Chagas disease in the Chaco

Laboratory and field studies for the control of Chagas disease vectors using the fungus Metarhizium anisopliae

Chagas disease is one of the most important insect-vectored diseases in Brazil. The entomopathogenic fungus Metarhizium anisopliae was evaluated against nymphs and adults of Panstrongylus megistus, Triatoma infestans, and T. sordida. Pathogenicity tests at saturated humidity demonstrated high susceptibility to fungal infection. The shortest estimates of 50% lethal time (LT₅₀ ) for P. megistus varied from 4.6 (isolate E9) to 4.8 days (genetically modified strain 157p). For T. infestans, the shortest LT₅₀ was 6.3 (E9) and 7.3 days (157p). For T. sordida, the shortest LT₅₀ was 8.0 days (157p). The lethal concentration sufficient to kill 50% of T. infestans (LC₅₀ ) was 1.9 × 10⁷ conidia/ml for strain 157p. In three chicken coops that were sprayed with M. anisopliae, nymphs especially were well controlled, with a great population reduction of 38.5% after 17 days. Therefore M. anisopliae performed well, controlling Triatominae in both laboratory and field studies.

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.