Invasion speeds of Triatoma dimidiata, vector of Chagas disease: An application of orthogonal polynomials method

Insights from quantitative and mathematical modelling on the proposed WHO 2030 goals for Chagas disease

Chagas disease (CD) persists as one of the neglected tropical diseases (NTDs) with a particularly large impact in the Americas. The World Health Organization (WHO) recently proposed goals for CD elimination as a public health problem to be reached by 2030 by means of achieving intradomiciliary transmission interruption (IDTI), blood transfusion and transplant transmission interruption, diagnostic and treatment scaling-up and prevention and control of congenital transmission. The NTD Modelling Consortium has developed mathematical models to study Trypanosoma cruzi transmission dynamics and the potential impact of control measures. Modelling insights have shown that IDTI is feasible in areas with sustained vector control programmes and no presence of native triatomine vector populations. However, IDTI in areas with native vectors it is not feasible in a sustainable manner. Combining vector control with trypanocidal treatment can reduce the timeframes necessary to reach operational thresholds for IDTI (<2% seroprevalence in children aged <5 years), but the most informative age groups for serological monitoring are yet to be identified. Measuring progress towards the 2030 goals will require availability of vector surveillance and seroprevalence data at a fine scale, and a more active surveillance system, as well as a better understanding of the risks of vector re-colonization and disease resurgence after vector control cessation. Also, achieving scaling-up in terms of access to treatment to the expected levels (75%) will require a substantial increase in screening asymptomatic populations, which is anticipated to become very costly as CD prevalence decreases. Further modelling work includes refining and extending mathematical models (including transmission dynamics and statistical frameworks) to predict transmission at a sub-national scale, and developing quantitative tools to inform IDTI certification, post-certification and re-certification protocols. Potential perverse incentives associated with operational thresholds are discussed. These modelling insights aim to inform discussions on the goals and treatment guidelines for CD.

Modeling the Spatial Spread of Chagas Disease

The aim of this work is to understand the spatial spread of Chagas disease, which is primarily transmitted by triatomines. We propose a mathematical model using a system of partial differential reaction-diffusion equations to study and describe the spread of this disease in the human population. We consider the respective subclasses of infected and uninfected individuals within the human and triatomine populations. The dynamics of the infected human subpopulation considers two disease phases: acute and chronic. The human population is considered to be homogeneously distributed across a space to describe the local propagation of Chagas disease by triatomines during a short epidemic period. We determine the basic reproduction number that allows us to assess Chagas disease control measures, and we determine the speed of disease propagation by using traveling wave solutions for our model.