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Implementing a vector surveillance-response system for chagas disease control: a 4-year field trial in Nicaragua.

Abstract Chagas disease is one of the neglected tropical diseases (NTDs). International goals for its control involve elimination of vector-borne transmission. Central American countries face challenges in establishing sustainable vector control programmes, since the main vector, Triatoma dimidiata, cannot be eliminated. In 2012, the Ministry of Health in Nicaragua started a field test of a vector surveillance-response system to control domestic vector infestation. This paper reports the main findings from this pilot study.
PMID
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Authors

Mayor MeshTerms
Keywords

Chagas disease

Nicaragua

Programme integration

Surveillance-response system

Triatoma dimidiata

Vector control

Journal Title infectious diseases of poverty
Publication Year Start




PMID- 28260529
OWN - NLM
STAT- MEDLINE
DA  - 20170306
DCOM- 20170309
LR  - 20170312
IS  - 2049-9957 (Electronic)
IS  - 2049-9957 (Linking)
VI  - 6
IP  - 1
DP  - 2017 Mar 06
TI  - Implementing a vector surveillance-response system for chagas disease control: a 
      4-year field trial in Nicaragua.
PG  - 18
LID - 10.1186/s40249-016-0225-7 [doi]
AB  - BACKGROUND: Chagas disease is one of the neglected tropical diseases (NTDs).
      International goals for its control involve elimination of vector-borne
      transmission. Central American countries face challenges in establishing
      sustainable vector control programmes, since the main vector, Triatoma dimidiata,
      cannot be eliminated. In 2012, the Ministry of Health in Nicaragua started a
      field test of a vector surveillance-response system to control domestic vector
      infestation. This paper reports the main findings from this pilot study. METHODS:
      This study was carried out from 2012 to 2015 in the Municipality of Totogalpa.
      The Japan International Cooperation Agency provided technical cooperation in
      designing and monitoring the surveillance-response system until 2014. This system
      involved 1) vector reports by householders to health facilities, 2) data analysis
      and planning of responses at the municipal health centre and 3) house visits or
      insecticide spraying by health personnel as a response. We registered all vector 
      reports and responses in a digital database. The collected data were used to
      describe and analyse the system performance in terms of amount of vector reports 
      as well as rates and timeliness of responses. RESULTS: During the study period,
      T. dimidiata was reported 396 times. Spatiotemporal analysis identified some
      high-risk clusters. All houses reported to be infested were visited by health
      personnel in 2013 and this response rate dropped to 39% in 2015. Rates of
      insecticide spraying rose above 80% in 2013 but no spraying was carried out in
      the following 2 years. The timeliness of house visits improved significantly
      after the responsibility was transferred from a vector control technician to
      primary health care staff. CONCLUSIONS: We argue that the proposed vector
      surveillance-response system is workable within the resource-constrained health
      system in Nicaragua. Integration to the primary health care services was a key to
      improve the system performance. Continual efforts are necessary to keep adapting 
      the surveillance-response system to the dynamic health systems. We also discuss
      that the goal of eliminating vector-borne transmission remains unachievable. This
      paper provides lessons not only for Chagas disease control in Central America,
      but also for control efforts for other NTDs that need a sustainable
      surveillance-response system to support elimination.
FAU - Yoshioka, Kota
AU  - Yoshioka K
AUID- ORCID: http://orcid.org/0000-0001-8463-4913
AD  - Doctor of Public Health Program, Harvard T.H. Chan School of Public Health,
      Boston, USA. [email protected]
AD  - School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki,
      Japan. [email protected]
AD  - Former Chagas Disease Control Project, Japan International Cooperation Agency,
      Managua, Nicaragua. [email protected]
FAU - Tercero, Doribel
AU  - Tercero D
AD  - Former Chagas Disease Control Project, Japan International Cooperation Agency,
      Managua, Nicaragua.
FAU - Perez, Byron
AU  - Perez B
AD  - Former Chagas Disease Control Project, Japan International Cooperation Agency,
      Managua, Nicaragua.
FAU - Nakamura, Jiro
AU  - Nakamura J
AD  - Former Chagas Disease Control Project, Japan International Cooperation Agency,
      Managua, Nicaragua.
FAU - Perez, Lenin
AU  - Perez L
AD  - Former Chagas Disease Control Project, Japan International Cooperation Agency,
      Managua, Nicaragua.
AD  - Department of Disease Prevention, Ministry of Health in Nicaragua, Managua,
      Nicaragua.
LA  - eng
PT  - Journal Article
DEP - 20170306
PL  - England
TA  - Infect Dis Poverty
JT  - Infectious diseases of poverty
JID - 101606645
SB  - IM
MH  - Animals
MH  - Chagas Disease/epidemiology/*prevention & control
MH  - Humans
MH  - Insect Control/*methods
MH  - Insect Vectors/drug effects/parasitology
MH  - Neglected Diseases/epidemiology/prevention & control
MH  - Nicaragua/epidemiology
MH  - Pilot Projects
MH  - Population Surveillance/*methods
MH  - Program Evaluation
MH  - Triatoma/drug effects/parasitology
PMC - PMC5338093
OTO - NOTNLM
OT  - Chagas disease
OT  - Nicaragua
OT  - Programme integration
OT  - Surveillance-response system
OT  - Triatoma dimidiata
OT  - Vector control
EDAT- 2017/03/07 06:00
MHDA- 2017/03/10 06:00
CRDT- 2017/03/07 06:00
PHST- 2016/05/29 [received]
PHST- 2016/12/20 [accepted]
AID - 10.1186/s40249-016-0225-7 [doi]
AID - 10.1186/s40249-016-0225-7 [pii]
PST - epublish
SO  - Infect Dis Poverty. 2017 Mar 6;6(1):18. doi: 10.1186/s40249-016-0225-7.

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