Volume 86, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



In 2000, the Guatemalan Ministry of Health initiated a Chagas disease program to control and by periodic house spraying with pyrethroid insecticides to characterize infestation patterns and analyze the contribution of programmatic practices to these patterns. Spatial infestation patterns at three time points were identified using the Getis-Ord Gi*() test. Logistic regression was used to assess predictors of reinfestation after pyrethroid insecticide administration. Spatial analysis showed high and low clusters of infestation at three time points. After two rounds of spray, 178 communities persistently fell in high infestation clusters. A time lapse between rounds of vector control greater than 6 months was associated with 1.54 (95% confidence interval = 1.07–2.23) times increased odds of reinfestation after first spray, whereas a time lapse of greater than 1 year was associated with 2.66 (95% confidence interval = 1.85–3.83) times increased odds of reinfestation after first spray compared with localities where the time lapse was less than 180 days. The time lapse between rounds of vector control should remain under 1 year. Spatial analysis can guide targeted vector control efforts by enabling tracking of reinfestation hotspots and improved targeting of resources.


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  1. Hotez PJ, Molyneux DH, Fenwick A, Kumaresan J, Sachs SE, Sachs JD, Savioli L, , 2007. Control of neglected tropical diseases. N Engl J Med 357: 10181027.[Crossref] [Google Scholar]
  2. World Health Organization, 2002. Control of Chagas Disease: Second Report of the WHO Expert Committee. WHO Technical Report Series. Geneva, Switzerland: World Health Organization. [Google Scholar]
  3. Tarleton RL, Reithinger R, Urbina JA, Kitron U, Gurtler RE, , 2007. The challenges of Chagas disease—grim outlook or glimmer of hope. PLoS Med 4: e332.[Crossref] [Google Scholar]
  4. Bern C, , 2011. Antitrypanosomal therapy for chronic Chagas' disease. N Engl J Med 364: 25272534.[Crossref] [Google Scholar]
  5. Dias JC, , 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]
  6. Schofield CJ, , 2005. 21 years of parasitology. Trends Parasitol 21: 483485.[Crossref] [Google Scholar]
  7. Gurtler RE, Kitron U, Cecere MC, Segura EL, Cohen JE, , 2007. Sustainable vector control and management of Chagas disease in the Gran Chaco, Argentina. Proc Natl Acad Sci USA 104: 1619416199.[Crossref] [Google Scholar]
  8. Yamagata Y, Nakagawa J, , 2006. Control of Chagas disease. Adv Parasitol 61: 129165.[Crossref] [Google Scholar]
  9. Rizzo NR, Arana BA, Diaz A, Cordon-Rosales C, Klein RE, Powell MR, , 2003. Seroprevalence of Trypanosoma cruzi infection among school-age children in the endemic area of Guatemala. Am J Trop Med Hyg 68: 678682. [Google Scholar]
  10. Paz-Bailey G, Monroy C, Rodas A, Rosales R, Tabaru R, Davies C, Lines J, , 2002. Incidence of Trypanosoma cruzi infection in two Guatemalan communities. Trans R Soc Trop Med Hyg 96: 4852.[Crossref] [Google Scholar]
  11. King RJ, Cordon-Rosales C, Cox J, Davies CR, Kitron UD, , 2011. Triatoma dimidiata infestation in Chagas disease endemic regions of Guatemala: comparison of random and targeted cross-sectional surveys. PLoS Negl Trop Dis 5: e1035.[Crossref] [Google Scholar]
  12. Pan American Health Organization, 2007. Guatemala. Health in the Americas. Washington, DC: Pan American Health Organization, 374393. [Google Scholar]
  13. Monroy C, Rodas A, Mejia M, Rosales R, Tabaru Y, , 2003. Epidemiology of Chagas disease in Guatemala: infection rate of Triatoma dimidiata, Triatoma nitida and Rhodnius prolixus (Hemiptera, Reduviidae) with Trypanosoma cruzi and Trypanosoma rangeli (Kinetoplastida, Trypanosomatidae). Mem Inst Oswaldo Cruz 98: 305310.[Crossref] [Google Scholar]
  14. Yamagata Y, Nakagawa J, Shimoda M, Tabaru Y, , 2003. Management of infectious disease control in a decentralized organization: the case of the Japan-Guatemala Project for Chagas' Disease Control in Guatemala. Technol Develop 16: 4754. [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 (Reduviiade; Triatominae), the principal vector of Chagas disease in Jutiapa, Guatemala. Am J Trop Med Hyg 75: 226230. [Google Scholar]
