ABSTRACT
Vector-borne transmission of Chagas disease in urban areas of Argentina has been an overlooked phenomena. We conducted the first comprehensive cross-sectional study of domestic infestation with Triatoma infestans and vector infection with Trypanosoma cruzi in a metropolitan area of San Juan, Argentina. Our results document the occurrence of T. infestans infected with T. cruzi in human sleeping quarters. In this urban setting, we also show that infestation was associated with construction materials, the presence of chickens, cats and a large number of dogs that can provide blood meals for the vector. Our findings reveal new challenges for vectorial control agencies.
Subject(s)
Animals , Cats , Dogs , Triatoma , Trypanosoma cruzi , Chagas Disease , Argentina , Chickens , Cross-Sectional Studies , Insect VectorsABSTRACT
BACKGROUND The eco-epidemiological status of Chagas disease in the Monte Desert ecoregion of western Argentina is largely unknown. We investigated the environmental and socio-demographic determinants of house infestation with Triatoma infestans, bug abundance, vector infection with Trypanosoma cruzi and host-feeding sources in a well-defined rural area of Lavalle Department in the Mendoza province. METHODS Technical personnel inspected 198 houses for evidence of infestation with T. infestans, and the 76 houses included in the current study were re-inspected. In parallel with the vector survey, an environmental and socio-demographic survey was also conducted. Univariate risk factor analysis for domiciliary infestation was carried out using Firth penalised logistic regression. We fitted generalised linear models for house infestation and bug abundance. Blood meals were tested with a direct ELISA assay, and T. cruzi infection was determined using a hot-start polymerase chain reaction (PCR) targeting the kinetoplast minicircle (kDNA-PCR). FINDINGS The households studied included an aged population living in precarious houses whose main economic activities included goat husbandry. T. infestans was found in 21.2% of 198 houses and in 55.3% of the 76 re-inspected houses. Peridomestic habitats exhibited higher infestation rates and bug abundances than did domiciles, and goat corrals showed high levels of infestation. The main host-feeding sources were goats. Vector infection was present in 10.2% of domiciles and 3.2% of peridomiciles. Generalised linear models showed that peridomestic infestation was positively and significantly associated with the presence of mud walls and the abundance of chickens and goats, and bug abundance increased with the number of all hosts except rabbits. MAIN CONCLUSIONS We highlight the relative importance of specific peridomestic structures (i.e., goat corrals and chicken coops) associated with construction materials and host abundance as sources of persistent bug infestation driving domestic colonisation. Environmental management strategies framed in a community-based programme combined with improved insecticide spraying and sustained vector surveillance are needed to effectively suppress local T. infestans populations.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Triatoma/physiology , Triatoma/parasitology , Trypanosoma cruzi/isolation & purification , Chagas Disease/transmission , Feeding Behavior/physiology , Insect Vectors/physiology , Insect Vectors/parasitology , Argentina , Rural Population , Socioeconomic Factors , Goats , Cats , Chickens , Risk Factors , Population Density , DogsABSTRACT
The primary, secondary and terciary prevention of congenitak malformations are analized in this study
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Congenital Abnormalities/prevention & control , Primary Prevention/methods , Congenital Abnormalities/surgery , Prenatal Diagnosis , Risk FactorsABSTRACT
Con el objetivo de determinar las principales alteraciones oftalmológicas y factores sanguíneos asociados, se realizó un estudio prospectivo con 113 pacientes falcémicos que asistieron a la consulta externa de Hematología del hospital Padre Billini, en Santo Domingo, República Dominicana, durante el período comprendido entre noviembre de 1991 y mayo de 1992. A todos se les tomó hemoglobina, hematócrito y electroferesis y se les citó al servicio de oftalmología del Instituto Nacional de la Diabetes, donde se les evaluó agudeza visual, tensión ocular y fondo de ojo. De los 113 pacientes 73 fueron heterocigotos para A1 y 40 homocigotos para hemoglobina S. Del grupo de los heterocigotos 18 eran masculinos y 55 femeninos; mientras, de los homocigotos la proliferación neovascular fue la alteración más frecuente y en los heterocigotos el sunburst