Percepciones de la comunidad rural de Los Llanos riojanos sobre la importancia y prevención de la enfermedad de Chagas / Perceptions about Chagas disease importance and prevention in rural community of Los Llanos riojanos

INTRODUCCIÓN: La provincia de La Rioja es endémica para la enfermedad de Chagas, que es transmitida principalmente en forma vectorial por el insecto hematófago Triatoma infestans (vinchuca). El objetivo de este trabajo fue generar un abordaje integrador para conocer la importancia asignada por la comunidad a la enfermedad de Chagas y sus vectores, y relevar información relacionada con la prevención de la transmisión. MÉTODOS: Se realizó un estudio de corte transversal con un abordaje mixto no probabilístico mediante una encuesta semiestructurada, con la cual se indagaron las percepciones de 96 pobladores pertenecientes a 41 localidades de Los Llanos riojanos. RESULTADOS: T. infestans apareció en sexto lugar entre los animales que más preocupan a la población. El 83% de los encuestados fue capaz de identificar correctamente a los adultos de T. infestans respecto de otros triatominos. Sin embargo, el 79% expresó confusión con relación al proceso de transmisión vectorial de la enfermedad de Chagas. El gallinero fue reconocido como el sitio más frecuente donde se encontraban vinchucas, seguido por los corrales. El 92% informó que nunca había colectado insectos que encontraba en su vivienda para llevarlos a analizar a un centro de salud. DISCUSIÓN: Esta investigación descriptiva permitió generar información útil para guiar el trabajo en conjunto con las comunidades locales e identificar aspectos a ser abordados para evitar la transmisión vectorial de Chagas en el área de estudio.

Rethinking the old hypothesis that new housing construction has an impact on the vector control of Triatoma infestans: A metapopulation analysis.

Triatoma infestans (Hemiptera: Reduviidae) is a hematophagous insect, vector of the parasite Trypanosoma cruzi, etiological agent of the Chagas disease. In the south of La Rioja, Argentina, the persistent infestation by triatomines encouraged a program of construction of brand new dwellings in rural areas since 2008, to reduce infestation. According to the metapopulation theory approach, each dwelling was considered to be a patch with different degrees of quality concerning the availability of shelters for T. infestans. Accordingly, brand new dwellings (BNDs) are considered of lower quality for triatomines, compared to traditional dwellings (TDs). The main objective of this study was to analyse the occupancy in patches of different quality and to evaluate the effect of BNDs in the control of T. infestans. 397 patches from three departments of the southern part of La Rioja province were analysed during the period from 2014 to 2017. Six samplings were carried out to estimate the occupancy by T. infestans in patches assigned with different qualities. During the studied period, changes in the occupancy status of the patches among samplings were recorded, and the metapopulation variables which affect the occupancy of T. infestans were analysed. The results showed that all patches, even those considered of lower quality and smaller size, were occupied by T. infestans in a range from 3.8% to 25.5%. In general, the probability of T. infestans occupancy among samplings showed no difference among all studied patches. The occupancy of patches by T. infestans was associated with "department", "number of patches" and "number of positive patches in the radius of 400 m" (analysis GEE models). However, "patch quality", "size", and "distance" showed no effect on T. infestans occupancy. 44.1% of patches with BND were occupied at least once during the study period. Some of these showed "persistent occupancy" by T. infestans. No differences in the T. infestans occupancy between BNDs and TDs were observed. These results allowed us to analyse the impact of the new housing construction as a vector control measure in the metapopulation context of La Rioja province.

Activity levels of female Triatoma infestans change depending on physiological condition.

BACKGROUND: Triatoma infestans (Hemiptera: Reduviidae) is the main vector of Trypanosoma cruzi, the etiological agent of Chagas disease, in South America. Active dispersal of this vector is the principal cause of recolonization of human dwellings previously treated with insecticides. Due to the persistence of vector populations and their movement between habitats, dispersive behavior studies are important for understanding the epidemiology of Chagas disease. The aim of this study was to analyze the relationship among T. infestans females' activity levels according to their physiological conditions. RESULTS: Two groups of insects were used, unfed and fed females. Each was composed of three subgroups in relation to the reproductive state: fifth-stage nymphs, virgin and fertilized females. There was a significant interaction between reproductive and nutritional states among T. infestans female' activity levels. During the experiments, unfed and fed nymphs remained inactive. Virgin females showed a dual behavior in their movement; fasted insects were more active. Fertilized females, both fed and unfed, were always active. CONCLUSION: The reproductive and nutritional conditions of T. infestans females affect their activity levels. When females with different reproductive states remained together, fertilized females showed permanent activity levels, suggesting that this subgroup of females represents the highest epidemiological risk as colonizers of human dwellings.

