Abstract
BackgroundNon-domiciliated (intrusive) triatomine vectors remain a challenge for the sustainability of Chagas disease vector control as these triatomines are able to transiently (re-)infest houses. One of the best-characterized examples is Triatoma dimidiata from the Yucatan peninsula, Mexico, where adult insects seasonally infest houses between March and July.MethodsWe focused our study on three rural villages in the state of Yucatan, Mexico, in which we performed a situation analysis as a first step before the implementation of an ecohealth (ecosystem approach to health) vector control intervention.ResultsThe identification of the key determinants affecting the transient invasion of human dwellings by T. dimidiata was performed by exploring associations between bug presence and qualitative and quantitative variables describing the ecological, biological and social context of the communities. We then used a participatory action research approach for implementation and evaluation of a control strategy based on window insect screens to reduce house infestation by T. dimidiata.ConclusionsThis ecohealth approach may represent a valuable alternative to vertically-organized insecticide spraying. Further evaluation may confirm that it is sustainable and provides effective control (in the sense of limiting infestation of human dwellings and vector/human contacts) of intrusive triatomines in the region.
Highlights
Chagas disease is a major cause of morbidity and mortality in the Americas, with an estimated 9–10 million people currently infected, causing an annual burden of 806 170 disability-adjusted life years (DALYs) and an annual health care cost of US$627.46 million.[1,2] In Mexico, the Ministry of Health reports a few hundred cases every year,[3] but estimates suggest that there may currently be up to 6 million people infected.[4]
One of the best-characterized examples is Triatoma dimidiata from the Yucatan peninsula, Mexico, where we have shown that adult T. dimidiata transiently infest houses on a seasonal basis during the months of March to July.[27,28,29]
We review studies aimed at identifying the major eco-bio-social determinants contributing to house infestation by intrusive T. dimidiata, and the implementation process of an integrated ecohealth intervention tailored to control Chagas disease vectors in Yucatan, Mexico
Summary
Chagas disease is a major cause of morbidity and mortality in the Americas, with an estimated 9–10 million people currently infected, causing an annual burden of 806 170 disability-adjusted life years (DALYs) and an annual health care cost of US$627.46 million.[1,2] In Mexico, the Ministry of Health reports a few hundred cases every year,[3] but estimates suggest that there may currently be up to 6 million people infected.[4]. The difficulties associated with the sustainability of this strategy, together with the emergence of insecticide resistance[11] and recognition of the increased role of intrusive triatomines in parasite transmission to humans, are making long-term vector control challenging.[12,13] There is a strong need for better and integrated tools for the control of Chagas disease, as proposed by the One Health[14,15,16] or the ecohealth (ecosystem approach to health)[17,18,19] approaches. One of the bestcharacterized examples is Triatoma dimidiata from the Yucatan peninsula, Mexico, where adult insects seasonally infest houses between March and July
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