Impact of home improvements and health education on the transmission of Trypanosoma cruzi Chagas in a rural area of western Mexico.

Abstract

Chagas disease is one of the most important vector-borne diseases in Latin America. Instituting home improvement preventive measures and increasing health education contribute to successful control of the triatomine insect vector. The impact of home and road improvements and health education upon the inhabitants of 37 human dwellings in three small towns in western Mexico were studied. Initially, few house roofs were made of concrete and few walls were cement-lined. Almost all houses initially lacked metal window screens and none used barbed wire fences. One year after the intervention, all of these measures were more common, and almost 100% of houses continued to use window screens and barbed wire fences ten years post-intervention. By ten years post-intervention, >75% of houses had cement-lined walls. Initially, 24.3% of human dwellings were infested with Triatoma longipennis Usinger; at one and ten years post-intervention, only 2.7% of dwellings were infested. The abundance of peridomestic opossums decreased after intervention and remained low ten years later. Approximately 10% of dogs were infected in both surveys. Human infections decreased from 2.98% to zero by 13 years post-intervention. Implementation of these intervention measures led to the successful control of Trypanosoma cruzi Chagas transmission in these towns.