Infestation of rural houses by Triatoma infestans (Hemiptera: Reduviidae) in southern area of Gran Chaco in Argentina

Seroprevalence of the Strongyloides stercoralis Infection in Humans from Yungas Rainforest and Gran Chaco Region from Argentina and Bolivia

The threadworm, Strongyloides stercoralis, is endemic in tropical and subtropical areas. Data on the prevalence and distribution of infection with this parasite species is scarce in many critical regions. We conducted a seroprevalence study of S. stercoralis infection in 13 locations in the Gran Chaco and Yungas regions of Argentina and Bolivia during the period 2010-2016. A total of 2803 human serum samples were analyzed by ELISA-NIE which has a sensitivity of 75% and specificity of 95%. Results showed that 551 (19.6%) of those samples were positive. The adjusted prevalence was 20.9%, (95% confidence interval (CI) 19.4%-22.4%). The distribution of cases was similar between females and males with an increase of prevalence with age. The prevalence in the different locations ranged from 7.75% in Pampa del Indio to 44.55% in Santa Victoria Este in the triple border between Argentina, Bolivia, and Paraguay in the Chaco region. Our results show that S. stercoralis is highly prevalent in the Chaco and Yungas regions, which should prompt prospective surveys to confirm our findings and the design and deployment of control measures.

Beating the odds: Sustained Chagas disease vector control in remote indigenous communities of the Argentine Chaco over a seven-year period

BACKGROUND

Rapid reinfestation of insecticide-treated dwellings hamper the sustained elimination of Triatoma infestans, the main vector of Chagas disease in the Gran Chaco region. We conducted a seven-year longitudinal study including community-wide spraying with pyrethroid insecticides combined with periodic vector surveillance to investigate the house reinfestation process in connection with baseline pyrethroid resistance, housing quality and household mobility in a rural section of Pampa del Indio mainly inhabited by deprived indigenous people (Qom).

METHODOLOGY/PRINCIPAL FINDINGS

Despite evidence of moderate pyrethroid resistance in local T. infestans populations, house infestation dropped from 31.9% at baseline to 0.7% at 10 months post-spraying (MPS), with no triatomine found at 59 and 78 MPS. Household-based surveillance corroborated the rare occurrence of T. infestans and the house invasion of other four triatomine species. The annual rates of loss of initially occupied houses and of household mobility were high (4.6-8.0%). Housing improvements did not translate into a significant reduction of mud-walled houses and refuges for triatomines because most households kept the former dwelling or built new ones with mud walls.

CONCLUSIONS/SIGNIFICANCE

Our results refute the assumption that vector control actions performed in marginalized communities of the Gran Chaco are doomed to fail. The larger-than-expected impacts of the intervention program were likely associated with the combined effects of high-coverage, professional insecticide spraying followed by systematic vector surveillance-and-response, broad geographic coverage creating a buffer zone, frequent housing replacement and residential mobility. The dynamical interactions among housing quality, mobility and insecticide-based control largely affect the chances of vector elimination.

Morphometric Wings Similarity among Sylvatic and Domestic Populations of Triatoma infestans (Hemiptera: Reduviidae) from the Gran Chaco Region of Paraguay

Despite sustained efforts for eliminating Triatoma infestans, reinfestation still persists in large part of the endemic area of Chagas disease from the Gran Chaco region. Sylvatic T. infestans populations seem to threat success of control programs of domestic T. infestans. In this study, we analyze whether T. infestans collected after a community-wide spraying were survivors or were immigrants from elsewhere using geometric morphometric tools. We used 101 right wings of female T. infestans captured before and after intervention program carried out in 12 de Junio and Casuarina, villages from Paraguayan Chaco, and in Puerto Casado during presprayed collection. There were no significant differences in wing size of domestic T. infestans between pre- and postspraying populations, and between domestic and sylvatic ones. When shape variables originating from postintervention individuals from 12 de Junio were introduced one by one into a discriminant analysis, the greatest weight (53%) was allocated to the sylvatic group. Furthermore, from the prespraying population, 25% were reallocated as postintervention individuals. Only 11% of the insects were reassigned to other groups Puerto Casado and Casuarina. These results suggest that postspraying individuals appear to have different origins. Half of the postspraying individuals from 12 de Junio were similar to the sylvatic ones and 25% of these were similar to those captured in the prespraying period. This remarkable morphometric wings similarity between sylvatic and domestic populations is new evidence suggesting that they could be highly related to each other in the Paraguayan Chaco; human-fed bugs from sylvatic area also support this.

