Chagas Disease Has Not Been Controlled in Ecuador

Dumonteil, Eric; Herrera, Claudia; Martini, Luiggi; Grijalva, Mario J.; Guevara, Ángel; Costales, Jaime A.; Aguilar, H Marcelo; Brenière, Simone Frédérique; Waleckx, Etienne

doi:10.1371/journal.pone.0158145

Cited by 32 publications

(23 citation statements)

References 22 publications

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“…In short, this means more basic and clinical research to solve the puzzle piece by piece which will require the Chagas research community as a whole pulling together with a spirit of collaboration. Finally, Chagas disease is also a political challenge that will need to be addressed; serious measures and processes are required to overcome the current situation and barriers to access to treatment as currently too few patients are being treated [17], [66], [67]. This is a sine qua non condition to ensure that CD patients will benefit from new R&D developments for that disease.…”

Section: Discussionmentioning

confidence: 99%

Chagas disease research and development: Is there light at the end of the tunnel?

Chatelain

2017

Computational and Structural Biotechnology Journal

130

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Chagas disease, or American trypanosomiasis, is the result of infection by the parasite Trypanosoma cruzi. It is endemic in Latin America, and spreading around the globe due to human migration. Although it was first identified more than a century ago, only two old drugs are available for treatment and a lot of questions related to the disease progression, its pathologies, and not to mention the assessment of treatment efficacy, are subject to debate and remain to be answered. Indeed, the current status of evidence and data available does not allow any absolute statement related to treatment needs and outcome for Chagas patients to be made. Although there has been some new impetus in Research and Development for Chagas disease following recent new clinical trials, there is a scientific requirement to review and challenge the current status of evidence and define basic and clinical research priorities and next steps in the field. This should ensure that the best drugs for Chagas disease are developed, but will require a focused and collaborative effort of the entire Chagas disease research community.

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Section: Discussionmentioning

confidence: 99%

Chagas disease research and development: Is there light at the end of the tunnel?

Chatelain

2017

Computational and Structural Biotechnology Journal

130

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“…The vector control program started in 2004, but important variations in the geographic coverage of the surveillance and control activities were observed year to year due to limited human and financial resources [40]. For example, during the study time, the intervention with insecticide was only focused in two of twenty two counties (Portoviejo and Santa Ana counties) of Manabí province.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, most efforts of surveillance and vector control activities have ceased as a result of elimination of the National Chagas Disease Control Program and Servicio Nacional de Control y Vigilancia de Enfermedades Transmitidas por Vectores Artrópodos (SNEM) in 2015. To our knowledge their actions have not yet been replaced [40]. …”

Section: Discussionmentioning

confidence: 99%

Distribution of triatomine species in domestic and peridomestic environments in central coastal Ecuador

et al. 2017

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BackgroundAlthough the central coast of the Ecuador is considered endemic for Chagas disease, few studies have focused on determining the risk of transmission in this region. In this study we describe the triatomine household infestation in Manabí province (Central Coast region), determine the rate of Trypanosoma cruzi infection and study the risk factors associated with infestation by Rhodnius ecuadoriensis.Methodology/Principal findingsAn entomological survey found three triatomine species (Rhodnius ecuadoriensis, Panstrongylus rufotuberculatus and P. howardi) infesting domiciles in 47.4% of the 78 communities visited (total infestation rate of 4.5%). Four percent of domiciles were infested, and nymphs were observed in 77% of those domiciles. The three species were found in altitudes below 500 masl and in all ecological zones except cloud forest. Within the domicile, we found the three species mostly in bedrooms. Rhodnius ecuadoriensis and P. rufotuberculatus were abundant in bird nests, including chicken coops and P. howardi associated with rats in piles of bricks, in the peridomicile. Triatomine infestation was characterized by high rates of colonization, especially in peridomicile. Flagelates infection was detected in only 12% of the samples by microscopy and Trypanosoma cruzi infection in 42% of the examined triatomines by PCR (n = 372). The most important risk factors for house infestation by R. ecuadoriensis were ecological zone (w = 0.99) and presence of chickens (w = 0.96). Determinants of secondary importance were reporting no insecticide applications over the last twelve months (w = 0.86) and dirt floor (w = 0.70). On the other hand, wood as wall material was a protective factor (w = 0.85).Conclusion/SignificanceAccording the results, approximately 571,000 people would be at high risk for T. cruzi infection in Manabí province. A multidisciplinary approximation and the adhesion to a periodic integrated vector management (IVM) program are essential to guarantee sustainable preventive and control strategies for Chagas disease in this region.

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“…Many of the challenges involved in treating CD in Colombia are shared by other endemic and even nonendemic countries (30)(31)(32)(33)(34)(35). Although local contexts differ, several core components of the Colombian pilot project could provide a framework for increasing access to CD health care in diverse countries (Figure 2).…”

Section: Public Health Implicationsmentioning

confidence: 99%

Increasing access to comprehensive care for Chagas disease: development of a patient-centered model in Colombia

Marchiol¹,

Forsyth²,

Bernal³

et al. 2017

Rev Panam Salud Publica

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et al. Increasing access to comprehensive care for Chagas disease: development of a patient-centered model in Colombia. Rev Panam Salud Publica. 2017;41:e153. doi: 10.26633/RPSP.2017.153 Worldwide, over 6 million people are infected with Trypanosoma cruzi, the protozoan that causes Chagas disease (CD), yet fewer than 1% of them receive treatment. In Colombia, CD poses a major public health challenge. An estimated 437 000 Colombians are infected with T. cruzi, of whom 131 000 suffer from cardiomyopathy due to the advancement of the disease (1). CD also creates a heavy economic burden; the estimated annual cost of treating a patient in the chronic stage of the disease was US$ 1 028 in 2004 (equivalent to US$ 1 336 in 2017) (2). This entails a total annual cost of US$ 175 016 000 (2017 dollars) for Colombia's health system.CD is most often transmitted by insects of the triatomine subfamily, also known as kissing bugs or, in Colombia, pitos. However, CD can also spread via

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Chagas Disease Has Not Been Controlled in Ecuador

Cited by 32 publications

References 22 publications

Chagas disease research and development: Is there light at the end of the tunnel?

Chagas disease research and development: Is there light at the end of the tunnel?

Distribution of triatomine species in domestic and peridomestic environments in central coastal Ecuador

Increasing access to comprehensive care for Chagas disease: development of a patient-centered model in Colombia

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