Reinfestation with Triatoma infestans despite vigilance efforts in the municipality of Saipina, Santa Cruz, Bolivia: Situational description two months after fumigation

Abstract

Chagas disease is still a major public health problem in Bolivia mostly due to the recurrent reinfestation of houses by Triatoma infestans. The current study evaluated the danger of reinfesting bugs by determining their infection rate, the genetic group (discrete typing unit, DTU) of Trypanosoma cruzi that infect them, and the possible association of recurrent infestation with environmental variables. In the municipality of Saipina, 254 km from Santa Cruz de la Sierra, 57 dwellings with reinfestation background and the latest fumigation 1 or 2 months before were actively searched for triatomines. The infection of the bugs and the DTUs of T. cruzi were determined with PCR methods. Microenvironmental variables were estimated surfaces of the different ground covers around each dwelling. Principal component analysis (PCA) and logistic regression were applied to the data set. Among the houses visited, 54.4% were still infested with T. infestans, and 201 T. infestans were captured, 56% indoors and 43.8% outdoors. The infection rate with T. cruzi was 24%. The TcII/TcV/TcVI group of DTUs was 80%, while TcI and TcIII/TcIV had equal values of 10%. No significant differences of DTU distribution were found between nymphs and adults, females and males, nor between intradomicile and peridomicile areas. PCA identified urban and nonurban dwellings: the former was associated with intradomicile reinfestation by nymphs. From the logistic regression analyses, the intradomicile reinfestation tended to be associated with the peridomicile around dwellings. In contrast, peridomicile infestation was more associated with sylvatic areas. Interestingly, the presence of fields (pasture, crops) around the dwelling might have a protective role regarding reinfestation. The results show that vector control actions fail, and the inhabitants of the municipality of Saipina continue to be exposed to T. cruzi transmission risk.