Spatial and temporal distribution of house infestation by Triatoma infestans in the Toro Toro municipality, Potosi, Bolivia

BACKGROUND

Triatoma infestans is the main vector of Trypanosoma cruzi in Bolivia. The species is present both in domestic and peridomestic structures of rural areas, and in wild ecotopes of the Andean valleys and the Great Chaco. The identification of areas persistently showing low and high house infestation by the vector is important for the management of vector control programs. This study aimed at analyzing the temporal and spatial distribution of house infestation by T. infestans in the Toro Toro municipality (Potosi, Bolivia) between 2009 and 2014, and its association with environmental variables.

METHODS

House infestation and T. infestans density were calculated from entomological surveys of houses in the study area, using a fixed-time effort sampling technique. The spatial heterogeneity of house infestation was evaluated using the SatScan statistic. Association between house infestation with Bioclim variables (Worldclim database) and altitude was analyzed using a generalized linear model (GLM) with a logit link. Model selection was based on the Akaike information criteria after eliminating collinearity between variables using the variable inflation factor. The final model was used to create a probability map of house infestation for the Toro Toro municipality.

RESULTS

A total of 73 communities and 16,489 house evaluation events were analyzed. Presence of T. infestans was recorded on 480 house evaluation events, giving an overall annual infestation of 2.9% during the studied period (range 1.5-5.4% in 2009 and 2012). Vector density remained at about 1.25 insects/ house. Infestation was highly aggregated in five clusters, including 11 communities. Relative risk of infestation within these clusters was 1.7-3.9 times the value for the regional average. Four environmental variables were identified as good descriptors of house infestation, explaining 57% of house infestation variability. The model allowed the estimation of a house infestation surface for the Toro Toro municipality.

CONCLUSION

This study shows that residual and persistent populations of T. infestans maintain low house infestation, representing a potential risk for the transmission of T. cruzi in these communities, and it is possible to stratify house infestation using EV, and produce a risk map to guide the activities of vector control interventions in the municipality of Toro Toro (Potosi, Bolivia).

Residual infestation and recolonization during urban Triatoma infestans Bug Control Campaign, Peru

Chagas disease vector control campaigns are being conducted in Latin America, but little is known about medium-term or long-term effectiveness of these efforts, especially in urban areas. After analyzing entomologic data for 56,491 households during the treatment phase of a Triatoma infestans bug control campaign in Arequipa, Peru, during 2003-2011, we estimated that 97.1% of residual infestations are attributable to untreated households. Multivariate models for the surveillance phase of the campaign obtained during 2009-2012 confirm that nonparticipation in the initial treatment phase is a major risk factor (odds ratio [OR] 21.5, 95% CI 3.35-138). Infestation during surveillance also increased over time (OR 1.55, 95% CI 1.15-2.09 per year). In addition, we observed a negative interaction between nonparticipation and time (OR 0.73, 95% CI 0.53-0.99), suggesting that recolonization by vectors progressively dilutes risk associated with nonparticipation. Although the treatment phase was effective, recolonization in untreated households threatens the long-term success of vector control.

Deltamethrin toxicological profile of peridomestic Triatoma sordida in the North of Minas Gerais, Brazil

Background

In general, there was a large reduction in the occurrence of cases of Chagas disease in the last decades in Brazil. However, despite all of these efforts, there have been various reports of persistent reinfestations of T. sordida in a large part of the state of Minas Gerais, for reasons still little investigated. Thus, this purpose of this study was to characterize the deltamethrin susceptibility profile of peridomestic T. sordida populations from North of Minas Gerais – Brazil.

