Volume 93, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Chagas disease is one of the most serious health problems in Latin America. Because the disease is transmitted mainly by triatomine vectors, a three-phase vector control strategy was used to reduce its vector-borne transmission. In Nicaragua, we implemented an indoor insecticide spraying program in five northern departments to reduce house infestation by . The spraying program was performed in two rounds. After each round, we conducted entomological evaluation to compare the vector infestation level before and after spraying. A total of 66,200 and 44,683 houses were sprayed in the first and second spraying rounds, respectively. The entomological evaluation showed that the proportion of houses infested by was reduced from 17.0% to 3.0% after the first spraying, which was statistically significant ( < 0.0001). However, the second spraying round did not demonstrate clear effectiveness. Space–time analysis revealed that reinfestation of is more likely to occur in clusters where the pre-spray infestation level is high. Here we discuss how large-scale insecticide spraying is neither effective nor affordable when is widely distributed at low infestation levels. Further challenges involve research on reinfestation, diversification of vector control strategies, and implementation of sustainable vector surveillance.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Coura JR, , 2015. The main sceneries of Chagas disease transmission. The vectors, blood and oral transmissions—a comprehensive review. Mem Inst Oswaldo Cruz 110: 277282.[Crossref] [Google Scholar]
  2. PAHO, 2006. Estimación cuantitativa de la Enfermedad de Chagas en las Américas. OPS/HDM/CD/425-06. Department of Control of Neglected Tropical Diseases, Innovative and Intensified Disease Management, Pan American Health Organization, 29. [Google Scholar]
  3. WHO, 2015. Chagas disease in Latin America: an epidemiological update based on 2010 estimates. Wkly Epidemiol Rec 90: 3344. [Google Scholar]
  4. Hashimoto K, Yoshioka K, , 2012. Review: surveillance of Chagas disease. Adv Parasitol 79: 375428.[Crossref] [Google Scholar]
  5. Moncayo A, Silveira AC, Talleria J, Tibayrenc M, , 2010. Current trends and future prospects for control of Chagas disease. , eds. American Trypanosomiasis Chagas Disease—One Hundred Years of Research. Burlington, MA: Elsevier Inc., 5582. [Google Scholar]
  6. Dias JCP, , 2007. Southern Cone Initiative for the elimination of domestic populations of Triatoma infestans and the interruption of transfusional Chagas disease. Historical aspects, present situation, and perspectives. Mem Inst Oswaldo Cruz 102 (Suppl 1): 1118.[Crossref] [Google Scholar]
  7. Hashimoto K, Álvarez H, Nakagawa J, Juarez J, Monroy C, Cordón-Rosales C, Gil E, , 2012. Vector control intervention towards interruption of transmission of Chagas disease by Rhodnius prolixus, main vector in Guatemala. Mem Inst Oswaldo Cruz 107: 877887.[Crossref] [Google Scholar]
  8. Hashimoto K, Schofield CJ, , 2012. Elimination of Rhodnius prolixus in Central America. Parasit Vectors 5: 45.[Crossref] [Google Scholar]
  9. IPCA, 2013. Recomendaciones: Conclusiones. XVa Reunión de la Comisión Intergubernamental de la Iniciativa de los Países de Centroamérica (IPCA) para la Interrupción de la Transmisión Vectorial, Transfusional y Atención Médica de la Enfermedad de Chagas, 22–23 de octubre de 2013, Ciudad de México, México. [Google Scholar]
  10. Waleckx E, Gourbière S, Dumonteil E, , 2015. Intrusive versus domiciliated triatomines and the challenge of adapting vector control practices against Chagas disease. Mem Inst Oswaldo Cruz 110: 324338.[Crossref] [Google Scholar]