Rural houses infestation by Triatoma infestans in northwestern Argentina: Vector control in a high spatial heterogeneous infestation area.

Triatoma infestans (Hemiptera: Reduviidae) is a vector of the Trypanosoma cruzi parasite, causative agent of Chagas disease. During the last decade, vector control activities have been systematically carried out in northwestern Argentina, an endemic region for this disease. The general aim of this study to evaluate was spatio-temporal variation of infestation by T. infestans in rural communities of Los Llanos in La Rioja province. We estimated house infestation using two sampling methods: passive and active. Passive collection was conducted with community participation collecting triatomines. Six passive collections were carried out in 397 houses during the warm season between 2014 and 2017. Active collection of T. infestans was thoroughly performed by trained staff for 60 minutes and was carried out once in March 2016. The estimate of intradomestic infestation did not show significant differences between both collection methods (p = 0.39). However, passive collection method had lower sensitivity than active collection method for the estimation of peridomestic infestation and intradomestic colonization (PDI: p< 0.01; ID colonization: p< 0.01). The results obtained with passive collection methods showed that the infestation in the study area was spatially heterogeneous and temporally variable. Intradomiciliary infestation decreased over time (14.4% to 7.9%, p<0.05) although the effect of the chemical treatment application was not associated with the infestation level of T. infestans (p = 0.15) and the Departments had a different response each year (p<0.01). A high infestation cluster was located in the south of our study area during 2016-2017. The vector presence in the houses confirms the importance of to improve entomological surveillance programs. The search for triatomines carried out by the inhabitants might be a useful method to complement the activities of vector control programs in isolated and rural areas.

Invasion of rural houses by wild Triatominae in the arid Chaco.

Triatomines are the vectors of Trypanosoma cruzi, the etiologic agent of Chagas disease, the main endemic disease affecting five to seven million people in Latin America. Besides Triatoma infestans, the most important T. cruzi vector in the Gran Chaco region, other triatomine species associated with sylvatic birds and mammals are responsible for the maintenance of the wild cycle of T. cruzi. The present study aimed at evaluating the house invasion by sylvatic triatomine species in rural communities of the Los Llanos region (La Rioja, Argentina) and its association with environmental variables. House invasion by flying adult triatomines was recorded by trained collectors that surveyed over 377 houses distributed over 73 localities in a 56,600 km(2) study region, between October, 2014 and February, 2015. The result of the study showed the frequent house invasion by adult triatomines: 26.3% houses were infested in 53% of the localities. Seven sylvatic triatomine species were collected, with T. guasayana and T. garciabesi among the most abundant. House invasion by triatomine species showed no spatial aggregation and was not associated with temperature, precipitation, or vegetation cover at the spatial scale considered in the present study. House invasion by the epidemiologically important T. infestans is a concern of rural communities. Besides constituting a latent, although low, risk, the presence of these species negatively interferes with the vigilance activities of the provincial Chagas disease program.

Circadian entrainment by light and host in the Chagas disease vector, Triatoma infestans.

Triatoma infestans (Reduviidae: Triatominae, "kissing bug") is the main insect vector of Trypanosoma cruzi, the causative agent of Chagas disease, a chronic trypanosomiasis infecting 10 million people world-wide. This hematophagous bug feeds on diurnal and nocturnal species during each host's quiescent time. As the hosts are also its major predators, kissing bugs are subjected to dual selective pressures from a single source. Therefore, synchronization of feeding with the host's behavior is critical to the insects' survival. We show that nonphotic signals linked to the host eclipse the role of light and dark as the primary circadian zeitgeber for these bugs, although light still strongly inhibits locomotor behavior directly. In nature, this combination provides the insect with great flexibility in organizing physiology and behavior: anticipating a quiescent host or avoiding its potential predation while remaining directly responsive to immediate environmental conditions. Manipulation of nonphotic entrainment could be a useful chronobiotic tool in the control of Chagas disease.

