María C. Cecere

The role of the peridomiciliary area in the elimination of Triatoma infestans from rural Argentine communities.

The purpose of this study was to identify the origin of Triatoma infestans reinfestation and study its dynamics following spraying with deltamethrin inside and around 94 houses in three rural communities in northwestern Argentina. The effectiveness of the spraying was evaluated immediately after the houses were sprayed and two months later. In addition, five residual peridomiciliary foci were found and sprayed, as well as three preexisting ones that had not been sprayed. To monitor reinfestation, biosensors were placed in the houses and each family was also asked to capture triatomines and keep them in plastic bags; in addition, triatomines were searched for in and around houses, using an aerosol that dislodged them from their hiding places. Selective sprayings were carried out only where a colony of T. infestans was found. During the 30 months of follow-up, the percentage of houses in which any T. infestans were captured varied between 3% and 9%. In six houses, T. infestans were captured during more than one evaluation. The number of peridomiciliary areas found to be infested (19) was double the number of infested houses (9). Colonies of T. infestans were found only in the peridomiciliary areas, where the number of T. infestans captured was six times higher than in the houses. Chickens were the host most frequently associated with peridomiciliary foci. This area was the origin and principal source of reinfestation. To reduce the speed of reinfestation and the frequency with which sprayings are needed, the following environmental and chemical control methods must be combined in the peridomiciliary area: reduce the number of hiding places of triatomines; restrict the raising of birds to structures that cannot be colonized by triatomines; apply an insecticide that is less likely to be degraded by exposure to the elements, or perform a second spraying 6 to 12 months after the first; and employ a device for early detection of the presence of T. infestans around houses.

Reinfestation Sources for Chagas Disease Vector, Triatoma infestans, Argentina

Treating all communities within 1,500 m of a target community may reduce reinfestation risk.

Chagas disease in north-west Argentina: risk of domestic reinfestation by Triatoma infestans after a single community-wide application of deltamethrin

The risk of domestic reinfestation by Triatoma infestans after a single community-wide application of delta-methrin (2.5% suspension concentrate at 25 mg active ingredient/m2) was studied in Amamá, north-west Argentina, where no insecticide spraying had been done by official control services. The percentage of infested houses fell from 88% before spraying in 1985 to nil during the 6 months after spraying, and thereafter increased from 5% in 1986 to 96% before a second treatment in 1992, fitting closely to a logistic model (r2 = 0.997). Significant risk factors associated with domestic reinfestation determined from stepwise logistic regression and one-factor analysis were the density of T. infestans in bedrooms just before spraying and the surface structure of indoor walls. Peak densities of bugs in 1988-1989 significantly differed between levels of both risk factors. Our study suggests the existence of stable determinants of infestation linked to the household which, in the absence of effective control measures, would also determine the speed of house recolonization and the ensuing bug densities. Plastering of mud walls before application of insecticides to all domestic and peridomestic structures is supported by the study.

Chagas disease in north-west Argentina: infected dogs as a risk factor for the domestic transmission of Trypanosoma cruzi

The association between household seroreactivity to Trypanosoma cruzi in dogs and children and T. cruzi infection rates in domestic Triatoma infestans was investigated in 1988-1989 in the rural community of Amamá, north-west Argentina, where house spraying with residual pyrethroids was carried out in 1985. Three years after spraying, a greater reduction of the average T. cruzi prevalence rate in dogs (from 83% to 40%) than in children (from 48% to 30%) was accompanied by a substantial decrease in vector infection rates from 51%-63% to 21%. At a household level, in homes with or without seroreactive children, the percentage of infected T. infestans was 4.5-4.7 times higher when seroreactive dogs were present (27.1%-34.8%) than when they were not (5.8%-7.7%; stratified relative risk [RR] = 4.58). The contribution of seroreactive children to bug infection rates was not significant (RR = 1.29). The combined effect of both seroreactive dogs and seroreactive children fitted equally well with additive or multiplicative transmission models. Bug infection rates showed an increasing trend with the number of seroreactive dogs and an inverse association with the age of the youngest seroreactive dog. Our study supports the hypothesis of a causal association between the presence and number of infected dogs and increased levels of T. cruzi transmission to domestic T. infestans.

