Seroprevalence of Trypanosoma cruzi infection and vector control activities in rural communities of the southern Gran Chaco (Argentina)

Predictor Variables in the Spread of Chagas Disease in Rural Areas

Over a hundred years ago after the discovery of Chagas disease (CD) in Brazil, the World Health Organization estimates a number of 6 to 7 million people infected by Trypanosoma cruzi worldwide. Therefore, the goal of this work was to identify variables related to the spread of infection by T. cruzi in humans living in rural areas, seeking predictor variables. A systematic review of the literature has been conducted, with a search in the Scopus platform, using the search string "Chagas disease" and "rural", resulting in 85 valid and analyzed scientific studies (1977 and 2022). Twenty-seven predictor variables have been acquired, and 19 of them have been grouped, such as: socioeconomic and educational, housing, environmental, sanitary, and cultural; and 8 variables related to T. cruzi seropositive individuals. The predictor variables yielded significant results (p-value < 0.05) in 59.5% of the cases (195/328), with a median of 66.7%. In other words, studies relating to 50% of the 27 variables showed significance equal to or greater than 66.7% of the time. The independent variables with the highest proportion of significant data (p-value < 0.05) were Education (87.6%), Intradomicile building (70%), Domestic animals (69.6%), and Triatomines (69.2%) in the households. Some variables reached 100%; however, few articles were found, indicating the need for further research, especially for Sanitation and Culture. It has been concluded that, in the several contexts found, the social vulnerability and lack of information led the individual to living in environments where inhabitability is inadequate, to perform limited work activity and develop habits and behaviors which impair them in an environmental insalubrity situation, favorable to the access of vectors and pathogens of anthropozoonoses such as CD.

Chagas Disease: Seroprevalence and Associated Factors in Indigenous Communities of the Southern Limit of Argentine Chaco

Chagas disease is more prevalent in socially vulnerable communities in the Gran Chaco Eco-region. The study evaluated the seroprevalence of Chagas disease and associated factors between May 2014 and September 2015, in indigenous communities of Santa Fe, Argentina, in the southern Chaco. Lysate ELISA and indirect hemagglutination tests were used to detect antibodies against Trypanosoma cruzi, and recombinant ELISA was used in the case of disagreement. Household surveys were conducted with the head of household about risk factors for the disease. Serological tests were conducted on 298 people from three indigenous communities, 127 male and 171 female. Seroprevalence was 18.5%. A total of 64 surveys were conducted; 82.8% of the heads of household were male, with a median age of 39 years, and 61.0% had not completed primary school. In 35.9% of the households, there was at least one member of the cohabiting group infected with T. cruzi. The level of education of the head of household showed a statistically significant association with Chagas disease (OR = 3.43), among all the risk factors studied. The prevalence of infection is lower than that of other indigenous communities of the Gran Chaco, probably because environmental conditions are moderating and disfavoring the establishment of the insect vector in homes, but also because of socioeconomic differences with the rest of the eco-region. Beyond this, serological controls are needed to prevent vertical transmission.

Chagas disease in children from the Gran Chaco region: A bibliographic appraisal

In the Gran Chaco region, the Pan American Health Organization (PAHO) declared the interruption of vector transmission of Chagas Disease in Paraguay and some district of Argentina.After a bibliographic search, by using the words "Chagas, prevalence, children, Chaco", on scientiphic articles indexed in Pubmed and Lilacs during the 2010-2021 period, we found nine studies which dealt with entomological data seroprevalence surveys of Chagas Disease in Argentine children and three studies in Bolivian children.More field studies need to be published to better understand the epidemiological situation in children from the region. Due to its social and ecological characteristics, the Gran Chaco region remains a hotspot for Chagas Disease affecting disproportionally rural communities and certain vulnerable ethnics groups.

Triatominae of the semi-arid Chaco in central Argentina

The epidemiological scenario in central Argentinian Chaco region shows persistence of Triatoma infestans domestic populations in endemic areas, with control interventions historically affected by the economic instability of the region. Considering this situation, we aimed to (i) update the information regarding to the diversity of triatomines present in domestic, peridomestic and sylvatic environments in departments historically endemic of the Chaco region, (ii) to report the occurrence of secondary vectors of Chagas disease invading domestic environments and (iii) to discuss the possible sources of dispersal of these sylvatic species towards anthropic habitats. Between November 2017 and March 2020, we visited fourteen rural communities of northwest Córdoba province (central Argentina). Entomological data were collected through community vector surveillance in domiciles, active search in peridomiciles and the use of light and yeast traps in sylvatic environments. Seven Triatominae species were captured invading domiciles (T. guasayana, T. garciabesi, T. platensis, T. delpontei, T. breyeri, Panstrongylus guentheri and T. infestans). T. guasayana and T. garciabesi were the species with the highest number of captures. The 32% of the peridomiciles registered infestation with T. infestans (n ​= 355), mostly in chicken coops and goat pens. In sylvatic environments, T. garciabesi, T. guasayana, T. infestans and P. guentheri were collected. Only one adult specimen of T. infestans was positive for the presence of Trypanosoma cruzi. Our results suggest that the persistence of T. infestans populations in peridomiciles continues to be a serious challenge for control programs, whereas the finding of secondary vectors of Chagas disease actively invading domiciles emphasizes the need to implement new strategies for entomological surveillance.

