Abstract
BackgroundInterruption of vector-borne transmission of Trypanosoma cruzi remains an unrealized objective in many Latin American countries. The task of vector control is complicated by the emergence of vector insects in urban areas.MethodsUtilizing data from a large-scale vector control program in Arequipa, Peru, we explored the spatial patterns of infestation by Triatoma infestans in an urban and peri-urban landscape. Multilevel logistic regression was utilized to assess the associations between household infestation and household- and locality-level socio-environmental measures.ResultsOf 37,229 households inspected for infestation, 6,982 (18.8%; 95% CI: 18.4 – 19.2%) were infested by T. infestans. Eighty clusters of infestation were identified, ranging in area from 0.1 to 68.7 hectares and containing as few as one and as many as 1,139 infested households. Spatial dependence between infested households was significant at distances up to 2,000 meters. Household T. infestans infestation was associated with household- and locality-level factors, including housing density, elevation, land surface temperature, and locality type.ConclusionsHigh levels of T. infestans infestation, characterized by spatial heterogeneity, were found across extensive urban and peri-urban areas prior to vector control. Several environmental and social factors, which may directly or indirectly influence the biology and behavior of T. infestans, were associated with infestation. Spatial clustering of infestation in the urban context may both challenge and inform surveillance and control of vector reemergence after insecticide intervention.
Highlights
Interruption of vector-borne transmission of Trypanosoma cruzi remains an unrealized objective in many Latin American countries
While the Southern Cone Initiative has succeeded in interrupting T. cruzi transmission by T. infestans in Brazil, Chile, and Uruguay [6,7], T. infestans-mediated T. cruzi transmission persists in parts of Argentina, Bolivia, Paraguay, and Peru [8,9]
To advance understanding of vector infestation in the urban context, this study examines infestation by T. infestans across an urban and peri-urban landscape prior to implementation of vector control
Summary
Interruption of vector-borne transmission of Trypanosoma cruzi remains an unrealized objective in many Latin American countries. Infection may result from congenital transmission, blood transfusion, organ transplantation, and Prevention and control of Chagas disease are achieved primarily via large-scale insecticide application initiatives [5], and T. infestans, which lives predominantly in and around human households, is a principal target for vector control [2]. The effects of housing density, land surface temperature, and elevation were evaluated at the household level, while the effects of urban shantytowns, which have been identified as areas at higher risk for infestation by Chagas diesease vectors and vector-borne transmission of T. cruzi, were evaluated at the locality level [11,13,14,15]
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