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Modelling historical changes in the force-of-infection of Chagas disease to inform control and elimination programmes: application in Colombia

BMJ global health, 2017-09, Vol.2 (3), p.e000345-e000345 [Peer Reviewed Journal]

Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. ;2017 Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/ Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. 2017 ;ISSN: 2059-7908 ;EISSN: 2059-7908 ;DOI: 10.1136/bmjgh-2017-000345 ;PMID: 29147578

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  • Title:
    Modelling historical changes in the force-of-infection of Chagas disease to inform control and elimination programmes: application in Colombia
  • Author: Cucunubá, Zulma M ; Nouvellet, Pierre ; Conteh, Lesong ; Vera, Mauricio Javier ; Angulo, Victor Manuel ; Dib, Juan Carlos ; Parra -Henao, Gabriel Jaime ; Basáñez, María Gloria
  • Subjects: Age groups ; Blood banks ; Chagas disease ; Global health ; Infections ; Surveillance ; Trends
  • Is Part Of: BMJ global health, 2017-09, Vol.2 (3), p.e000345-e000345
  • Description: BackgroundWHO's 2020 milestones for Chagas disease include having all endemic Latin American countries certified with no intradomiciliary Trypanosoma cruzi transmission, and infected patients under care. Evaluating the variation in historical exposure to infection is crucial for assessing progress and for understanding the priorities to achieve these milestones.MethodsFocusing on Colombia, all the available age-structured serological surveys (undertaken between 1995 and 2014) were searched and compiled. A total of 109 serosurveys were found, comprising 83 742 individuals from rural (indigenous and non-indigenous) and urban settings in 14 (out of 32) administrative units (departments). Estimates of the force-of-infection (FoI) were obtained by fitting and comparing three catalytic models using Bayesian methods to reconstruct temporal and spatial patterns over the course of three decades (between 1984 and 2014).ResultsSignificant downward changes in the FoI were identified over the course of the three decades, and in some specific locations the predicted current seroprevalence in children aged 0–5 years is <1%. However, pronounced heterogeneity exists within departments, especially between indigenous, rural and urban settings, with the former exhibiting the highest FoI (up to 66 new infections/1000 people susceptible/year). The FoI in most of the indigenous settings remain unchanged during the three decades investigated. Current prevalence in adults in these 15 departments varies between 10% and 90% depending on the dynamics of historical exposure.ConclusionsAssessing progress towards the control of Chagas disease requires quantifying the impact of historical exposure on current age-specific prevalence at subnational level. In Colombia, despite the evident progress, there is a marked heterogeneity indicating that in some areas the vector control interventions have not been effective, hindering the possibility of achieving interruption by 2020. A substantial burden of chronic cases remains even in locations where serological criteria for transmission interruption may have been achieved, therefore still demanding diagnosis and treatment interventions.
  • Publisher: England: BMJ Publishing Group LTD
  • Language: English
  • Identifier: ISSN: 2059-7908
    EISSN: 2059-7908
    DOI: 10.1136/bmjgh-2017-000345
    PMID: 29147578
  • Source: BMJ Open Access Journals
    PubMed Central
    ProQuest Central
    DOAJ Directory of Open Access Journals
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