Modelling the effect of density vegetation coverage and the occurrence of peridomestic infestation by Triatoma infestans in rural houses of northwest of Córdoba, Argentina

To better understand the dispersion strategies of Triatoma infestans (Klug) (Hemiptera: Reduviidae, Triatominae), we evaluated the spatial effect of infested peridomicile and density vegetation cover in a historically endemic area for Chagas disease. The study was conducted in rural houses of the northwest of Córdoba province, Argentine, during 2012-2013. Active search of triatomines were made in domicile and peridomicile habitats. To characterize vegetation coverage, a thematic map was obtained considering five types of vegetation cover (closed/open forest, closed/open shrubland and cultural land). From each house we extracted the area of vegetation coverage, housing density and infested peridomiciles density. We used generalized linear models to evaluate the effect of these variables on the occurrence of infested peridomicile. According to our results, the probability of a peridomicile to be infested increases by 1.34 (95%CI [0.98; 1.90]) times more when peridomicile structures are in environments with higher housing density and by 1.25 (95%CI [0.84; 1.88]) more times when houses are surrounded by open shrublands. Among the multiple ecological determinants of peridomestic infestation, the influence of vegetation cover has been poorly studied. In this study we discussed the effect of the vegetation as a potential modulator of the dispersion strategies of T. infestans.

Factors associated with the presence of triatomines in rural areas of south Argentine Chaco

INTRODUCTION

The domestic and peridomestic presence of Triatoma infestans depends on several factors, such as human behavior, vector behavior, ecology, and the environment.

METHODS

This work was conducted in 139 domiciliary units, where triatomines were captured and risk factors in domiciles and peridomicilies were recorded. Household dwellers were interviewed to obtain information about practices regarding this disease and entomological indicators were calculated.

RESULTS

Infestation indices were 59.7% for house compounds, 4.3% for domestic areas and 58.3% for the peridomestic areas. Intradomicile infestation was significantly associated with housing characteristics. The presence of chicken coops in peridomicilies was associated with an increased risk of infestation. Of the respondents, 80% did not recognize the importance of the peridomiciliary structures for triatomine control and had infested peridomicilies.

CONCLUSIONS

The results show the importance of peridomiciles as refuge sites for Triatominae bugs; however, household dwellers do not perceive peridomiciles as areas that favor the presence of vectors. Actions for raising awareness about factors that favor the presence of triatomines are needed to improve the conditions of peridomiciliary environments.

Cultural barriers to effective communication between Indigenous communities and health care providers in Northern Argentina: an anthropological contribution to Chagas disease prevention and control

Introduction

Ninety percent of the aboriginal communities of Argentina are located in areas of endemic vectorial transmission of Chagas disease. Control activities in these communities have not been effective. The goal of this research was to explore the role played by beliefs, habits, and practices of Pilaga and Wichi indigenous communities in their interaction with the local health system in the province of Formosa. This article contributes to the understanding of the cultural barriers that affect the communication process between indigenous peoples and their health care providers.

Methods

Twenty-nine open ended interviews were carried out with members of four indigenous communities (Pilaga and Wichi) located in central Formosa. These interviews were used to describe and compare these communities’ approach to health and disease as they pertain to Chagas as well as their perceptions of Western medicine and its incarnation in local health practice.

Results

Five key findings are presented: 1) members of these communities tend to see disease as caused by other people or by the person’s violation of taboos instead of as a biological process; 2) while the Pilaga are more inclined to accept Western medicine, the Wichi often favour the indigenous approach to health care over the Western approach; 3) members of these communities do not associate the vector with the transmission of the disease and they have little awareness of the need for vector control activities; 4) indigenous individuals who undergo diagnostic tests and accept treatment often do so without full information and knowledge; 5) the clinical encounter is rife with conflict between the expectations of health care providers and those of members of these communities.

Conclusion

Our analysis suggests that there is a need to consider the role of the cultural patterning of health and disease when developing interventions to prevent and control Chagas disease among indigenous communities in Northern Argentina. This is especially important when communicating with these communities about prevention and control. These research findings might also be of value to national and provincial agencies in charge of decreasing the rates of Chagas disease among indigenous populations.

A new endemic focus of Chagas disease in the northern region of Veraguas Province, Western Half Panama, Central America

BACKGROUND

Chagas disease was originally reported in Panama in 1931. Currently, the best knowledge of this zoonosis is restricted to studies done in historically endemic regions. However, little is known about the distribution and epidemiology of Chagas disease in other rural areas of the country.

METHODS AND FINDINGS

A cross-sectional descriptive study was carried out between May 2005 - July 2008 in four rural communities of the Santa Fe District, Veraguas Province. The study included an entomologic search to collect triatomines, bloodmeal type identification and infection rate with trypanosomes in collected vectors using a dot- blot and PCR analysis, genotyping of circulating Trypanosoma cruzi (mini-exon gene PCR analysis) and the detection of chagasic antibodies among inhabitants. The vector Rhodnius pallescens was more frequently found in La Culaca and El Pantano communities (788 specimens), where it was a sporadic household visitor. These triatomines presented darker coloration and larger sizescompared with typical specimens collected in Central Panama. Triatoma dimidiata was more common in Sabaneta de El Macho (162 specimens). In one small sub-region (El Macho), 60% of the houses were colonized by this vector. Of the examined R. pallescens, 54.7.0% (88/161) had fed on Didelphis marsupialis, and 24.6% (34/138) of T. dimidiata specimens collected inside houses were positive for human blood. R. pallescens presented an infection index with T. cruzi of 17.7% (24/136), with T. rangeli of 12.5% (17/136) and 50.7% (69/136) were mixed infections. In 117 T. dimidiata domestic specimens the infection index with T. cruzi was 21.4%. Lineage I of T. cruzi was confirmed circulating in these vectors. A T. cruzi infection seroprevalence of 2.3% (24/1,056) was found in this population.

CONCLUSIONS

This is the first report of Chagas disease endemicity in Santa Fe District, and it should be considered a neglected public health problem in this area of Panama.