The residual efficacy of a cypermethrin pour-on formulation applied on goats on the mortality and blood intake of Triatoma infestans

Triatoma infestans is the main vector of Trypanosoma cruzi, the aetiological agent of Chagas disease in the Gran Chaco region of South America. As a frequent blood meal source for triatomine bugs, domestic goats play a key role in the eco-epidemiology of Chagas disease. The aim of this study was to evaluate the mortality and blood intake of T. infestans fed on goats that had been treated with different doses of pour-on insecticide. Third-instar nymphs were fed on goats that had been treated with 0 cc, 5 cc, 10 cc or 15 cc of a pour-on formulation of cypermethrin. The exposure of T. infestans to animals treated at different post-application intervals revealed a residual activity of the insecticide. The mortality rate in the treated groups was higher than in the control groups until 30 days post-insecticide application (p = 0.03), except in the group treated with 5 cc, in which no mortality was detected after seven days of insecticide application. Rainfall affected the triatomicide effect, reducing the time of residual activity. The cypermethrin pour-on treatment decreased the blood intake of T. infestans. Thirty days after the cypermethrin application, nymph mortality was 16% (± 13) with both doses (10 cc and 15 cc). The 15 cc dose did not result in higher insect mortality or increased persistence compared to the 10 cc dose.

Effects of fipronil on dogs over Triatoma infestans, the main vector of Trypanosoma cruzi, causative agent of Chagas disease.

Chagas disease is the most important endemic disease in Latin America, mainly transmitted by Triatoma infestans in the Southern Cone countries of South America. Dogs are one of the main domestic reservoirs of Trypanosoma cruzi, the etiological agent of Chagas disease. The presence of dogs in rural households of endemic areas significantly increases the likelihood of the vectorial transmission of the parasite. We studied the mortality and blood intake of T. infestans exposed to dogs treated with different doses and formulations of fipronil. Two doses, two formulations, and different distances to the application point of fipronil were compared. Third instar nymphs of T. infestans were fed at different time intervals after the insecticide application up to 45 days post-application. No significant difference was found between the blood intake of nymphs fed on control and treated dogs with different doses and formulations (p > 0.05). The spray formulation showed lower effect and persistence than the spot-on formulation. The mortality rate caused by the spot-on formulation in the 26.8-mg active ingredient (a.i.)/kg dose was higher (48%) than with the 13.4-mg a.i./kg dose (25%), 24 h after the insecticide application. The effect was highly heterogeneous among replicates of the same treatment. The mortality rate of nymphs fed over the point of the insecticide application was higher than the mortality of nymphs fed over places 12 cm apart from the fipronil application point, suggesting that the distribution of fipronil over the dog body is lower than the needed one to obtain a persistent triatomicide effect.

The residual efficacy of a cypermethrin pour-on formulation applied on goats on the mortality and blood intake of Triatoma infestans.

Triatoma infestans is the main vector of Trypanosoma cruzi, the aetiological agent of Chagas disease in the Gran Chaco region of South America. As a frequent blood meal source for triatomine bugs, domestic goats play a key role in the eco-epidemiology of Chagas disease. The aim of this study was to evaluate the mortality and blood intake of T. infestans fed on goats that had been treated with different doses of pour-on insecticide. Third-instar nymphs were fed on goats that had been treated with 0 cc, 5 cc, 10 cc or 15 cc of a pour-on formulation of cypermethrin. The exposure of T. infestans to animals treated at different post-application intervals revealed a residual activity of the insecticide. The mortality rate in the treated groups was higher than in the control groups until 30 days post-insecticide application (p = 0.03), except in the group treated with 5 cc, in which no mortality was detected after seven days of insecticide application. Rainfall affected the triatomicide effect, reducing the time of residual activity. The cypermethrin pour-on treatment decreased the blood intake of T. infestans. Thirty days after the cypermethrin application, nymph mortality was 16% (± 13) with both doses (10 cc and 15 cc). The 15 cc dose did not result in higher insect mortality or increased persistence compared to the 10 cc dose.

Variability of the susceptibility to deltamethrin in Triatoma infestans: the female factor.

We analyzed the variability of susceptibility to deltamethrin in putatively susceptible Triatoma infestans Klug (Hemiptera: Reduviidae), and evaluated the sample size implications on the hypotheses used in the current World Health Organization protocol for the measure of insecticide resistance in Triatominae. Following the protocol, using topical application of deltamethrin to unfed first instar nymphs of T. infestans, we found that susceptibility showed significant differences between offspring from different females, a significant association with female age, and significant interaction female x female age. Considering individual female data, three patterns of nymphal mortality were identified: one showed a strong positive relation between nymphal mortality and their mother's age, another showed high mortality with low variability and the third showed intermediate mortality with high variability along female age. The analysis suggests revision of the World Health Organization protocol for resistance detection in Triatominae, not only to take into consideration the sources of variation in susceptibility, but also the effects of sample size in relation to the significance and power probabilities of the test.

