including intra domestic and peri-domestic habitats. Chagas Disease is the leading cause of death associated with heart disease in Latin America, affecting mostly low-resources populations and the presence of the vector is associated to poor house constructions.Methods: A multi-institutional project named "Alliances for the elimination of Chagas in Central America" was created to help reduce the incidence of the disease in the region. Each institution performing speci c role including aspects of vector control, quality of housing, surveillance implementation, diagnosis and treatment of individuals, health promotion, and training of human resources.Results: Eleven villages were entomologically evaluated; ve villages were found to have high infestation rates (>20%), three had average infestation rates (10-20%) and three had low-infestation rates (<10%), coinciding with the type of risk-dwelling found in each of one.Additionally, all the villages had colonization rates greater than 50%, and several showed important levels of triatomine overcrowding. This high colonization dynamic represents a high risk of vector transmission of Chagas disease; it was necessary to improve the household so as to make them refractory to infestation, reducing those characteristics that are appropriate for colonization. Serological tests carried out in two of the 11 villages showed that children under ve years of age were not infected and the prevalence of infection was higher in women than men, showing the importance of women in the disease transmission dynamics, making education and empowerment directed towards women critical for transmission control.Conclusion: Several institutions working together with speci c roles promotes the community partition in several activities as vector control and patience attendance. Some epidemiological factor of the native vector was described.

Domestic Triatoma spp. Infections with Trypanosoma cruzi, Household Infestations, and Molecular Identification in Oaxaca, México

“…per household and 3.1% of households with Triatoma spp. (<8% is considered a low infestation rate [35]), respectively, were lower than the overall values of 5.9 and 7% (range = 5.1-8.2%), respectively, for T. phyllosoma, reported by Ramsey et al (2000) [12]. However, vector index thresholds for control may differ between epidemiological settings.…”

Chagas prevention and control in an endemic area from the Argentinian Gran Chaco Region: Data from 14 years of uninterrupted intervention

“…The program described herein, incorporated the collection of standardized data (SOP´s), adjusted the type of the data collected and incorporated a data platform with GIS. Given the impact of this intervention, with high acceptance by the population, we believe this experience and its records can be used for transference to other countries of the region, especially those that have their own similar characteristics and experiences [ 49 , 52 , 56 , 57 , 75 ]. One of the important aspects of the program is its flexibility, changing through time and adapting to different situations and difficulties encountered through the years, making it dynamic, with the integration of proposals suggested by the beneficiaries themselves.…”

Assessing risk of vector transmission of Chagas disease through blood source analysis using LC-MS/MS for hemoglobin sequence identification

“…This study is part of a multidisciplinary, collaborative, inter-agency and comprehensive approach for the control of Chagas disease [ 14 ]. Specifically, this study focuses combining detection of blood meal sources with household surveys to understand how biological, ecological, and socioeconomic variables influence Chagas disease transmission dynamics.…”