House-level risk factors for triatomine infestation in Colombia

• Published in: International journal of epidemiology Vol. 36; no. 4; pp. 866 - 872
• Main Authors: Campbell-Lendrum, DH, Angulo, VM, Esteban, L, Tarazona, Z, Parra, GJ, Restrepo, M, Restrepo, BN, Guhl, F, Pinto, N, Aguilera, G, Wilkinson, P, Davies, CR
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.08.2007; Oxford Publishing Limited (England)
• Subjects: Animals; Animals, Domestic; Biological and medical sciences; Chagas disease; Chagas Disease - prevention & control; Chagas Disease - transmission; Colombia; Ectoparasitic Infestations; Health Surveys; Housing; Housing, Animal; Human protozoal diseases; Humans; Infectious diseases; Insect Vectors; Medical sciences; Multivariate Analysis; Odds Ratio; Parasitic diseases; Probability; Protozoal diseases; Rhodnius; Risk Assessment - methods; Risk Factors; Triatominae; Tropical medicine; Trypanosomiasis; South America; Colombia; America; Latin America; Chagas disease; Colombia; risk factors; Triatominae; housing; Human; Protozoal disease; Insecta; Parasitosis; Housing; Epidemiology; Heteroptera; Infection; Triatoma infestans; Arthropoda; Risk factor; Invertebrata; Infestation; Trypanosomiasis; Public health; Reduviidae
• ISSN: 0300-5771; 1464-3685
• DOI: 10.1093/ije/dym065

Background Chagas disease, transmitted domestically by triatomine bugs, is the most important vector-borne disease in Latin America. The association between triatomine infestation and housing characteristics was investigated based on a standardized survey in 41 971 houses in 15 Departments in Colombia. Methods Multivariate logistic regression was used to test for associations of two highly correlated infestation measures of infestation (householders reporting having seen triatomines inside the house, and sending triatomines to the survey team), with 15 household-level risk factors. Risks were measured relative to a reference category of houses with up to three inhabitants, area up to 50 m2, unplastered adobe walls, thatch roof and no outbuildings or domestic animals. Results The probability of seeing triatomines was highest for households with over seven inhabitants (OR = 1.24, 95% CI 1.11–1.39), overhead storage space (OR = 1.16, 95% CI 1.03–1.32), grain shed (OR = 1.25, 95% CI 1.02–1.52), cats (OR = 1.27, 95% CI 1.14–1.42) and pigs (OR = 1.16, 95% CI 1.03–1.30). Lowest risks were in houses with wooden walls (OR = 0.46, 95% CI 0.34–0.61), fully plastered walls (OR = 0.78, 95% CI 0.68–0.88), roofs made of tiles (OR = 0.51, 95% CI 0.33–0.78) and flagstone floors (OR = 0.57, 95% CI 0.42–0.76). Results for householders returning triatomines support this set of risk factors, but with wider confidence intervals. Conclusions Surveillance of a few easily assessed household characteristics provides an accurate, rapid assessment of house-level variation in risk. Measured effect sizes for specific structural characteristics could be used to maximize the cost-effectiveness of programmes to reduce vector infestation and interrupt Chagas disease transmission by improving house quality.