Effectiveness of Large-Scale Chagas Disease Vector Control Program in Nicaragua by Residual Insecticide Spraying Against Triatoma dimidiata.

Chagas disease is one of the most serious health problems in Latin America. Because the disease is transmitted mainly by triatomine vectors, a three-phase vector control strategy was used to reduce its vector-borne transmission. In Nicaragua, we implemented an indoor insecticide spraying program in five northern departments to reduce house infestation by Triatoma dimidiata. The spraying program was performed in two rounds. After each round, we conducted entomological evaluation to compare the vector infestation level before and after spraying. A total of 66,200 and 44,683 houses were sprayed in the first and second spraying rounds, respectively. The entomological evaluation showed that the proportion of houses infested by T. dimidiata was reduced from 17.0% to 3.0% after the first spraying, which was statistically significant (P < 0.0001). However, the second spraying round did not demonstrate clear effectiveness. Space-time analysis revealed that reinfestation of T. dimidiata is more likely to occur in clusters where the pre-spray infestation level is high. Here we discuss how large-scale insecticide spraying is neither effective nor affordable when T. dimidiata is widely distributed at low infestation levels. Further challenges involve research on T. dimidiata reinfestation, diversification of vector control strategies, and implementation of sustainable vector surveillance.

Chagas disease: assessing the existence of a threshold for bug infestation rate.

To examine the existence of a possible threshold for the domestic infestation rate of Triatoma dimidiata, below which transmission becomes unlikely, a census was conducted in 59 Chagas disease endemic communities of El Salvador and Honduras. Entomological and serological tests were conducted targeting 4,083 households and 6,324 children between 6 months and 15 years of age. The overall domestic infestation rate of Triatoma dimidiata and seroprevalence among children were 12.9% and 0.49%, respectively. Communities with a domestic infestation rate at 8% or less consistently showed a seroprevalence of 0%. In communities with a domestic infestation rate above 8%, there was a wide range in seroprevalence. A domestic infestation rate of 8% could serve as the possible threshold below which transmission would become unlikely. The implementation of an 8% threshold for determining needs for universal insecticide spraying would lead to a 21% reduction in spraying-related costs.

Epidemiology of Chagas disease in Guatemala: infection rate of Triatoma dimidiata, Triatoma nitida and Rhodnius prolixus (Hemiptera, Reduviidae) with Trypanosoma cruzi and Trypanosoma rangeli (Kinetoplastida, Trypanosomatidae).

A five-year domiciliary collection in the 22 departments of Guatemala showed that out of 4,128 triatomines collected, 1,675 were Triatoma dimidiata (Latreille, 1811), 2,344 were Rhodnius prolixus Stal 1859, and only 109 were T. nitida Usinger 1939. The Chagas disease parasite, Trypanosoma cruzi, was found in all three species. Their natural infection rates were similar in the first two species (20.6%; 19.1%) and slightly lower in T. nitida(13.8%). However there was no significant difference in the infection rates in the three species (p = 0.131). T. dimidiata males have higher infection rates than females (p = 0.030), whereas for R. prolixus there is no difference in infection rates between males and females (p = 0.114). The sex ratios for all three species were significantly skewed. More males than females were found inside houses for T. dimidiata (p < 0.0001) and T. nitida (p = 0.011); a different pattern was seen for R. prolixus (p = 0.037) where more females were found. Sex ratio is proposed as an index to show the mobility of T. dimidiata in different populations. T. dimidiata is widely distributed in the country, and is also the main vector in at least ten departments, but R. prolixus with higher vectorial capacity is an important vector in at least two departments.

Geographic distribution and morphometric differentiation of Triatoma nitida usinger 1939 (Hemiptera: Reduviidae: Triatominae) in Guatemala.

Triatoma nitida was found in 14 (0.4%) out of 3,726 houses located in six departments across Guatemala, which were surveyed from 1994 to 1998 by the man-hour collection method. Compared to previous information, the distribution of T. nitida in Guatemala has increased from five to nine departments; the species is present in mild climates at altitudes from 960 to 1,500 m. Fourteen percent of the intradomestic T. nitida were infected with Trypanosoma cruzi. The species was often found in conjunction with other triatomines (T. dimidiata and Rhodnius prolixus). The domestic and peridomestic presence of T. nitida in Guatemala was rare, but occasionally this species was colonizing human-made constructions. T. nitida appears to have a low importance as Chagas disease vector in Guatemala, as indicated by its scarce presence in the domestic habitats and defecation patterns. However, it clearly has potential to become a Chagas vector so we recommend an on-going study of the intradomestic presence of T. nitida following the control programs in Guatemala. Morphometric analysis of 47 T. nitida males from three localities showed quantitative differences between the populations, which indicates that geographic distance is an important factor in the structuring of T. nitida populations.

Epidemiology of Chagas disease in Guatemala: infection rate of Triatoma dimidiata, Triatoma nitida and Rhodnius prolixus (Hemiptera, Reduviidae) with Trypanosoma cruzi and Trypanosoma rangeli (Kinetoplastida, Trypanosomatidae)

A five-year domiciliary collection in the 22 departments of Guatemala showed that out of 4,128 triatomines collected, 1,675 were Triatoma dimidiata (Latreille, 1811), 2,344 were Rhodnius prolixus Stal 1859, and only 109 were T. nitida Usinger 1939. The Chagas disease parasite, Trypanosoma cruzi, was found in all three species. Their natural infection rates were similar in the first two species (20.6 percent; 19.1 percent) and slightly lower in T. nitida(13.8 percent). However there was no significant difference in the infection rates in the three species (p = 0.131). T. dimidiata males have higher infection rates than females (p = 0.030), whereas for R. prolixus there is no difference in infection rates between males and females (p = 0.114). The sex ratios for all three species were significantly skewed. More males than females were found inside houses for T. dimidiata (p < 0.0001) and T. nitida (p = 0.011); a different pattern was seen for R. prolixus (p = 0.037) where more females were found. Sex ratio is proposed as an index to show the mobility of T. dimidiata in different populations. T. dimidiata is widely distributed in the country, and is also the main vector in at least ten departments, but R. prolixus with higher vectorial capacity is an important vector in at least two departments

Geographic distribution and morphometric differentiation of Triatoma nitida usinger 1939 (Hemiptera: Reduviidae: Triatominae) in Guatemala

Triatoma nitida was found in 14 (0.4 percent) out of 3,726 houses located in six departments across Guatemala, which were surveyed from 1994 to 1998 by the man-hour collection method. Compared to previous information, the distribution of T. nitida in Guatemala has increased from five to nine departments; the species is present in mild climates at altitudes from 960 to 1,500 m. Fourteen percent of the intradomestic T. nitida were infected with Trypanosoma cruzi. The species was often found in conjunction with other triatomines (T. dimidiata and Rhodnius prolixus). The domestic and peridomestic presence of T. nitida in Guatemala was rare, but occasionally this species was colonizing human-made constructions. T. nitida appears to have a low importance as Chagas disease vector in Guatemala, as indicated by its scarce presence in the domestic habitats and defecation patterns. However, it clearly has potential to become a Chagas vector so we recommend an on-going study of the intradomestic presence of T. nitida following the control programs in Guatemala. Morphometric analysis of 47 T. nitida males from three localities showed quantitative differences between the populations, which indicates that geographic distance is an important factor in the structuring of T. nitida populations