Methods

Susceptibility to deltamethrin was assessed in seventeen peridomestic populations of T. sordida from North region of Minas Gerais, Brazil. Serial dilutions of deltamethrin in acetone (0.2 μL) were topically applied in first instar nymphs (F1, five days old, fasting, weight 1.2 ± 0.2 mg). Dose response results were analyzed with POLO program, determining the lethal doses, slope and resistance ratios (RR).

Results

Susceptibility profile characterization of T. sordida populations revealed resistance ratios (RR₅₀) ranging from 2.50 to 7.08.

Conclusions

In fact, we know very little about the real impact of the resistance ratios obtained in the laboratory bioassays on the effectiveness of the vector control activities in the field. Thus, we prefer to refer to the populations with RR > 5 as populations with altered susceptibility. For these populations, the realization of laboratory and field trials, simultaneous and complementary, permitting the evaluation of both, is recommended.

Where do these bugs come from? Phenotypic structure of Triatoma infestans populations after control interventions in the Argentine Chaco

House re-invasion by native triatomines after insecticide-based control campaigns represents a major threat for Chagas disease vector control. We conducted a longitudinal intervention study in a rural section (Area III, 407 houses) of Pampa del Indio, northeastern Argentina, and used wing geometric morphometry to compare pre-spray and post-spray (re-infestant bugs) Triatoma infestans populations. The community-wide spraying with pyrethroids reduced the prevalence of house infestation by T. infestans from 31.9% to < 1% during a four-year follow-up, unlike our previous studies in the neighbouring Area I. Two groups of bug collection sites differing in wing shape variables before interventions (including 221 adults from 11 domiciles) were used as a reference for assigning 44 post-spray adults. Wing shape variables from post-spray, high-density bug colonies and pre-spray groups were significantly different, suggesting that re-infestant insects had an external origin. Insects from one house differed strongly in wing shape variables from all other specimens. A further comparison between insects from both areas supported the existence of independent re-infestation processes within the same district. These results point to local heterogeneities in house re-infestation dynamics and emphasise the need to expand the geographic coverage of vector surveillance and control operations to the affected region.

Is imidacloprid an effective alternative for controlling pyrethroid-resistant populations of Triatoma infestans (Hemiptera: Reduviidae) in the Gran Chaco ecoregion?

The prevention of Chagas disease is based primarily on the chemical control of Triatoma infestans (Klug) using pyrethroid insecticides. However, high resistance levels, correlated with control failures, have been detected in Argentina and Bolivia. A previous study at our laboratory found that imidacloprid could serve as an alternative to pyrethroid insecticides. We studied the delayed toxicity of imidacloprid and the influence of the blood feeding condition of the insect on the toxicity of this insecticide; we also studied the effectiveness of various commercial imidacloprid formulations against a pyrethroid-resistant T. infestans population from the Gran Chaco ecoregion. Variations in the toxic effects of imidacloprid were not observed up to 72 h after exposure and were not found to depend on the blood feeding condition of susceptible and resistant individuals. Of the three different studied formulations of imidacloprid on glass and filter paper, only the spot-on formulation was effective. This formulation was applied to pigeons at doses of 1, 5, 20 and 40 mg/bird. The nymphs that fed on pigeons treated with 20 mg or 40 mg of the formulation showed a higher mortality rate than the control group one day and seven days post-treatment (p < 0.01). A spot-on formulation of imidacloprid was effective against pyrethroid-resistant T. infestans populations at the laboratory level.

A country bug in the city: urban infestation by the Chagas disease vector Triatoma infestans in Arequipa, Peru

BACKGROUND

Interruption of vector-borne transmission of Trypanosoma cruzi remains an unrealized objective in many Latin American countries. The task of vector control is complicated by the emergence of vector insects in urban areas.