Trypanosoma cruzi infection in Triatoma infestans and other triatomines: long-term effects of a control program in rural northwestern Argentina

The prevalence of Trypanosoma cruzi infection in Triatoma infestans, Triatoma guasayana, and Triatoma sordida was evaluated in Amamá and other neighboring rural villages in northwestern Argentina for five years after massive spraying with deltamethrin in 1992 and selective sprays thereafter. Local residents and expert staff collected triatomines in domiciliary and peridomestic sites. During 1993-1997, the prevalence of T. cruzi was 2.4% in 664 T. infestans, 0.7% in 268 T. guasayana, and 0.2% in 832 T. sordida. T. cruzi infection was more frequently detected in adult bugs and in triatomines collected at domiciliary sites. The infected T. guasayana and T. sordida were nymphs and adults, respectively, captured at peridomestic sites. The prevalence of T. cruzi infection in T. infestans decreased from 7.7% to 1.5% during the surveillance period, although that change was not statistically significant. Comparison of T. infestans infection rates before the control program and during surveillance showed a highly significant decrease from 49% to 4.6% in bedrooms, as well as a fall from 6% to 1.8% in peridomestic sites. Because of its infection with T. cruzi and frequent invasion of domiciliary areas and attacks on humans and dogs, T. guasayana appeared implicated as a putative secondary vector of T. cruzi in domestic and peridomestic sites during the surveillance period. T. sordida was the most abundant species, but it was strongly associated with chickens and showed little tendency to invade bedrooms.

Chagas disease in north-west Argentina: association between Trypanosoma cruzi parasitaemia in dogs and cats and infection rates in domestic Triatoma infestans

The association between Trypanosoma cruzi parasitaemia in dogs and cats and Tryp. cruzi infection rates in domestic Triatoma infestans was studied in a cross-sectional survey of 31 houses (89%) in the rural villages of Trinidad and Mercedes, north-west Argentina, where no spraying of insecticides had ever been done. Similar prevalence rates of parasitaemia, determined by xenodiagnosis, were recorded among 68 dogs (41.2%) and 28 cats (39.3%). Bug infection rates were significantly associated with the presence of infected cats (those with positive xenodiagnosis) stratified by the number of infected dogs (relative risk = RR = 1.90; 95% confidence interval = CI = 1.51-2.38), and with the number of infected dogs stratified by the presence of infected cats (RR = 2.71; CI = 1.81-4.07). The percentage of infected bugs in houses with and without children stratified by the presence of infected dogs or cats was not significantly different (RR = 0.69; CI = 0.45-1.05). The combined effect of infected dogs and infected cats on bug infection rates fitted closely with an additive transmission model. Bug infection rates were significantly higher when infected dogs shared the sleeping areas of people than when they did not (RR = 1.79; CI = 1.1-2.91). Our study showed that infected dogs and infected cats increase the risk of domestic transmission of Tryp. cruzi to T. infestans.

Effects of chickens on the prevalence of infestation and population density of Triatoma infestans in rural houses of north-west Argentina.

Abstract Effects of the presence of chickens on population density of the bug Triatoma infestans, principal vector of Chagas disease, were investigated by standardized sampling (indoors and peridomestically) from sixty‐eight houses of three rural communities in north‐west Argentina, during March 1992.

