Chagas disease control initiatives are yielding promising results. Molecular research has helped successful programs by identifying and characterizing introduced vector populations and by defining intervention targets accurately. However, researchers and health officials are facing new challenges throughout Latin America. Native vectors persistently reinfest insecticide-treated households, and sylvatic triatomines maintain disease transmission in humid forest regions (including Amazonia) without colonizing human dwellings. In these scenarios, fine-scale vector studies are essential to define epidemiological risk patterns and clarify the involvement of little-known triatomine taxa in disease transmission. These eco-epidemiological investigations, as well as the planning and monitoring of control interventions, rely by necessity on accurate taxonomic judgments. The problems of cryptic speciation and phenotypic plasticity illustrate this need -and how molecular systematics can provide the fitting answers. Molecular data analyses also illuminate basic aspects of vector evolution and adaptive trends. Here we review the applications of molecular markers (concentrating on allozymes and DNA sequencing) to the study of triatomines. We analyze the suitability, strengths and weaknesses of the various techniques for taxonomic, systematic and evolutionary investigations at different levels (populations, species, and higher taxonomic categories).Key words: molecular systematics, DNA, allozymes, Triatominae, Chagas disease.
CHAGAS DISEASE: BURDEN, CONTROL EFFORTS AND NEW CHALLENGESChagas disease (CD), caused by Trypanosoma cruzi and transmitted by triatomine bugs, is a major public health problem in Latin America. An overall prevalence of ∼ 18 million infections was estimated in the late 1980s, with 90 million people living at risk and 45000 deaths/year. CD was the most important parasitic disease in Latin America in terms of its impact on national economies and public health systems (WHO 1991, World Bank 1993.In the absence of vaccines or adequate drugs for large-scale treatment, the reduction of disease burden critically depends on the control of transmission by triatomine vectors and infected blood transfusion.
Several multinational initiatives have been launchedAn Acad Bras Cienc (2005) 77 (3)
438FERNANDO ABAD-FRANCH and FERNANDO A. MONTEIRO with that purpose. Ten years of concerted action in the Southern Cone have resulted in the elimination of transmission by Triatoma infestans (the most widespread domestic vector) from vast areas of the region. Incidence dropped by an average of 94% in the area, and by 65% in Latin America (WHO 2002). Recent estimates show however that substantial efforts are still necessary: overall prevalence remains over 12 million, with 200000 new cases/year in 15 countries (Morel and Lazdins 2003).The success of the Southern Cone initiative was eased by the fact that the main vector species, T. infestans, is entirely domestic throughout most of its range, making reinfestation of insectic...