Complementary paths to chagas disease elimination: the impact of combining vector control with aetiological treatment

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Title: Complementary paths to chagas disease elimination: the impact of combining vector control with aetiological treatment
Author(s): Cucunuba Perez, Z
Nouvellet, P
Peterson, J
Bartsch, S
Lee, B
Dobson, A
Basanez, MG
Item Type: Journal Article
Abstract: Background: The World Health Organization’s 2020 goals for Chagas disease are (1) interrupting vector-borne intradomiciliary transmission and (2) having all infected people under care in endemic countries. Insecticide spraying has proved efficacious for reaching the first goal, but active transmission remains in several regions. For the second, treatment has mostly been restricted to recently infected patients, who comprise only a small proportion of all infected individuals. Methods: We extended our previous dynamic transmission model to simulate a domestic Chagas disease transmission cycle and examined the effects of both vector control and etiological treatment on achieving the operational criterion proposed by the Pan American Health Organization for intradomiciliary, vectorial transmission interruption (ie, <2% seroprevalence in children <5 years of age). Results: Depending on endemicity, an antivectorial intervention that decreases vector density by 90% annually would achieve the transmission interruption criterion in 2–3 years (low endemicity) to >30 years (high endemicity). When this strategy is combined with annual etiological treatment in 10% of the infected human population, the seroprevalence criterion would be achieved, respectively, in 1 and 11 years. Conclusions: Combining highly effective vector control with etiological (trypanocidal) treatment in humans would substantially reduce time to transmission interruption as well as infection incidence and prevalence. However, the success of vector control may depend on prevailing vector species. It will be crucial to improve the coverage of screening programs, the performance of diagnostic tests, the proportion of people treated, and the efficacy of trypanocidal drugs. While screening and access can be incremented as part of strengthening the health systems response, improving diagnostics performance and drug efficacy will require further research.
Publication Date: 1-Jun-2018
Date of Acceptance: 3-Jan-2018
URI: http://hdl.handle.net/10044/1/55710
DOI: https://dx.doi.org/10.1093/cid/ciy006
ISSN: 1058-4838
Publisher: Oxford University Press (OUP)
Start Page: S293
End Page: S300
Journal / Book Title: Clinical Infectious Diseases
Volume: 66
Issue: Suppl. 4
Sponsor/Funder: The Task Force for Global Health
Funder's Grant Number: MA4501180169
Copyright Statement: © The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Science & Technology
Life Sciences & Biomedicine
Immunology
Infectious Diseases
Microbiology
Chagas disease
mathematical model
vector control
etiological treatment
prevalence
RANDOMIZED-TRIAL
BENZNIDAZOLE
TRANSMISSION
POSACONAZOLE
COLOMBIA
06 Biological Sciences
11 Medical And Health Sciences
Microbiology
Publication Status: Published
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care



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