The long-term impact of an Ecohealth intervention: Entomological data suggest the interruption of Chagas disease transmission in southeastern Guatemala

Pereira, Fredy; Penados, Daniel; Dorn, Patricia L.; Alcántara, Belter; Monroy, María Carlota

doi:10.1016/j.actatropica.2022.106655

Cited by 6 publications

(6 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The peri-domiciliary infestation (PDI) fluctuated more through the years decreasing from a peak of 20.4% in 2009 to 3% in 2019 ( Fig 3 ). This fluctuation in the peri-domicile is to be expected, as observed in other studies [ 7 , 50 , 51 , 53 , 56 , 59 , 68 ] and is probably due to the presence of animals (including chickens and goats, but also dogs) and the passive transfer of triatomines from other areas, especially with firewood. In some settlements, including El Desvío, Miel de Palo, La Salamanca, Lote 27, Lote 46, Lote 47, Lote 58, Lote 59 and Malacara, the IDI was kept low, but the PDI was more variable with the need for frequent chemical control activities ( S2 Table ).…”

Section: Discussionsupporting

confidence: 81%

“…We believe that the ecohealth approach applied, taking into consideration individual and social determinants, stimulated the participation of the population, reflected through a participation greater than 90% in the S&C activities throughout the years, as observed in other intervention areas of Guatemala and Ecuador [49,51,52,55,56]. By providing improvements and listening to needs that went beyond the specific problem of ChD, individual and community engagement was achieved and sustained.…”

Section: Discussionmentioning

confidence: 82%

“…The program described herein, incorporated the collection of standardized data (SOP´s), adjusted the type of the data collected and incorporated a data platform with GIS. Given the impact of this intervention, with high acceptance by the population, we believe this experience and its records can be used for transference to other countries of the region, especially those that have their own similar characteristics and experiences [ 49 , 52 , 56 , 57 , 75 ]. One of the important aspects of the program is its flexibility, changing through time and adapting to different situations and difficulties encountered through the years, making it dynamic, with the integration of proposals suggested by the beneficiaries themselves.…”

Section: Discussionmentioning

confidence: 99%

“…One of the first countries to pioneer these types of interventions and highlight the importance of the household was Venezuela [46]. Subsequently, other countries began including house improvement as part of their control programs [14,47] or as pilot experiences in specific areas [48][49][50][51][52][53][54][55][56][57], with varied results and difficulties in sustainability. Through these different experiences, as well as extensive research, the factors of the rural household that contribute to the presence of kissing bugs have been determined [7,49,50,52,53,[58][59][60][61].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, in those cases where it did, observations show that some families use the houses for storage or other purposes while the original rancho remains intact [63]. Different studies highlight the importance of community participation [7,47,51,52,54,56] and the need for a comprehensive improvement of households, given that tackling only one of the factors that facilitate triatomine infestation has proven insufficient [7,48,49,[58][59][60][61]65,66]. The experience described herein took into consideration the local traditions and way of life of the inhabitants, as well as their experiences and suggestions to together improve the situation of vector transmission of ChD in the area as well as other issues such as lack of water or basic sanitation.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Chagas prevention and control in an endemic area from the Argentinian Gran Chaco Region: Data from 14 years of uninterrupted intervention

Weinberg

Casale

Cejas³

et al. 2023

PLoS Negl Trop Dis

View full text Add to dashboard Cite

Background Chagas Disease (ChD) is a Neglected Tropical Disease (NTD) affecting 6 to 7 million people worldwide, mostly from Latin America. In Argentina, a national control program has been implemented since 1962, yet there are still an estimated 1.6 million infected individuals. Control programs were based almost exclusively on entomological surveillance and chemical control of households and were not continuous given a lack of coordination and resources. Argentina´s ChD program was originally vertical and centralized; later, it was partially and, in general, unsuccessfully transferred to the provinces. Herein, we describe the implementation of a control program for ChD with an ecohealth approach in rural settlements around the city of Añatuya, Santiago del Estero. Methods The program included yearly household visits for entomological surveillance and control, health promotion workshops, and structural house improvements. Improved structures included internal and external walls and roofs, as well as the construction of water wells and latrines, and the organization and improvement of peri-domestic structures. Activities were carried out by specifically trained personnel except for house improvements, which were performed by the community, under technical guidance and provision of materials. Data was collected using standardized questionnaires for household characterization, entomological infestation status and chemical control activities. Results This program was continuously implemented since 2005 with high community participation and adherence, incorporating 13 settlements and 502 households. During the surveillance phase, 4,193 domiciliary inspections were performed, and both the intra- and peri-domestic infestation rate were reduced from 17.9% to 0.2% (P < 0.01) and from 20.4% to 3%, respectively. Additionally, 399 households were structurally improved. Conclusion The program is still ongoing and, after 14 years of implementation, has built social networks and collaboration between implementers and beneficiaries with a reduction of T. infestans infestation in the intra- and peri-domicile. This reduction, especially inside the household, has enabled access to diagnosis and treatment of the population, with minimal risk of re-infection.

show abstract