Chagas disease transmission in periurban communities of Arequipa, Peru.
BACKGROUND
Chagas disease, caused by Trypanosoma cruzi infection, is an urban problem in Arequipa, Peru, and the epidemiology of Chagas disease is likely to be quite different in this area, compared with in rural zones.


METHODS
We conducted a serosurvey of 1615 children <18 years old in periurban districts that included hillside shantytowns and slightly more affluent low-lying communities. In addition, 639 adult residents of 1 shantytown were surveyed to provide data across the age spectrum for this community.


RESULTS
Of 1615 children, 75 (4.7%) were infected with Trypanosoma cruzi. Infection risk increased by 12% per year of age, and children living in hillside shantytowns were 2.5 times as likely to be infected as were those living in lower-lying communities. However, age-prevalence data from 1 shantytown demonstrated that adults were no more likely to be seropositive than were teenagers; the results of maximum likelihood modeling suggest that T. cruzi transmission began in this community <20 years ago.


CONCLUSIONS
The problem of Chagas disease in periurban settings, such as those around Arequipa, must be addressed to achieve elimination of vector-borne T. cruzi transmission. Identification of infected children, vector-control efforts, and education to avoid modifiable risk factors are necessary to decrease the burden of Chagas disease.
Bowman
Natalie M
NM
Asociación Benéfica Proyectos en Informática, Salud, Medicina y Agricultura, Lima, Peru.
Kawai
Vivian
V
Levy
Michael Z
MZ
Cornejo del Carpio
Juan Geny
JG
Cabrera
Lilia
L
Delgado
F
F
Malaga
Francisco
F
Cordova Benzaquen
Eleazar
E
Pinedo
Viviana V
VV
Steurer
Francis
F
Seitz
Amy E
AE
Gilman
Robert H
RH
Bern
Caryn
C
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000818:Animals; D014355:Chagas Disease / Q000453:epidemiology* / Q000635:transmission*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016013:Likelihood Functions; D008297:Male; D010568:Peru / Q000453:epidemiology; D016036:Seroepidemiologic Studies; D013997:Time Factors; D014349:Trypanosoma cruzi / Q000276:immunology / Q000302:isolation & purification*; D014505:Urban Population