Sustainability of Vector Control Strategies in the Gran Chaco Region: Current Challenges and Possible Approaches

• Published in: Memórias do Instituto Oswaldo Cruz Vol. 104; no. suppl 1; pp. 52 - 59
• Main Author: Guertler, R E
• Format: Journal Article
• Language: English
• Published: Brazil Fundação Oswaldo Cruz, Fiocruz 01.07.2009; Instituto Oswaldo Cruz, Ministério da Saúde; Fundação Oswaldo Cruz (FIOCRUZ)
• Subjects: Animals; Argentina; Chagas Disease - prevention & control; Chagas Disease - transmission; community participation; development; ecosystem health; ecosystem health - sustainability - integrated vector control - development - community participation - insecticide resistance - pyrethroids; Humans; Insect Control - methods; Insect Vectors; insecticide resistance; integrated vector control; National Health Programs; PARASITOLOGY; pyrethroids; sustainability; Triatoma infestans; Triatominae; TROPICAL MEDICINE; Trypanosoma cruzi; Argentina; Argentina, Chaco; pyrethroids; development; integrated vector control; ecosystem health; insecticide resistance; sustainability; community participation
• ISSN: 1678-8060; 0074-0276; 0074-0276; 1678-8060
• DOI: 10.1590/S0074-02762009000900009

Sustainability has become a focal point of the international agenda. At the heart of its range of distribution in the Gran Chaco Region, the elimination of Triatoma infestans has failed, even in areas subject to intensive professional vector control efforts. Chagas disease control programs traditionally have been composed of two divorced entities: a vector control program in charge of routine field operations (bug detection and insecticide spraying) and a disease control program in charge of screening blood donors, diagnosis, etiologic treatment and providing medical care to chronic patients. The challenge of sustainable suppression of bug infestation and Trypanosoma cruzi transmission can be met through integrated disease management, in which vector control is combined with active case detection and treatment to increase impact, cost-effectiveness and public acceptance in resource-limited settings. Multi-stakeholder involvement may add sustainability and resilience to the surveillance system. Chagas vector control and disease management must remain a regional effort within the frame of sustainable development rather than being viewed exclusively as a matter of health pertinent to the health sector. Sustained and continuous coordination between governments, agencies, control programs, academia and the affected communities is critical.