ABSTRACT
Chagas disease control strategies strongly depend on the triatomine vector species involved in Trypanosoma cruzi transmission within each area. Here we report the results of the identification of specimens belonging to various species of Triatominae captured in Ecuador (15 species from 17 provinces) and deposited in the entomological collections of the Catholic University of Ecuador (Quito), Instituto Oswaldo Cruz (Brazil), the Natural History Museum London (UK), the London School of Hygiene and Tropical Medicine (UK), the National Institute of Hygiene (Quito), and the Vozandes Hospital (Quito). A critical review of published information and new field records are presented. We analysed these data in relation to the life zones where triatomines occur (11 life zones, excluding those over 2,200 m altitude), and provide biogeographical maps for each species. These records are discussed in terms of epidemiological significance and design of control strategies. Findings relevant to the control of the main vector species are emphasised. Different lines of evidence suggest that Triatoma dimidiata is not native to Ecuador-Peru, and that synanthropic populations of Rhodnius ecuadoriensis in southern Ecuador-northern Peru might be isolated from their sylvatic conspecifics. Local eradication of T. dimidiata and these R. ecuadoriensis populations might therefore be attainable. However, the presence of a wide variety of native species indicates the necessity for a strong longitudinal surveillance system
Subject(s)
Animals , Chagas Disease/prevention & control , Insect Vectors/classification , Triatominae/classification , Chagas Disease/epidemiology , Ecuador/epidemiology , Environment , Panstrongylus/classification , Population Density , Rhodnius/classification , Triatoma/classificationABSTRACT
La enfermedad de Chagas es uno de los graves problemas de salud de América Latina: más de 11 millones de personas están infectadas por Trypanosoma cruzi, el parásito que la produce. Felizmente, varios programas de control coordinados (Cono Sur, Area Andina, América Central, etc.) han resultado en la interrupción de la transmisión en grandes áreas del continente. Sólo Ecuador, entre los países andinos, carece de un programa estructurado de control. Se estima que 120000 personas están infectadas en el país, lo que supone unas 300 muertes y unos 3000 nuevos casos por año. La carga financiera relacionada con la ausencia de medidas preventivas pueden calcularse en unos 30 millones de dólares anuales. Sin embargo, el costo de un programa de control no superaría los 1.67 millones de dólares/año...
Subject(s)
Chagas Disease/epidemiology , Chagas Disease/etiology , Chagas Disease/therapy , Chagas Disease/transmission , Ecuador , Public HealthABSTRACT
Chagas disease is a complex public health problem that has been underestimated in Ecuador. Here we review the relevant published information, and present unpublished and new data that help to understand the current Chagas disease epidemiological situation and its evolution in the country. Three main characteristics have been identified: (i) persistence of Trypanosoma cruzi transmission in already known foci; (ii) a marked endemicity in some urban areas of Guayaquil; and (iii) the transformation of new Amazon foci into truly endemic areas. The situation in other suspect areas remains uncertain. Five Triatominae species have been implicated in the transmission of T. cruzi to people in Ecuador (Triatoma dimidiata, Rhodnius ecuadoriensis, R. pictipes, R. robustus and Panstrongylus geniculatus), but some others may also play a role in some areas (P. rufotuberculatus, P. howardi, T. carrioni and P. chinai). Other Triatominae reported seem to have little or no epidemiological relevance (T. venosa, T. dispar, Eratyrus mucronatus, E. cuspidatus, P. lignarius and Cavernicola pilosa). High frequency of acute cases and severe chronic disease has been observed. Although cardiomyopathy is more frequent, serious digestive disease is also present. It is estimated that around 120,000-200,000 people may be infected. 2.2 to 3.8 million people are estimated to live under transmission risk conditions.