title: Investigation of Chagas disease in four periurban areas in northeastern Brazil: epidemiologic survey in man, vectors, non-human hosts and reservoirs.
abstract: Chagas disease was investigated in four periurban areas of Ceará state, northeastern Brazil, through serological, parasitological and molecular methods in humans, reservoirs and vectors. A cross-sectional survey revealed a seroprevalence rate of 1.2% (13/1076 residents, six also proving positive through PCR). Trypanosoma cruzi infection was not detected in children under 10 years old. Triatoma pseudomaculata prevailed in the peridomiciles: 63 specimens, 69% (34/49) infected with trypanosomatids. Rhodnius nasutus was captured in Copernicia prunifera palm trees (n=280; 25.0% infected with trypanosomatids) and inside dwellings (n=8, all uninfected). Trypanosoma cruzi seropositive reservoirs, represented by Didelphis albiventris (n=27), Rattus rattus (n=24), Thrichomys laurentius (n=2), Mus musculus (n=1) and Monodelphis domestica (n=1), were identified. Among domestic dogs (n=96) seroprevalence reached 21.9%. Miniexon multiplex PCR assays characterized TcI in triatomines. Both TcI and TcII were detected in wild mammal hosts. We conclude that Trypanosoma cruzi circulates within a domestic zoonotic cycle, requiring continuous surveillance. Insecticide application to domiciles does not appear to prevent continuous reintroduction of wild triatomine specimens, presenting a challenge to authorities involved in Chagas disease control.
authors.affiliation: Laboratório de Ecoepidemiologia da Doença de Chagas - IOC, Fiocruz, Rio de Janeiro, Brasil. mmlima@ioc.fiocruz.br
authors.forename: Marli M
authors.initials: MM
authors.lastname: Lima
authors.forename: Otília
authors.initials: O
authors.lastname: Sarquis
authors.forename: Tiago Guedes
authors.initials: TG
authors.lastname: de Oliveira
authors.forename: Taís F
authors.initials: TF
authors.lastname: Gomes
authors.forename: Carolina
authors.initials: C
authors.lastname: Coutinho
authors.forename: Natália F
authors.initials: NF
authors.lastname: Daflon-Teixeira
authors.forename: Helena K
authors.initials: HK
authors.lastname: Toma
authors.forename: Constança
authors.initials: C
authors.lastname: Britto
authors.forename: Bernardo R
authors.initials: BR
authors.lastname: Teixeira
authors.forename: Paulo S
authors.initials: PS
authors.lastname: D'Andrea
authors.forename: Ana M
authors.initials: AM
authors.lastname: Jansen
authors.forename: Marcio N
authors.initials: MN
authors.lastname: Bóia
authors.forename: Filipe A
authors.initials: FA
authors.lastname: Carvalho-Costa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D001938:Brazil / Q000453:epidemiology; D014355:Chagas Disease / Q000453:epidemiology* / Q000235:genetics / Q000276:immunology / Q000635:transmission; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004197:Disease Reservoirs; D004285:Dogs; D005260:Female; D006790:Host-Parasite Interactions; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D051379:Mice; D008875:Middle Aged; D060885:Multiplex Polymerase Chain Reaction; D009893:Opossums / Q000469:parasitology; D051381:Rats; D012239:Rhodnius / Q000469:parasitology; D016036:Seroepidemiologic Studies; D014224:Triatoma / Q000469:parasitology; D014349:Trypanosoma cruzi / Q000472:pathogenicity*; D055815:Young Adult