Laboratory of Applied Entomology and Parasitology, Faculty of Chemical Sciences and Pharmacy, University of San Carlos of Guatemala, Guatemala City, Guatemala.
Laboratory of Applied Entomology and Parasitology, Faculty of Chemical Sciences and Pharmacy, University of San Carlos of Guatemala, Guatemala City, Guatemala.
Acta Trop. 2022 Nov;235:106655. doi: 10.1016/j.actatropica.2022.106655. Epub 2022 Aug 14.
Triatoma dimidiata is the main vector of Chagas disease in southern Mexico, Central America and northern South America. As a native vector, it moves readily among domestic, peri‑domestic and sylvatic environments, making it difficult to control only using insecticide as this requires regular application, and re-infestation frequently occurs. Other social innovation alternatives such as those based on Ecohealth principles can be used to tackle the dynamics of the disease in an integral way. We asked whether an Ecohealth intervention, implemented beginning in 2001 in a highly infested village, 41.8%, in southeastern Guatemala, was sustainable in the long term. This intervention included initial insecticide treatments, followed by making low-cost house improvements to eliminate transmission risk factors such as repairing cracked walls, covering dirt floors with a cement-like substance and moving domestic animals outside. We assessed the long-term sustainability through entomological and house condition surveys, as well as an analysis of community satisfaction. We found over a 19-year period, infestation with T. dimidiata was reduced to 2.2% and maintained at a level below the level (8%) where vector transmission is unlikely. This long-term maintenance of low infestation coincided with a large proportion of villagers (88.6%) improving their houses and completing other aspects of the Ecohealth approach to maintain the village at low risk for Chagas transmission. There was unanimous satisfaction among the villagers with their houses, following improvements using the Ecohealth method, which likely played a role in the long-term persistence of the modifications. Although the infestation has remained low, 11 years following the last intervention and as the population grew there has been an increase in the proportion of "at-risk" houses, to 33%, pointing out the necessity of maintaining vigilance. The Ecohealth approach is a low-cost, sustainable approach for the long-term control of vector-borne Chagas disease. We recommend this approach including ongoing community monitoring and institutional response for the long-term, integrated control of Chagas disease.
长角血蜱是墨西哥南部、中美洲和南美洲北部地区恰加斯病的主要传播媒介。作为一种本地传播媒介，它在家庭、半家庭和森林环境中自由移动，仅使用杀虫剂进行控制非常困难，因为这需要定期使用，而且经常会再次受到感染。其他社会创新替代方案，如基于生态健康原则的方案，可以用于整体解决疾病的动态问题。我们询问了 2001 年在危地马拉东南部一个高度感染的村庄（感染率为 41.8%）实施的生态健康干预措施是否能够长期持续。该干预措施包括最初的杀虫剂处理，然后进行低成本的房屋改善，以消除传播风险因素，例如修复裂缝墙壁、用类似水泥的物质覆盖泥土地面以及将家畜移到室外。我们通过昆虫学和房屋状况调查以及社区满意度分析来评估长期可持续性。我们发现，在 19 年的时间里，长角血蜱的感染率从 2.2%降低到了一个低于媒介传播可能性的水平（8%）。这种长期的低感染率与村民中很大一部分（88.6%）改善房屋状况以及完成生态健康方法的其他方面以保持村庄处于低恰加斯病传播风险的情况相符。在使用生态健康方法进行改进后，村民对他们的房屋都非常满意，这可能是这些改进能够长期持续的原因之一。尽管感染率仍然很低，但在最后一次干预 11 年后，随着人口的增长，“高风险”房屋的比例增加到了 33%，这表明必须保持警惕。生态健康方法是一种低成本、可持续的方法，可长期控制媒介传播的恰加斯病。我们建议采取这种方法，包括持续的社区监测和机构响应，以实现恰加斯病的长期综合控制。