The effects of cypermethrin pour-on and piperonyl butoxide on Triatoma infestans under laboratory conditions.

The effect of exposing Triatoma infestans to chickens treated with cypermethrin pour-on combined with piperonyl butoxide (PBO) was studied. Four groups of treated chickens and one control group were used. Each treatment received 1 or 2 ml of the cypermethrin formulation with and without PBO. Independent groups of nymphs were fed 1, 7, 15, 30, and 45 d after the treatment application. Blood intake was estimated after each feeding occasion. Up to 15 d after the pour-on application, high mortality was observed in all nymphs fed on treated chickens (> 93% +/- 12), and lower than the nymphs of the control group (< 33% +/- 15). After 30 d of the pour-on application, there was significantly different mortality between the treatment with 1 ml (80% +/- 9) and 2 ml (> 96% +/- 5); no difference was observed between groups with or without PBO addition. After 45 d of the pour-on application, the treatments did not show significant differences (77% +/- 7), although all treatments showed higher mortality than the control group (10% +/- 9). Up to 45 d after the pour-on application, blood intake by nymphs exposed to treated chickens (0.85 +/- 0.96 mg/nymph) was lower than blood intake by nymphs exposed to control chickens (6.7 +/- 5 mg/nymph). This study shows that cypermethrin pour-on produces high mortality and reduces the blood intake of third-instar nymphs of T. infestans up to 45 d after the insecticide application to chickens. PBO did not produce a detectable effect.

Experimental evaluation of insecticidal paints against Triatoma infestans (Hemiptera: Reduviidae), under natural climatic conditions.

BACKGROUND: Triatoma infestans is the main vector of Chagas disease in the Gran Chaco region of South America. The traditional spraying technique used for the application of pyrethroid insecticides has shown low efficiency in the elimination of the vector species populations occupying peridomestic structures of rural houses in the endemic area of Argentina. As part of studies looking for better alternatives, we evaluated the residual effect of insecticidal paints on the mortality of fourth instar nymphs of T. infestans. RESULTS: The study was based on an experimental design that included two groups treated with an organophosphate (Inesfly 5A IGR) and a pyrethroid (Inesfly 5A IGR NG) formulations of the paint, that were applied on wood, cement blocks and adobe bricks under natural climatic conditions. A third group was an untreated control. Both paint formulations showed very long residual activity, producing mortality of 84% and 98% (pyrethroid and organophosphate formulations, respectively) after 12 months of the paint application. After eight months, nymphs exposed during 6 hours to the painted surfaces with the pyrethroid and organophosphate formulations showed 81.33% and 100% mortality, respectively. CONCLUSION: The organophosphate- and pyrethroid-based insecticidal paints showed a very long residual activity on the mortality of fourth instar nymphs of T infestans, compared with the traditional spraying technique used for the application of pyrethroid insecticides in peridomestic structures of rural houses in the endemic region for Chagas disease in the Gran Chaco of Argentina. The application of the paints by trained personnel of the vector control programmes could be considered as an alternative control tool in areas where the traditional methods have failed or showed low efficacy.

Response of Triatoma infestans to pour-on cypermethrin applied to chickens under laboratory conditions.

This article reports the effects of a pour-on formulation of cypermethrin (6% active ingredient) applied to chickens exposed to Triatoma infestans, the main vector of Chagas disease in rural houses of the Gran Chaco Region of South America. This study was designed as a completely random experiment with three experimental groups and five replicates. Third instar nymphs were fed on chickens treated with 0, 1 and 2 cc of the formulation. Nymphs were allowed to feed on the chickens at different time intervals after the insecticide application. Third-instar nymphs fed on treated chickens showed a higher mortality, took less blood during feeding and had a lower moulting rate. The mortality rate was highest seven days after the insecticide solution application and blood intake was affected until 30 days after the application of the solution.

Response of Triatoma infestans to pour-on cypermethrin applied to chickens under laboratory conditions

This article reports the effects of a pour-on formulation of cypermethrin (6 percent active ingredient) applied to chickens exposed to Triatoma infestans, the main vector of Chagas disease in rural houses of the Gran Chaco Region of South America. This study was designed as a completely random experiment with three experimental groups and five replicates. Third instar nymphs were fed on chickens treated with 0, 1 and 2 cc of the formulation. Nymphs were allowed to feed on the chickens at different time intervals after the insecticide application. Third-instar nymphs fed on treated chickens showed a higher mortality, took less blood during feeding and had a lower moulting rate. The mortality rate was highest seven days after the insecticide solution application and blood intake was affected until 30 days after the application of the solution.