Quinde-Calderón Leonardo, Rios-Quituizaca Paulina, Solorzano Luis, Dumonteil Eric
Programa Nacional de Chagas, Leishmaniasis y Oncocercosis, Ministerio de Salud Pública, Guayaquil, Ecuador.
Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador.
Trop Med Int Health. 2016 Jan;21(1):84-92. doi: 10.1111/tmi.12620. Epub 2015 Nov 9.
To describe the current situation of Chagas disease in Ecuador and to evaluate the impact of vector control for the period 2004-2014.
Since 2004, the Ministry of Public Health has formalized activities for the surveillance and control of Chagas disease and we analyzed here available records.
More than 200 000 houses were surveyed, and 2.6% were found to be infested (95% CI: 2.6-2.7), and more than 51 000 houses were sprayed with residual insecticide, with important yearly variations. A total of 915 cases of T. cruzi infection were registered. The Amazon region is emerging as a high priority area, where nearly half of T. cruzi infection cases originate. The costal region and the southern highland valleys remain important high-risk area. Vector control efforts over the past 10 years have been effective in the coastal region, where T. dimidiata predominates, and resulted in important reductions in house infestation indices in many areas, even reaching negligible levels in some parishes.
Vector efforts need to be sustained and expanded for the elimination of T. dimidiata to be feasible. Novel vector control interventions need to be designed to reduce intrusion by several triatomine species present in the Amazon region and southern Ecuador. Strong political commitment is needed to sustain current achievements and improve the national coverage of these programmes.
描述厄瓜多尔恰加斯病的现状，并评估2004 - 2014年病媒控制的影响。
自2004年以来，公共卫生部已将恰加斯病监测和控制活动正式化，我们在此分析了现有记录。
调查了超过20万所房屋，发现2.6%的房屋有虫媒感染（95%置信区间：2.6 - 2.7），超过5.1万所房屋喷洒了残留杀虫剂，每年有显著变化。共登记了915例克氏锥虫感染病例。亚马逊地区正成为一个高度优先区域，近一半的克氏锥虫感染病例起源于此。沿海地区和南部高地山谷仍然是重要的高风险区域。过去10年的病媒控制工作在以二斑锥猎蝽为主的沿海地区取得了成效，导致许多地区房屋感染指数大幅下降，甚至在一些教区降至可忽略不计的水平。
为使消除二斑锥猎蝽可行，病媒控制工作需要持续并扩大。需要设计新的病媒控制干预措施，以减少亚马逊地区和厄瓜多尔南部存在的几种锥蝽属物种的侵入。需要坚定的政治承诺来维持当前的成果并提高这些项目在全国的覆盖范围。
