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ALTERNATIVES. What alternatives to the chemical control of Chagas disease vectors?

Abstract

Chagas disease or American Trypanosomiasis is an essentially rural disease which affects 20 million people in South America. Transmission to man is mainly the fact of hematophagous bugs of the Reduvidae family of which Triatoma infestans, a main vector in the Southern Cone countries (Argentina, Bolivia, Paraguay, Peru…). The life cycle of this insect takes place in human habitations, and because there is no mass prophylactic treatment (vaccine, drugs…) the efforts to control transmission are based on vector control. It consists of peri- and intra-domicile chemical treatments carried out by the services of the health ministries of the countries concerned. After several decades of chemical fight, Chagas disease remains poorly controlled and even seems to spread into new territories so far preserved such as big cities. Recently, high insecticide resistances have appeared jeopardizing the chemical control of these insects. Unfortunately, because of the early success of chemical control, alternative strategies have been neglected and never been developed. To face the recrudescence of Chagas disease and the operational failures of the chemical treatments, new control strategies are urgently needed. They might be developed if the dynamics of the vector population would be fully understood, which is not yet the case. It is thus the main objective of the ALTERNATIVES project which proposes an in-depth analysis of the significant population parameters in the framework of an operational control of such a vectored disease. These are in particular (1) the spatial structures and (2) the analysis of the vectorial capacity of the insect. Then these data will be integrated in a relevant and biologically interpretable mathematical model aimed at simulating various control strategies. The project will take place in Bolivia where field population data will be collected. Spatial structures will be analyzed at various scales: human dwelling, village, amongst villages. They will enable to plan further operational control actions at large scale and identify the control units to treat. Population dynamics, through the analysis of the parameters of the vectorial capacity, will enable to identify the most relevant eco-bio phases to control, and will enable the simulation of control action and their impact on the development of the vector population. It will be carried out by the follow-up of a vector population in a village and completed by vector life traits studies in controlled climatic chambers in the laboratory. A mathematical model will be built and calibrated with these field and laboratory data. This model will enable the optimization of the present control strategy and better, will enable to propose new control strategies in which the role pesticides is minimum. The framework of the ALTERNATIVES project may serve as a baseline for the study of other transmitted diseases which vectors are described as “anthropic” such as dengue or chikungunya. Indeed they share numerous concepts and Chagas disease even appears as a sort of model of this type of “anthropic”endemic disease.

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