Abstract
Human-k triatomine insects’ interaction is a milestone in Chagas Disease (CD) prevention and control. We studied and compared ethnoecology and cultural knowledge and experiences about triatomines and Chagas of two urban social groups, and of health technicians of the vector control program in Merida city, southeastern Mexico. We conducted semi-structure interviews: 24 participants living in very low marginalization index (VLMi) and 26 of very high marginalization index (VHMi) areas in Merida, and 15 health workers. Questions focused on ethno-ecology and health-related knowledge of blood-sucking insects, and experiences on triatomine bites and CD, same than treatment and diagnosis of both bites and the disease. A thematic content-analysis and descriptive statistics were followed. Triatomines were considered a health danger due to the perception of them as poisonous and causing infection. Participants of VLMi were more knowledgeable about CD compared to VHMi participants, but they had limited understanding of the overall to chronicity when compared to health technicians. VHMi showed a more elaborate ethno-ecological knowledge about triatomines and had more exposition to them. Across participants, a biased understanding about CD has been recorded, since it was given emphasis only on acute phase aspects but not on chronic symptomatology. Cultural knowledge about CD remains rather theoretical since it keeps a very unfamiliar disease due to the lack of individual and collectively shared experiences on therapeutic itineraries and illness. There is an urgent need to focus on CD also as a chronic disease by giving more visibility to its prevalence, more advances in diagnostic and treatment, a proper medical care need, as well as illness experiences, and its human impact.
Highlights
Chagas disease (CD), which is caused by the protozoan Trypanosoma cruzi, is the most expanded parasitic infection worldwide and causes more than 7,000 deaths annually, mostly in Latin American, according to conservative estimation of international health organizations (PAHO, 2006)
With more than two million of inhabitants, it is considered a socioeconomic and spatial polarized urban setting.Urban marginalization, an index elaborated based on statistic census data of wealth, access to health and education services, and dwelling’s physical conditions showed a concentration of population with very high marginalization index (VHMi) at the south of the city; on the contrary, a very low marginalization index (VLMi) is found at the north of the city (LÓPEZ-SANTILLAR et al 2014; INEGI 2010)
Study design and findings offer an innovative for an interdisciplinary dialogue and interchange of ethnoscience with health public and medical anthropology disciplines to contribute for a more integral understanding of the multidimensional of Chagas disease
Summary
Chagas disease (CD), which is caused by the protozoan Trypanosoma cruzi, is the most expanded parasitic infection worldwide and causes more than 7,000 deaths annually, mostly in Latin American, according to conservative estimation of international health organizations (PAHO, 2006). While neglect within official health systems in endemic countries, it is widely known its sub-report of both prevalence of individuals infected with T. cruzi and individuals in the chronic phase. While human infection with T. cruzi has traditionally being associated with rural areas, due to human migration to cities and urban growth concomitant with environmental perturbation, CD has become an urban phenomenon in the last decades in endemic Latin Americn. A more rapid transformation of natural habitats or enclaves of triatomines and their host mammals, passive transportation of the vector to the domestic in urban contexts, and extension of rural practices that promotes infestation to cities are eco-social process in the urbanization of the problematic
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