METHODS

Utilizing data from a large-scale vector control program in Arequipa, Peru, we explored the spatial patterns of infestation by Triatoma infestans in an urban and peri-urban landscape. Multilevel logistic regression was utilized to assess the associations between household infestation and household- and locality-level socio-environmental measures.

RESULTS

Of 37,229 households inspected for infestation, 6,982 (18.8%; 95% CI: 18.4 - 19.2%) were infested by T. infestans. Eighty clusters of infestation were identified, ranging in area from 0.1 to 68.7 hectares and containing as few as one and as many as 1,139 infested households. Spatial dependence between infested households was significant at distances up to 2,000 meters. Household T. infestans infestation was associated with household- and locality-level factors, including housing density, elevation, land surface temperature, and locality type.

CONCLUSIONS

High levels of T. infestans infestation, characterized by spatial heterogeneity, were found across extensive urban and peri-urban areas prior to vector control. Several environmental and social factors, which may directly or indirectly influence the biology and behavior of T. infestans, were associated with infestation. Spatial clustering of infestation in the urban context may both challenge and inform surveillance and control of vector reemergence after insecticide intervention.

Intensified surveillance and insecticide-based control of the Chagas disease vector Triatoma infestans in the Argentinean Chaco

BACKGROUND

The elimination of Triatoma infestans, the main Chagas disease vector in the Gran Chaco region, remains elusive. We implemented an intensified control strategy based on full-coverage pyrethroid spraying, followed by frequent vector surveillance and immediate selective insecticide treatment of detected foci in a well-defined rural area in northeastern Argentina with moderate pyrethroid resistance. We assessed long-term impacts, and identified factors and procedures affecting spray effectiveness.

METHODS AND FINDINGS

After initial control interventions, timed-manual searches were performed by skilled personnel in 4,053 sites of 353-411 houses inspected every 4-7 months over a 35-month period. Residual insecticide spraying was less effective than expected throughout the three-year period, mainly because of the occurrence of moderate pyrethroid resistance and the limited effectiveness of selective treatment of infested sites only. After initial interventions, peridomestic infestation prevalence always exceeded domestic infestation, and timed-manual searches consistently outperformed householders' bug detection, except in domiciles. Most of the infestations occurred in houses infested at baseline, and were restricted to four main ecotopes. Houses with an early persistent infestation were spatially aggregated up to a distance of 2.5 km. An Akaike-based multi-model inference approach showed that new site-level infestations increased substantially with the local availability of appropriate refugia for triatomine bugs, and with proximity to the nearest site found infested at one or two preceding surveys.

CONCLUSIONS AND SIGNIFICANCE

Current vector control procedures have limited effectiveness in the Gran Chaco. Selective insecticide sprays must include all sites within the infested house compound. The suppression of T. infestans in rural areas with moderate pyrethroid resistance requires increased efforts and appropriate management actions. In addition to careful, systematic insecticide applications, housing improvement and development policies that improve material conditions of rural villagers and reduce habitat suitability for bugs will contribute substantially to sustainable vector and disease control in the Gran Chaco.

Factors affecting infestation by Triatoma infestans in a rural area of the humid Chaco in Argentina: a multi-model inference approach

Background

Transmission of Trypanosoma cruzi by Triatoma infestans remains a major public health problem in the Gran Chaco ecoregion, where understanding of the determinants of house infestation is limited. We conducted a cross-sectional study to model factors affecting bug presence and abundance at sites within house compounds in a well-defined rural area in the humid Argentine Chaco.

