Development of a community-based intervention for the control of Chagas disease based on peridomestic animal management: an eco-bio-social perspective

Abstract

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.

Reservoir host competence and the role of domestic and commensal hosts in the transmission of Trypanosoma cruzi

“…Recent data from Guatemala corroborated that both M. musculus and R. rattus were frequently infected with T. cruzi and served as bloodmeal sources of T. dimidiata, and house infestation was closely associated with presence of mice and dogs (Bustamante et al, 2014). A community-operated rodent control trial reduced significantly the house prevalence of R. rattus infestation, the relative abundance of mice, and the relative odds of infection with T. cruzi in early-stage bugs, as predicted (De Urioste-Stone et al, 2015).…”

“…Cultural and socio-economic reasons may jointly explain why in some rural areas householders traditionally allow the entrance of dogs and cats to human sleeping quarters or decide to keep chickens indoors. Rodent infestations vary greatly across settings and seasons, and householders may or may not decide to combat rodents in effective ways or have the means to do so (De Urioste-Stone et al, 2015).…”

Information to Act: Household Characteristics are Predictors of Domestic Infestation with the Chagas Vector Triatoma dimidiata in Central America

“…24 A recent study in Guatemala showed good community acceptance of rodent control as part of an integrated vector management strategy. 49 The people in these rural areas already improve their houses on a regular basis. About a quarter of our study population in the three countries reported having made improvements to their homes in the 2 years prior to the study.…”

Natural infection by Trypanosoma cruzi in triatomines and seropositivity for Chagas disease of dogs in rural areas of Rio Grande do Norte, Brazil

“…The transmission of CD is undoubtedly influenced by sociocultural, political, economic, environmental, and historical factors 22 , because the occurrence of this disease reflects how the population occupies and explores the environment in which it lives 23 . Studies have shown that information about the vectors of CD in endemic areas is lacking, leading to the inefficiency of intervention programs 24 . Control programs of these areas should focus on educational measures adapted to the local context, elucidating the importance of the capture of the vectors and notification of the authorities to control the disease 25 .…”