Abstract
In Guatemala, the Ministry of Health (MoH) began a vector control project with Japanese cooperation in 2000 to reduce the risk of Chagas disease infection. Rhodnius prolixus is one of the principal vectors and is targeted for elimination. The control method consisted of extensive residual insecticide spraying campaigns, followed by community-based surveillance with selective respraying. Interventions in nine endemic departments identified 317 villages with R. prolixus of 4,417 villages surveyed. Two cycles of residual insecticide spraying covered over 98% of the houses in the identified villages. Fourteen villages reinfestated were all resprayed. Between 2000-2003 and 2008, the number of infested villages decreased from 317 to two and the house infestation rate reduced from 0.86% to 0.0036%. Seroprevalence rates in 2004-2005, when compared with an earlier study in 1998, showed a significant decline from 5.3% to 1.3% among schoolchildren in endemic areas. The total operational cost was US$ 921,815, where the cost ratio between preparatory, attack and surveillance phases was approximately 2:12:1. In 2008, Guatemala was certified for interruption of Chagas disease transmission by R. prolixus. What facilitated the process was existing knowledge in vector control and notable commitment by the MoH, as well as political, managerial and technical support by external stakeholders.
Highlights
A century has passed since Carlos Chagas first described the disease caused by the protozoan, Trypanosoma cruzi, in 1909
Financial support: Ministry of Health (MoH) Guatemala, Japan International Cooperation Agency (JICA), PAHO, USAC, University of Guatemala (UVG), Médecins Sans frontières (MSF) Spain, European Commission Latin America Triatomine Research Network (ECLAT) KH current address: Chagas Disease Control Central America, JICA, Tegucigalpa, Honduras JN current address: Malaria, other Vector-borne and Parasitic Diseases, WHO/Western Pacific Region, Manila, Philippines EG current address: Chronic Disease Prevention and Control, PAHO/WHO Mexico, Mexico + Corresponding author: hashimok@gmail.com Received 16 February 2012 Accepted 19 July 2012 In Central America, 1.8 million people were estimated to be infected by Chagas disease in 2000 (WHO 2000)
In addition to the 301 villages identified with R. prolixus in the baseline survey, a further 16 villages were reported infested by the villagers
Summary
A century has passed since Carlos Chagas first described the disease caused by the protozoan, Trypanosoma cruzi, in 1909. The paper describes the vector control interventions against R. prolixus from 2000-2008 and its impact on T. cruzi seroprevalence on children in endemic areas for Chagas disease in Guatemala. Intervention against R. prolixus - The National Chagas Disease Control Programme of the Guatemalan MoH implemented the vector control interventions through three phases: preparatory, attack and surveillance.
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