  11. Bustamante DM, Monroy C, Pineda S, Rodas A, Castro X, Ayala V, Quiñónes J, Moguel B, Trampe R, , 2009. Risk factors for intradomiciliary infestation by the Chagas disease vector Triatoma dimidiata in Jutiapa, Guatemala. Cad Saúde Pública 25 (Suppl 1): S83S92.[Crossref] [Google Scholar]
  12. Tabaru Y, Monroy C, Rodas A, Mejia M, Rosales R, , 1998. Chemical control of Triatoma dimidiata and Rhodnius prolixus (Reduviidae: Triatominae), the principal vectors of Chagas' disease in Guatemala. Med Entomol Zool 49: 8792.[Crossref] [Google Scholar]
  13. Nakagawa J, Cordón-Rosales C, Juárez J, Itzep C, Nonami T, , 2003. Impact of residual spraying on Rhodnius prolixus and Triatoma dimidiata in the department of Zacapa in Guatemala. Mem Inst Oswaldo Cruz 98: 277281.[Crossref] [Google Scholar]
  14. Nakagawa J, Hashimoto K, Cordón-Rosales C, Juárez JA, Trampe R, Marroquín L, , 2003. The impact of vector control on Triatoma dimidiata in the Guatemalan department of Jutiapa. Ann Trop Med Parasitol 97: 289298.[Crossref] [Google Scholar]
  15. Hashimoto K, Cordon-Rosales C, Trampe R, Kawabata M, , 2006. Impact of single and multiple residual sprayings of pyrethroid insecticides against Triatoma dimidiata (Reduviidae; Triatominae), the principal vector of Chagas disease in Jutiapa, Guatemala. Am J Trop Med Hyg 75: 226230. [Google Scholar]
  16. Manne J, Nakagawa J, Yamagata Y, Goehler A, Brownstein JS, Castro MC, , 2012. Triatomine infestation in Guatemala: spatial assessment after two rounds of vector control. Am J Trop Med Hyg 86: 446454.[Crossref] [Google Scholar]
  17. Lugo E, Marín F, , 2005. Results of an entomological survey of triatomine (Heteroptera: Reduviidae: Triatominae) in 15 departments of Nicaragua, 1998–1999 [in Spanish]. Rev Nica Ent 65: 112. [Google Scholar]
  18. Yoshioka K, Tercero D, Pérez B, Lugo E, , 2011. Rhodnius prolixus in Nicaragua: geographical distribution, control, and surveillance, 1998–2009 [in Spanish]. Rev Panam Salud Publica 30: 439444.[Crossref] [Google Scholar]
  19. IPCA, 2011. Conclusiones, recomendaciones y resoluciones. Décimo tercera reunión de la Comisión Intergubernamental de la Iniciativa de los Países de Centroamérica (IPCA) para la interrupción de la transmission vectorial, transfusional y atención médica de la Enfermedad de Chagas, 17–19 de agosto de 2011, Tegucigalpa, Honduras. [Google Scholar]
  20. MoH, 2012. Informe final: encuesta basal de la Enfermedad de Chagas en 5 SILAIS, Nicaragua, 2010. Managua, Nicaragua: Ministerio de Salud de Nicaragua, Organización Panamericana de la Salud, Agencia de Cooperación Internacional del Japón. [Google Scholar]
  21. Yamagata Y, Nakagawa J, , 2006. Control of Chagas disease. Adv Parasitol 61: 129165.[Crossref] [Google Scholar]
  22. WHO, 2006. Pesticides and Their Application: For the Control of Vectors and Pests of Public Health Importance, 6th edition. WHO/CDS/NTD/WHOPES/GCDPP/2006.1. Geneva, Switzerland: World Health Organization. [Google Scholar]
  23. WHO, 2007. Manual for Indoor Residual Spraying: Application of Residual Sprays for Vector Control, 3rd edition. WHO/CDS/NTD/WHOPES/GCDPP/2007.3. Geneva, Switzerland: World Health Organization. [Google Scholar]
  24. Monroy C, Mejía M, Rodas A, Rosales R, Horio M, Tabaru Y, , 1998. Comparison of indoor searches with whole house demolition collections of the vectors of Chagas disease and their indoor distribution. Med Entomol Zool 49: 195200.[Crossref] [Google Scholar]
