Abstract
Rhodnius prolixus is one of the main vectors of Trypanosoma cruzi, causative agent of Chagas disease. In Central America, it was first discovered in 1915 in El Salvador, from where it spread northwest to Guatemala and Mexico, and southeast to Nicaragua and Costa Rica, arriving also in Honduras in the late 1950s. Indoor residual spraying (IRS) by the antimalaria services of Costa Rica prevented its spread southwards, and similar IRS programmes appear to have eliminated it from El Salvador by the late 1970s. In 1997, by resolution of the Ministers of Health of the seven Central American countries, a multinational initiative against Chagas disease (IPCA) was launched with one of the specific objectives being the elimination of R. prolixus from the region. As a result, more and more infested areas were encountered, and progressively sprayed using an IRS strategy already deployed against Triatoma infestans in the southern cone countries of South America. In 2008, Guatemala became the first of these countries to be formally certified as free of Chagas disease transmission due to R. prolixus. The other infested countries have since been similarly certified, and none of these has reported the presence of R. prolixus since June 2010. Further surveillance is required, but current evidence suggests that R. prolixus may now been eliminated from throughout the mesoamerican region, with a corresponding decline in the incidence of T. cruzi infections.
Highlights
By August 2011, all the previously endemic countries of Central America had been formally certified as free of Chagas disease transmission due to their main domestic vector, Rhodnius prolixus
This review summarises the background and progress of the multinational initiative against Chagas disease transmission carried out in the Central American countries
In 1971 for example, in a single house in Francisco Morazán, three brothers simultaneously presented with acute infections and all eight family members proved to be serologically positive for T. cruzi; at that time over 600 R. prolixus were collected from their house, with similar numbers from neighbouring houses where 50% of the inhabitants showed positive serology for Chagas disease [26]
Summary
By August 2011, all the previously endemic countries of Central America had been formally certified as free of Chagas disease transmission due to their main domestic vector, Rhodnius prolixus. None of these countries, nor Mexico, has reported the presence of this vector since June 2010, suggesting that R. prolixus may have been completely eliminated from the mesoamerican region. Nor Mexico, has reported the presence of this vector since June 2010, suggesting that R. prolixus may have been completely eliminated from the mesoamerican region This is not to say that Chagas disease itself has been eliminated, since there is a residue of previously infected cases, but there is active transmission in some areas due to other vector species - especially Triatoma dimidiata. In mapping the historical distribution of R. prolixus (Figure 1) the location of some areas or villages was only approximate - some recent documents offer exact coordinates of infested villages, but most publications prior to the mid-1990s identified localities only by administrative departments or municipalities and for these, geographically centric points were selected
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