Gürtler Ricardo E, Yadon Zaida E
Laboratory of Eco-Epidemiology, Department of Ecology, Genetics and Evolution, Universidad de Buenos Aires-IEGEBA (CONICET-UBA), Buenos Aires, Argentina
Communicable Diseases Department, Pan American Health Organization, Washington, D.C., USA.
Trans R Soc Trop Med Hyg. 2015 Feb;109(2):91-8. doi: 10.1093/trstmh/tru203.
This article provides an overview of three research projects which designed and implemented innovative interventions for Chagas disease vector control in Bolivia, Guatemala and Mexico. The research initiative was based on sound principles of community-based ecosystem management (ecohealth), integrated vector management, and interdisciplinary analysis. The initial situational analysis achieved a better understanding of ecological, biological and social determinants of domestic infestation. The key factors identified included: housing quality; type of peridomestic habitats; presence and abundance of domestic dogs, chickens and synanthropic rodents; proximity to public lights; location in the periphery of the village. In Bolivia, plastering of mud walls with appropriate local materials and regular cleaning of beds and of clothes next to the walls, substantially decreased domestic infestation and abundance of the insect vector Triatoma infestans. The Guatemalan project revealed close links between house infestation by rodents and Triatoma dimidiata, and vector infection with Trypanosoma cruzi. A novel community-operated rodent control program significantly reduced rodent infestation and bug infection. In Mexico, large-scale implementation of window screens translated into promising reductions in domestic infestation. A multi-pronged approach including community mobilisation and empowerment, intersectoral cooperation and adhesion to integrated vector management principles may be the key to sustainable vector and disease control in the affected regions.
本文概述了三个研究项目，这些项目为玻利维亚、危地马拉和墨西哥的恰加斯病病媒控制设计并实施了创新干预措施。该研究倡议基于社区生态系统管理（生态健康）、病媒综合管理和跨学科分析的合理原则。初步的情况分析使人们对家庭感染的生态、生物和社会决定因素有了更好的理解。确定的关键因素包括：房屋质量；住宅周边栖息地类型；家犬、鸡和共生啮齿动物的存在和数量；与公共照明的距离；在村庄周边的位置。在玻利维亚，用合适的当地材料涂抹土墙，并定期清洁床边和墙边的衣物，大幅减少了家庭感染以及昆虫病媒克氏锥蝽的数量。危地马拉的项目揭示了啮齿动物对房屋的感染与二斑锥蝽以及病媒感染克氏锥虫之间的密切联系。一项由社区运营的新型啮齿动物控制计划显著减少了啮齿动物的感染和臭虫感染。在墨西哥，大规模安装纱窗有望减少家庭感染。包括社区动员与赋权、部门间合作以及坚持病媒综合管理原则在内的多管齐下方法，可能是受影响地区实现病媒和疾病可持续控制的关键。