Spatiotemporal Patterns of Reinfestation by Triatoma guasayana (Hemiptera: Reduviidae) in a Rural Community of Northwestern Argentina

Abstract Triatoma guasayana (Wygodzinsky & Abalos) is a secondary vector of Trypanosoma cruzi (Chagas), the etiologic agent of Chagas disease, in the Chaco region of Argentina, Bolivia, and Paraguay. The spatial distribution of T. guasayana in a rural community in northwestern Argentina is described and analyzed using very high spatial resolution satellite imagery, geographic information systems, and spatial statistics. Since a 1992 residual spraying with insecticides of all houses, site-specific domestic and peridomestic reinfestations by triatomine bugs were monitored using various methods semiannually from 1993 to 2002. The reinfestation by T. guasayana started with finding of only adult bugs in a few sites. Bug abundance was significantly clustered and predominantly peridomestic in the southern and northern extremes of the community. The identified source of reinfestation in the northern cluster was a colonized wood pile, whereas no potential peridomestic source was found for the southern cluster. The spatial distribution of T. guasayana was positively associated with the abundance and spatial distribution of goats. Active dispersal from the hypothesized source and the surrounding sylvatic environment, and passive transport of bugs in wood piles seems to be the most likely mechanisms underlying the observed spatial pattern of T. guasayana. The absence of domestic colonization indicates that, to date, there is no trend toward increased local domiciliation of T. guasayana. The clustering zones can be considered “hot spots” where bug invasion from other sources is expected to be higher and where eventually, introduction of sylvatic T. cruzi to suitable hosts may occur.

Domestic Animal Hosts Strongly Influence Human-Feeding Rates of the Chagas Disease Vector Triatoma infestans in Argentina

Background The host species composition in a household and their relative availability affect the host-feeding choices of blood-sucking insects and parasite transmission risks. We investigated four hypotheses regarding factors that affect blood-feeding rates, proportion of human-fed bugs (human blood index), and daily human-feeding rates of Triatoma infestans, the main vector of Chagas disease. Methods A cross-sectional survey collected triatomines in human sleeping quarters (domiciles) of 49 of 270 rural houses in northwestern Argentina. We developed an improved way of estimating the human-feeding rate of domestic T. infestans populations. We fitted generalized linear mixed-effects models to a global model with six explanatory variables (chicken blood index, dog blood index, bug stage, numbers of human residents, bug abundance, and maximum temperature during the night preceding bug catch) and three response variables (daily blood-feeding rate, human blood index, and daily human-feeding rate). Coefficients were estimated via multimodel inference with model averaging. Findings Median blood-feeding intervals per late-stage bug were 4.1 days, with large variations among households. The main bloodmeal sources were humans (68%), chickens (22%), and dogs (9%). Blood-feeding rates decreased with increases in the chicken blood index. Both the human blood index and daily human-feeding rate decreased substantially with increasing proportions of chicken- or dog-fed bugs, or the presence of chickens indoors. Improved calculations estimated the mean daily human-feeding rate per late-stage bug at 0.231 (95% confidence interval, 0.157–0.305). Conclusions and Significance Based on the changing availability of chickens in domiciles during spring-summer and the much larger infectivity of dogs compared with humans, we infer that the net effects of chickens in the presence of transmission-competent hosts may be more adequately described by zoopotentiation than by zooprophylaxis. Domestic animals in domiciles profoundly affect the host-feeding choices, human-vector contact rates and parasite transmission predicted by a model based on these estimates.

Spatial re-establishment dynamics of local populations of vectors of Chagas disease.

Background Prevention of Chagas disease depends mainly on control of the insect vectors that transmit infection. Unfortunately, the vectors have been resurgent in some areas. It is important to understand the dynamics of reinfestation where it occurs. Here we show how continuous- and discrete-time models fitted to patch-level infestation states can elucidate different aspects of re-establishment. Triatoma infestans, the main vector of Chagas disease, reinfested sites in three villages in northwest Argentina after community-wide insecticide spraying in October 1992. Methodology/Principal Findings Different methods of estimating the probabilities of bug establishment on each site were compared. The results confirmed previous results showing a 6-month time lag between detection of a new infestation and dispersal events. The analysis showed that more new bug populations become established from May to November than from November to May. This seasonal increase in bug establishment coincides with a seasonal increase in dispersal distance. In the fitted models, the probability of new bug establishment increases with increasing time since last detected infestation. Conclusions/Significance These effects of season and previous infestation on bug establishment challenge our current understanding of T. infestans ecology and highlight important gaps in knowledge. Experiments necessary to close these gaps are discussed.