A History of Chagas Disease Transmission, Control, and Re-Emergence in Peri-Rural La Joya, Peru
نویسندگان
چکیده
BACKGROUND The history of Chagas disease control in Peru and many other nations is marked by scattered and poorly documented vector control campaigns. The complexities of human migration and sporadic control campaigns complicate evaluation of the burden of Chagas disease and dynamics of Trypanosoma cruzi transmission. METHODOLOGY/PRINCIPAL FINDINGS We conducted a cross-sectional serological and entomological study to evaluate temporal and spatial patterns of T. cruzi transmission in a peri-rural region of La Joya, Peru. We use a multivariate catalytic model and Bayesian methods to estimate incidence of infection over time and thereby elucidate the complex history of transmission in the area. Of 1,333 study participants, 101 (7.6%; 95% CI: 6.2-9.0%) were confirmed T. cruzi seropositive. Spatial clustering of parasitic infection was found in vector insects, but not in human cases. Expanded catalytic models suggest that transmission was interrupted in the study area in 1996 (95% credible interval: 1991-2000), with a resultant decline in the average annual incidence of infection from 0.9% (95% credible interval: 0.6-1.3%) to 0.1% (95% credible interval: 0.005-0.3%). Through a search of archival newspaper reports, we uncovered documentation of a 1995 vector control campaign, and thereby independently validated the model estimates. CONCLUSIONS/SIGNIFICANCE High levels of T. cruzi transmission had been ongoing in peri-rural La Joya prior to interruption of parasite transmission through a little-documented vector control campaign in 1995. Despite the efficacy of the 1995 control campaign, T. cruzi was rapidly reemerging in vector populations in La Joya, emphasizing the need for continuing surveillance and control at the rural-urban interface.
منابع مشابه
Chagas Disease, Migration and Community Settlement Patterns in Arequipa, Peru
BACKGROUND Chagas disease is one of the most important neglected tropical diseases in the Americas. Vectorborne transmission of Chagas disease has been historically rare in urban settings. However, in marginal communities near the city of Arequipa, Peru, urban transmission cycles have become established. We examined the history of migration and settlement patterns in these communities, and thei...
متن کاملCommunity Based Epidemiological Study of Chagas Disease in Rural Peru
COMMUNITY BASED EPIDEMIOLOGICAL STUDY OF CHAGAS DISEASE IN RURAL PERU. Paul C. Walker, Robert H. Gilman, and Michael Z. Levy. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. (Sponsored by Michele Barry, Department of Medicine, Yale University School of Medicine, New Haven, CT.) The purpose of this study was to evaluate the epidemiology of Tryp...
متن کاملAndean subregional Chagas disease area and the Andean initiative of Chagas disease.
The Andean subregional Chagas disease area and the Andean initiative of Chagas disease consist of the association of Peru, Ecuador, Colombia, and Venezuela with their own and particular characteristics: 1. extensive area distributed in a broad latitude; 2. important echo-biological diversity; 3. biogeographically variables due to diverse altitude and latitude; 4. different epidemiological situa...
متن کاملChagas disease transmission in periurban communities of Arequipa, Peru.
BACKGROUND Chagas disease, caused by Trypanosoma cruzi infection, is an urban problem in Arequipa, Peru, and the epidemiology of Chagas disease is likely to be quite different in this area, compared with in rural zones. METHODS We conducted a serosurvey of 1615 children <18 years old in periurban districts that included hillside shantytowns and slightly more affluent low-lying communities. In...
متن کامل[Chagas disease in the Americas: an ecohealth perspective].
The historical processes involved in Chagas disease transmission relate to the patterns and conditions of human settlements, especially in rural areas, due to proximity to forest areas, where both vectors and Trypanosoma cruzi can occur, combined with precarious housing conditions and underlying poverty. However, seasonal and permanent rural-urban migration has played a major role in re-mobiliz...
متن کامل