We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Chagas prevention and control in an endemic area from the Argentinian Gran Chaco Region: Data from 14 years of uninterrupted intervention.
- Authors
Weinberg, Diego; Casale, Maria Florencia; Cejas, Rosa Graciela; Hoyos, Rafael; Periago, María Victoria; Segura, Elsa; Abril, Marcelo Claudio
- Abstract
Background: Chagas Disease (ChD) is a Neglected Tropical Disease (NTD) affecting 6 to 7 million people worldwide, mostly from Latin America. In Argentina, a national control program has been implemented since 1962, yet there are still an estimated 1.6 million infected individuals. Control programs were based almost exclusively on entomological surveillance and chemical control of households and were not continuous given a lack of coordination and resources. Argentina´s ChD program was originally vertical and centralized; later, it was partially and, in general, unsuccessfully transferred to the provinces. Herein, we describe the implementation of a control program for ChD with an ecohealth approach in rural settlements around the city of Añatuya, Santiago del Estero. Methods: The program included yearly household visits for entomological surveillance and control, health promotion workshops, and structural house improvements. Improved structures included internal and external walls and roofs, as well as the construction of water wells and latrines, and the organization and improvement of peri-domestic structures. Activities were carried out by specifically trained personnel except for house improvements, which were performed by the community, under technical guidance and provision of materials. Data was collected using standardized questionnaires for household characterization, entomological infestation status and chemical control activities. Results: This program was continuously implemented since 2005 with high community participation and adherence, incorporating 13 settlements and 502 households. During the surveillance phase, 4,193 domiciliary inspections were performed, and both the intra- and peri-domestic infestation rate were reduced from 17.9% to 0.2% (P < 0.01) and from 20.4% to 3%, respectively. Additionally, 399 households were structurally improved. Conclusion: The program is still ongoing and, after 14 years of implementation, has built social networks and collaboration between implementers and beneficiaries with a reduction of T. infestans infestation in the intra- and peri-domicile. This reduction, especially inside the household, has enabled access to diagnosis and treatment of the population, with minimal risk of re-infection. Author summary: Chagas disease (ChD) is caused by the parasite Trypanosoma cruzi, transmitted mainly through triatomine bugs of the Reduviidae family, genus Triatoma. These vectors are found in the Americas and T. infestans is the most common species in Southern Cone countries; closely tied to rural population that live in households with cracked walls and thatched roofs that serve as refuge for the bugs. Even though ChD can also be transmitted congenitally, through blood transfusions, or organ transplantation, among others, the main route of transmission is vectorial and programs for the prevention of this disease have traditionally focused on vector control through insecticide spraying. Argentina is the country with the greatest number ChD cases, and a national program of its control has been implemented since 1962, yet, due to a lack of sustainability, there are still 1.6 million infected individuals. Herein we describe a program that has been implemented since 2005 in rural areas from an endemic province of Argentina, Santiago del Estero, which worked together with the community, using an ecohealth approach, to monitor and control the vector and to improve the houses of the population to avoid the presence of the vector inside and prevent infection. The program achieved a reduction in triatomine infestation, especially in the domicile, therefore we hope it serves as an example to guide public health policy and enable diagnosis and treatment of ChD in endemic areas.
- Subjects
ARGENTINA; TICK infestations; TRYPANOSOMA cruzi; AEDES aegypti; HEALTH policy; PEDICULOSIS; NEGLECTED diseases; CHAGAS' disease; EXTERIOR walls; RURAL population
- Publication
PLoS Neglected Tropical Diseases, 2023, Vol 16, Issue 6, p1
- ISSN
1935-2727
- Publication type
Article
- DOI
10.1371/journal.pntd.0011410