Methodology/Principal Findings

Triatoma infestans bugs were found in 45.9% of 327 inhabited house compounds but only in 7.4% of the 2,584 sites inspected systematically on these compounds, even though the last insecticide spraying campaign was conducted 12 years before. Infested sites were significantly aggregated at distances of 0.8–2.5 km. The most frequently infested ecotopes were domiciles, kitchens, storerooms, chicken coops and nests; corrals were rarely infested. Domiciles with mud walls and roofs of thatch or corrugated tarred cardboard were more often infested (32.2%) than domiciles with brick-and-cement walls and corrugated metal-sheet roofs (15.1%). A multi-model inference approach using Akaike's information criterion was applied to assess the relative importance of each variable by running all possible (17,406) models resulting from all combinations of variables. Availability of refuges for bugs, construction with tarred cardboard, and host abundance (humans, dogs, cats, and poultry) per site were positively associated with infestation and abundance, whereas reported insecticide use showed a negative association. Ethnic background (Creole or Toba) adjusted for other factors showed little or no association.

Conclusions/Significance

Promotion and effective implementation of housing improvement (including key peridomestic structures) combined with appropriate insecticide use and host management practices are needed to eliminate infestations. Fewer refuges are likely to result in fewer residual foci after insecticide spraying, and will facilitate community-based vector surveillance. A more integrated perspective that considers simultaneously social, economic and biological processes at local and regional scales is needed to attain effective, sustainable vector and disease control.

Vector-borne transmission of Chagas disease remains a major public health problem in parts of Latin America. Triatoma infestans is the main vector in the countries located in the South American Cone, particularly in the Gran Chaco ecoregion where residual insecticide control has achieved only a moderate, irregular impact. To contribute to improved control strategies, we analyzed the factors associated with the presence and abundance of T. infestans in 327 inhabited houses in a well-defined rural area with no recent vector control interventions in the humid Argentine Chaco. Bugs were found mainly in domiciles, kitchens, storerooms, and chicken coops and nests, particularly where adequate refuge and animal hosts (humans, dogs, cats or poultry) were available. Domiciles constructed from mud were the most often infested, but brick-and-cement domiciles, even in good conditions, were also found infested. Availability of refuge and hosts for T. infestans are key targets for vector control. Ten-fold variations in domestic infestation observed across neighboring villages, and differences in the relevant factors for T. infestans presence with respect to other areas of the Gran Chaco region suggest that host management, building techniques and insecticide use need to be tailored to the local environment, socio-economic characteristics, and climatic conditions.

Community participation in Chagas disease vector surveillance: systematic review

BACKGROUND

Vector control has substantially reduced Chagas disease (ChD) incidence. However, transmission by household-reinfesting triatomines persists, suggesting that entomological surveillance should play a crucial role in the long-term interruption of transmission. Yet, infestation foci become smaller and harder to detect as vector control proceeds, and highly sensitive surveillance methods are needed. Community participation (CP) and vector-detection devices (VDDs) are both thought to enhance surveillance, but this remains to be thoroughly assessed.

METHODOLOGY/PRINCIPAL FINDINGS

We searched Medline, Web of Knowledge, Scopus, LILACS, SciELO, the bibliographies of retrieved studies, and our own records. Data from studies describing vector control and/or surveillance interventions were extracted by two reviewers. Outcomes of primary interest included changes in infestation rates and the detection of infestation/reinfestation foci. Most results likely depended on study- and site-specific conditions, precluding meta-analysis, but we re-analysed data from studies comparing vector control and detection methods whenever possible. Results confirm that professional, insecticide-based vector control is highly effective, but also show that reinfestation by native triatomines is common and widespread across Latin America. Bug notification by householders (the simplest CP-based strategy) significantly boosts vector detection probabilities; in comparison, both active searches and VDDs perform poorly, although they might in some cases complement each other.

CONCLUSIONS/SIGNIFICANCE

CP should become a strategic component of ChD surveillance, but only professional insecticide spraying seems consistently effective at eliminating infestation foci. Involvement of stakeholders at all process stages, from planning to evaluation, would probably enhance such CP-based strategies.

