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      Triatomine Fauna and Recent Epidemiological Dynamics of Chagas Disease in an Endemic Area of Northeast Brazil

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          Abstract

          Updated information of the dispersion dynamics of Chagas disease (CD) and a systemic analysis of these data will aid the early identification of areas that are vulnerable to transmission and enable efficient intervention. This work synthesized spatiotemporal information regarding triatomine fauna and analyzed this information in combination with the results from serological tests to elucidate the epidemiological panorama of CD in the state of Sergipe, Brazil. This is a retrospective analytical study that utilized information from the database of the National Chagas Disease Control Program. Between 2010 and 2016, 838 triatomines of eight species, namely, Panstrongylus geniculatus, which was first recorded in the state of Sergipe, Panstrongylus lutzi, P. megistus, Triatoma brasiliensis, T. pseudomaculata, T. tibiamaculata, T. melanocephala , and Rhodnius neglectus, were collected. Optical microscopy revealed that 13.2% of triatomines examined were infected by Trypanosoma cruzi-like flagellates. The distribution of triatomines exhibits an expanding south-central to northern dispersion, with a preference for semiarid and agreste areas and occasional observations in humid coastal areas due to anthropogenic actions reflected in the environment. Of the human cases analyzed from 2012 to 2016, 8.3% (191/2316) presented positive serology for Trypanosoma cruzi, and this proportion showed a gradual increase in the southern center of the state and new notifications in coastal regions. There is a need for intensification and continuity of the measures adopted by the Chagas Disease Control Program in Sergipe, identifying new priority areas for intervention and preferential ecotopes of the vectors, considering the occurrence of positive triatomines intradomicilliary and a source of new triatomines in the peridomiciles.

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          Biogeografia, origem e distribuição da domiciliação de triatomíneos no Brasil

          Considerando a distribuição atual da domicialiação triatomínea no Brasil, pode-se verificar sua associação com a referente aos espaços abertos. Estes podem ser considerados como naturais e artificiais. Os primeiros estão essencialmente situados nos domínios paisagísticos das caatingas, dos cerrados, totalmente incluídos em território brasileiro, e das pradarias mistas subtropicais pertencentes a paisagem que se estende além desses limites. Os outros são os originados da ação antrópica resultando em expansão da paisagem aberta principalmente em virtude da devastação da cobertura florestal do domínio tropical atlântico. Embora tentativamente, procurou-se aplicar o modelo de refúgios paleoecológicos e da existência de centros de endemismo às quatro espécies de domiciliação epidemiologicamente significante. O Triatoma sordida, Triatoma brasiliensis e Triatoma pseudomaculata parece ter seus centros de endemismo nos espaços abertos dos cerrados e das caatingas, enquanto o Panstrongylus megistus teria tido sua origem nas florestas do ambiente tropical atlântico. Quanto ao Triatoma infestans, sua área endêmica estaria localizada em território boliviano, de onde se dispersou e continua se dispersando pela ação do homem. A invasão domiciliar, ao que tudo indica, obedece a mecanismo oportunista propiciado por vários estímulos de abrigo e alimentação. Uma vez instalada, a domiciliação permite não apenas a sobrevivência, mas também a dispersão da espécie. Esses conceitos devem ser levados em conta nas campanhas de controle, uma vez que a probabilidade de sucesso aumenta com essa especialização do triatomíneo. A continuidade da ação antrópica sobre o ambiente, atualmente intensificada na região do domínio equatorial amazônico, resultará na expansão dos espaços abertos. Assim sendo, seja a custa de espécies locais seja a custa de espécies introduzidas, poderá ocorrer a domiciliação triatomínea, como problema de saúde pública, em região onde ainda não foi assinalada.
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            Southern Cone Initiative for the elimination of domestic populations of Triatoma infestans and the interruption of transfusion Chagas disease: historical aspects, present situation, and perspectives

