Abstract
The Pan American Health Organization (PAHO) has defined Chagas Disease hotspots in Central America associated with the vector Triatoma spp. Triatoma dimidiata is a native vector adapted to multiple environments, including intra-domestic and peri-domestic habitats. 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. Activities performed in the field as part of the project included aspects of vector surveillance and control, improvement of houses, diagnosis and treatment of individuals, health promotion, training of human resources and identification of access barriers to diagnosis and treatment. As a base line study, eleven villages, comprised of 1,572 households, were entomologically evaluated (83.4% overall participation); five were found to have very high infestation rates (>20%), three had high infestation rates (8-20%) and three had low-infestation rates (<8%), coinciding with the category of infestation-risk of the houses within each village. Serological tests were carried out in 812 people (>80% participation) in two of the 11 villages and none of the 128 children tested, less than 5 years of age, were positive for Trypanosoma cruzi infection. Community participation in all the activities was high (>70%). The collaboration between several subnational, national, and international institutions, each with specific roles, promoted community participation in the activities of vector control and patient care, thus, establishing a baseline to continue implementing and monitoring project progress.
Highlights
Chagas disease is the leading cause of death associated with heart disease in Latin America [1], with more than 8 million people at risk [2]
An inter-institutional agreement was signed between different public and private organizations. As part of this agreement, a project was elaborated with the objective of contributing to the elimination of Chagas disease as a public health problem in the geographical area of greatest transmission in Guatemala through the development of tools and methodologies that can be used in Central America to control transmission; under the name “Alliances for the elimination of Chagas in Central America”
This association, of national and international institutions, allowed complementary actions based on the experience and specialization of each organization, that addressed most of the aspects which contribute to the presence of the disease in the region: personvector-environment-habits-behavior, in a comprehensive approach for the elimination of Chagas disease as a public health problem
Summary
Chagas disease is the leading cause of death associated with heart disease in Latin America [1], with more than 8 million people at risk [2]. During the 20th century, an accidental circumstance led to the introduction of an important allochthonous species in the region, originally from the north of South America, Rhodnius prolixus [3] This introduction increased the number of cases, due to the better vector competence and domiciliation of this species, until its control / elimination during the first decades of the 21st century [4]. At the XVI Meeting of the IPCAM, the space shared by Guatemala and El Salvador was defined as a high-risk area "hotspot" which should be prioritized and addressed to achieve control of Chagas disease in the region [5] Based on this scenario, an inter-institutional agreement was signed between different public and private organizations. 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
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