  25. Schofield CJ, , 2001. Field Testing and Evaluation of Insecticides for Indoor Residual Spraying against Domestic Vectors of Chagas Disease. Global collaboration for development of pesticides for public health. WHO/CDS/WHOPES/GCDPP/2001.1. Geneva, Switzerland: World Health Organization, 62. [Google Scholar]
  26. Monroy C, Mejía M, Rodas A, Hashimoto T, Tabaru Y, , 1998. Assessing methods for the density of Triatoma dimidiata, the principal vector of Chagas' disease in Guatemala. Med Entomol Zool 49: 301307.[Crossref] [Google Scholar]
  27. Kulldorff M, , 1997. A spatial scan statistic. Commun Stat Theory Methods 26: 14811496.[Crossref] [Google Scholar]
  28. Monroy C, Bustamante DM, Pineda S, Rodas A, Castro X, Ayala V, Quiñónes J, Moguel B, , 2009. House improvements and community participation in the control of Triatoma dimidiata re-infestation in Jutiapa, Guatemala. Cad Saúde Pública 25 (Suppl 1): S168S178.[Crossref] [Google Scholar]
  29. Guzman-Tapia Y, Ramirez-Sierra MJ, Escobedo-Ortegon J, Dumonteil E, , 2005. Effect of hurricane Isidore on Triatoma dimidiata distribution and Chagas disease transmission risk in the Yacatán Peninsula of Mexico. Am J Trop Med Hyg 73: 10191025. [Google Scholar]
  30. Dumonteil E, Ruiz-Piña H, Rodriguez-Félix E, Barrera-Pérez M, Ramirez-Sierra MJ, Rabinovich JE, Menu F, , 2004. Re-infestation of houses by Triatoma dimidiata after intradomicile insecticide application in the Yucatán Peninsula, Mexico. Mem Inst Oswaldo Cruz 99: 253256.[Crossref] [Google Scholar]
  31. Picollo MI, Vassena C, Santo Orihuela P, Barrios S, Zaidemberg M, Zerba E, , 2005. High resistance to pyrethroid insecticides associated with ineffective field treatments in Triatoma infestans (Hemiptera: Reduviidae) from northern Argentina. J Med Entomol 42: 637642.[Crossref] [Google Scholar]
  32. Dorn PL, Melgar S, Rouzier V, Gutierrez A, Combe C, Rosales R, Rodas A, Kott S, Salvia D, Monroy CM, , 2003. The Chagas vector, Triatoma dimidiata (Hemiptera: Reduviidae), is panmictic within and among adjacent villages in Guatemala. J Med Entomol 40: 436440.[Crossref] [Google Scholar]
  33. Stevens L, Monroy MC, Rodas AG, Hicks RM, Lucero DE, Lyons LA, Dorn PL, , 2015. Migration and gene flow among domestic populations of the Chagas insect vector Triatoma dimidiata (Hemiptera: Reduviidae) detected by microsatellite loci. J Med Entomol 52: 419428.[Crossref] [Google Scholar]
  34. Dorn PL, Monroy C, Curtis A, , 2007. Triatoma dimidiata (Latreille, 1811): a review of its diversity across its geographic range and the relationship among populations. Infect Genet Evol 7: 343352.[Crossref] [Google Scholar]
  35. Gaspe MS, Provecho YM, Piccinali RV, Gürtler RE, , 2015. Where do these bugs come from? Phenotypic structure of Triatoma infestans populations after control interventions in the Argentine Chaco. Mem Inst Oswaldo Cruz 110: 310318.[Crossref] [Google Scholar]
  36. Nieto-Sanchez C, Baus EG, Guerrero D, Grijalva MJ, , 2015. Positive deviance study to inform a Chagas disease control program in southern Ecuador. Mem Inst Oswaldo Cruz 110: 299309.[Crossref] [Google Scholar]
  37. Hashimoto K, Zúniga C, Nakamura J, Hanada K, , 2015. Integrating an infectious disease programme into the primary health care service: a retrospective analysis of Chagas disease community-based surveillance in Honduras. BMC Health Serv Res 15: 116.[Crossref] [Google Scholar]
  38. Hashimoto K, Yoshioka K, , 2014. Certifying achievement in the control of Chagas disease native vectors: what is a viable scenario? Reader's opinion. Mem Inst Oswaldo Cruz 109: 834837.[Crossref] [Google Scholar]

Data & Media loading...

  • Received : 02 Jun 2015
  • Accepted : 20 Aug 2015
  • Published online : 09 Dec 2015

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error