            João Dias (2007)
            Created in 1991 by the governments of Argentina, Bolivia, Brazil, Chile, Paraguay, and Uruguay, the Southern Cone Initiative (SCI) has been extremely important for Chagas disease control in this region. Its basic objective was to reach the interruption of this disease, chiefly by means of the elimination of the principal vector Triatoma infestans and by the selection of safe donors in the regional blood banks. After a summarized historic of SCI, the text shows the advance of technical and operative activities, emphasizing some factors for the initiative success, as well as some difficulties and constraints. The future of SCI will depend of the continuity of the actions and of political priority. Scientific community has been highly responsible for this initiative and its maintenance. At the side of this, national and international efforts must be involved and reinforced to assure the accomplishment of the final targets of SCI. Very specially, the Pan American Health Organization has cooperated with the Initiative in all its moments and activities,being the most important catalytic and technical factor for SCI success.
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              The main sceneries of Chagas disease transmission. The vectors, blood and oral transmissions - A comprehensive review

              This review deals with transmission of Trypanosoma cruzi by the most important domestic vectors, blood transfusion and oral intake. Among the vectors, Triatoma infestans, Panstrongylus megistus, Rhodnius prolixus, Triatoma dimidiata, Triatoma brasiliensis, Triatoma pseudomaculata, Triatoma sordida, Triatoma maculata, Panstrongylus geniculatus, Rhodnius ecuadoriensis and Rhodnius pallescens can be highlighted. Transmission of Chagas infection, which has been brought under control in some countries in South and Central America, remains a great challenge, particularly considering that many endemic countries do not have control over blood donors. Even more concerning is the case of non-endemic countries that receive thousands of migrants from endemic areas that carry Chagas disease, such as the United States of America, in North America, Spain, in Europe, Japan, in Asia, and Australia, in Oceania. In the Brazilian Amazon Region, since Shaw et al. (1969) described the first acute cases of the disease caused by oral transmission, hundreds of acute cases of the disease due to oral transmission have been described in that region, which is today considered to be endemic for oral transmission. Several other outbreaks of acute Chagas disease by oral transmission have been described in different states of Brazil and in other South American countries.
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                Author and article information

                Contributors
                Journal
                Can J Infect Dis Med Microbiol
                Can J Infect Dis Med Microbiol
                CJIDMM
                The Canadian Journal of Infectious Diseases & Medical Microbiology = Journal Canadien des Maladies Infectieuses et de la Microbiologie Médicale
                Hindawi
                1712-9532
                1918-1493
                2018
                1 October 2018
                : 2018
                : 7020541
                Affiliations
                1Universidade Tiradentes, Programa de Pós-Graduação em Saúde e Ambiente, Laboratório de Doenças Infecciosas e Parasitárias (LDIP/ITP), Aracaju, Brazil
                2Secretaria de Estado da Saúde de Sergipe, Laboratório Central de Saúde Pública de Sergipe (Lacen-SE), Laboratório de Entomologia, Aracaju, Brazil
                3Universidade Tiradentes, Laboratório de Doenças Infecciosas e Parasitárias (LDIP/ITP), Aracaju, Brazil
                4Universidad de Chile, Facultad de Medicina, Santiago, Chile
                Author notes

                Academic Editor: Kinley Wangdi

                Author information
                http://orcid.org/0000-0001-9331-003X
                http://orcid.org/0000-0002-8236-8524
                http://orcid.org/0000-0003-3505-0211
                http://orcid.org/0000-0001-8426-0077
                http://orcid.org/0000-0002-1526-0687
                http://orcid.org/0000-0001-9813-7969
                Article
                10.1155/2018/7020541
                6188735
                1bf1946d-5fef-4acb-aead-38916103fdab
                Copyright © 2018 Cláudia M. Melo et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 29 March 2018
                : 1 July 2018
                : 15 August 2018
                Funding
                Funded by: Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
                Funded by: Fundação de Apoio à Pesquisa e à Inovação Tecnológica do Estado de Sergipe
                Award ID: 88881.157704/2017-01
                Categories
                Research Article

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