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Am J Trop Med Hyg. 2012 Jun;86(6):972-9. doi: 10.4269/ajtmh.2012.11-0652.

Chagas disease: assessing the existence of a threshold for bug infestation rate.

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Human Development Department, Japan International Cooperation Agency (JICA), Tokyo, Japan.


To examine the existence of a possible threshold for the domestic infestation rate of Triatoma dimidiata, below which transmission becomes unlikely, a census was conducted in 59 Chagas disease endemic communities of El Salvador and Honduras. Entomological and serological tests were conducted targeting 4,083 households and 6,324 children between 6 months and 15 years of age. The overall domestic infestation rate of Triatoma dimidiata and seroprevalence among children were 12.9% and 0.49%, respectively. Communities with a domestic infestation rate at 8% or less consistently showed a seroprevalence of 0%. In communities with a domestic infestation rate above 8%, there was a wide range in seroprevalence. A domestic infestation rate of 8% could serve as the possible threshold below which transmission would become unlikely. The implementation of an 8% threshold for determining needs for universal insecticide spraying would lead to a 21% reduction in spraying-related costs.

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