Phenotypic variability and population structure of peridomestic Triatoma infestans in rural areas of the arid Chaco (Western Argentina): spatial influence of macro- and microhabitats

Triatoma infestans, one of the main vectors of Trypanosoma cruzi, is strongly associated with rural human ecotopes. Infested peridomestic places could act as a source of house infestation as a result of the movement of vectors among habitats. The quantitative study of phenotypic traits and nutritional variables could be informative about the population structure and the relative mobility of vectors. This is the first approach toward analyzing the phenetic characteristics of T. infestans and the relationship with their potential role to invade and colonize other habitats in the arid Chaco region. This article compares the phenotypic structure of T. infestans populations living in chicken coops and goat corrals, analyzing the geometric morphometry of wings and heads, antennal phenotypes, and the nutritional status of 257 adults and nymphs. The study area remained untreated with insecticides during the 15 years before the present study. The insects collected in peridomestic structures located in two zones 80 km apart exhibited significant differences in their morphotypes, suggesting an environmental effect and/or the absence of individual exchange between zones. The population structure was clear in T. infestans from goat corrals and chicken coops in one zone and less pronounced in the other. These results suggest the existence of a different rate of individual exchange among ecotopes within each zone. Morphometric variables of heads and wings were significantly correlated in insects collected in goat corrals but not in chicken coops, suggesting a habitat effect and supporting the hypothesis of different canalization forces that affect the two organs. The nutritional status of adults indicated a low dispersal probability with zonal differences. This article provides the first combined morphometric analysis of the head of adults and fifth instar nymphs in triatomines and the first combined analysis of head and wing in T. infestans.

Experimental evaluation of insecticidal paints against Triatoma infestans (Hemiptera: Reduviidae), under natural climatic conditions

Background

Triatoma infestans is the main vector of Chagas disease in the Gran Chaco region of South America. The traditional spraying technique used for the application of pyrethroid insecticides has shown low efficiency in the elimination of the vector species populations occupying peridomestic structures of rural houses in the endemic area of Argentina. As part of studies looking for better alternatives, we evaluated the residual effect of insecticidal paints on the mortality of fourth instar nymphs of T. infestans.

Results

The study was based on an experimental design that included two groups treated with an organophosphate (Inesfly 5A IGR™) and a pyrethroid (Inesfly 5A IGR NG™) formulations of the paint, that were applied on wood, cement blocks and adobe bricks under natural climatic conditions. A third group was an untreated control. Both paint formulations showed very long residual activity, producing mortality of 84% and 98% (pyrethroid and organophosphate formulations, respectively) after 12 months of the paint application. After eight months, nymphs exposed during 6 hours to the painted surfaces with the pyrethroid and organophosphate formulations showed 81.33% and 100% mortality, respectively.

Conclusion

The organophosphate- and pyrethroid-based insecticidal paints showed a very long residual activity on the mortality of fourth instar nymphs of T infestans, compared with the traditional spraying technique used for the application of pyrethroid insecticides in peridomestic structures of rural houses in the endemic region for Chagas disease in the Gran Chaco of Argentina. The application of the paints by trained personnel of the vector control programmes could be considered as an alternative control tool in areas where the traditional methods have failed or showed low efficacy.

Sustainability of vector control strategies in the Gran Chaco Region: current challenges and possible approaches

Sustainability has become a focal point of the international agenda. At the heart of its range of distribution in the Gran Chaco Region, the elimination of Triatoma infestans has failed, even in areas subject to intensive professional vector control efforts. Chagas disease control programs traditionally have been composed of two divorced entities: a vector control program in charge of routine field operations (bug detection and insecticide spraying) and a disease control program in charge of screening blood donors, diagnosis, etiologic treatment and providing medical care to chronic patients. The challenge of sustainable suppression of bug infestation and Trypanosoma cruzi transmission can be met through integrated disease management, in which vector control is combined with active case detection and treatment to increase impact, cost-effectiveness and public acceptance in resource-limited settings. Multi-stakeholder involvement may add sustainability and resilience to the surveillance system. Chagas vector control and disease management must remain a regional effort within the frame of sustainable development rather than being viewed exclusively as a matter of health pertinent to the health sector. Sustained and continuous coordination between governments, agencies, control programs, academia and the affected communities is critical.