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A history of chagas disease transmission, control, and re-emergence in peri-rural La Joya, Peru.

Abstract：

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.

journal_name

PLoS Negl Trop Dis

journal_title

PLoS neglected tropical diseases

authors

Delgado S,Castillo Neyra R,Quispe Machaca VR,Ancca Juárez J,Chou Chu L,Verastegui MR,Moscoso Apaza GM,Bocángel CD,Tustin AW,Sterling CR,Comrie AC,Náquira C,Cornejo del Carpio JG,Gilman RH,Bern C,Levy MZ

doi

10.1371/journal.pntd.0000970

subject

Has Abstract

pub_date

2011-02-22 00:00:00

pages

e970

issue

eissn

1935-2727

issn

1935-2735

journal_volume

pub_type

历史文章,杂志文章

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A history of chagas disease transmission, control, and re-emergence in peri-rural La Joya, Peru.