  16. Hashimoto K, Kojima M, Nakagawa J, Yamagata Y, , 2005. Effectiveness of health education through primary school teachers: activities of Japan overseas cooperation volunteers in the control of Chagas' disease vectors in Guatemala. Technol Develop 18: 7176. [Google Scholar]
  17. Nakagawa J, Cordon-Rosales C, Juarez 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]
  18. Nakagawa J, Hashimoto K, Cordon-Rosales C, Abraham Juarez J, Trampe R, Marroquin Marroquin L, , 2003. The impact of vector control on Triatoma dimidiata in the Guatemalan department of Jutiapa. Ann Trop Med Parasitol 97: 288297.[Crossref] [Google Scholar]
  19. Nakagawa J, Juarez J, Nakatsuji K, Akiyama T, Hernandez G, Macal R, Flores C, Ortiz M, Marroquin L, Bamba T, Wakai S, , 2005. Geographical characterization of the triatomine infestations in north-central Guatemala. Ann Trop Med Parasitol 99: 307315.[Crossref] [Google Scholar]
  20. Schofield CJ, , 2001. Global Collaboration for the Development of Pesticides for Public Health (GCDPP): Field Testing and Evaluation of Insecticides for Indoor Residual Spraying Against Vectors of Chagas Disease. WHO Pesticide Evaluation Scheme: World Health Organization Communicable Disease Control, Prevention and Eradication. Geneva, Switzerland: World Health Organization. [Google Scholar]
  21. Rojas de Arias A, Lehane MJ, Schofield CJ, Fournet A, , 2003. Comparative evaluation of pyrethroid insecticide formulations against Triatoma infestans (Klug): residual efficacy on four substrates. Mem Inst Oswaldo Cruz 98: 975980.[Crossref] [Google Scholar]
  22. Gurtler RE, Canale DM, Spillmann C, Stariolo R, Salomon OD, Blanco S, Segura EL, , 2004. Effectiveness of residual spraying of peridomestic ecotopes with deltamethrin and permethrin on Triatoma infestans in rural western Argentina: a district-wide randomized trial. Bull World Health Organ 82: 196205. [Google Scholar]
  23. Getis A, Ord JK, , 1996. Local spatial statistics: an overview. Batty PLaM, ed. Spatial Analysis: Modelling in a GIS Environment. New York: Wiley. [Google Scholar]
  24. Gurevitz JM, Ceballos LA, Kitron U, Gurtler RE, , 2006. Flight initiation of Triatoma infestans (Hemiptera: Reduviidae) under natural climatic conditions. J Med Entomol 43: 143150.[Crossref] [Google Scholar]
  25. Castro MC, Singer BH, , 2006. Controlling the false discovery rate: a new application to account for multiple and dependent tests in local statistics of spatial association. Geogr Anal 38: 180.[Crossref] [Google Scholar]
  26. Benjamini Y, Hochberg Y, , 1995. Controlling the false discovery rate—a practical and powerful approach to multiple testing. J R Stat Soc B Stat Methodol 57: 289300. [Google Scholar]
  27. Ministerio de Salud Publica y Asistencia Social Republica de El Salvador, 2007. Norma Tecnica de Prevencion y Control de la Enfermedad de Chagas. El Salvador: Ministerio de Salud Publica y Asistencia Social Republica de El Salvador. [Google Scholar]
  28. Dumonteil E, Ruiz-Pina H, Rodriguez-Felix E, Barrera-Perez M, Ramirez-Sierra MJ, Rabinovich JE, Menu F, , 2004. Re-infestation of houses by Triatoma dimidiata after intra-domicile insecticide application in the Yucatan peninsula, Mexico. Mem Inst Oswaldo Cruz 99: 253256.[Crossref] [Google Scholar]
  29. Schofield CJ, , 2000. Global Collaboration for Development of Pesticides for Public Health (GCDPP): Challenges of Chagas Disease Vector Control in Central America. WHO Pesticide Evaluation Scheme: World Health Organization Communicable Disease Control, Prevention and Eradication. Geneva, Switzerland: World Health Organization. [Google Scholar]
  30. Barbu C, Dumonteil E, Gourbiere S, , 2009. Optimization of control strategies for non-domiciliated Triatoma dimidiata, Chagas disease vector in the Yucatan Peninsula, Mexico. PLoS Negl Trop Dis 3: e416.[Crossref] [Google Scholar]
  31. Ferral J, Chavez-Nunez L, Euan-Garcia M, Ramirez-Sierra MJ, Najera-Vazquez MR, Dumonteil E, , 2010. Comparative field trial of alternative vector control strategies for non-domiciliated Triatoma dimidiata . Am J Trop Med Hyg 82: 6066.[Crossref] [Google Scholar]
  32. Levy MZ, Malaga Chavez FS, Cornejo Del Carpio JG, Vilhena DA, McKenzie FE, Plotkin JB, , 2010. Rational spatio-temporal strategies for controlling a Chagas disease vector in urban environments. J R Soc Interface 7: 10611070.[Crossref] [Google Scholar]
  33. Barbu C, Dumonteil E, Gourbiere S, , 2011. Evaluation of spatially targeted strategies to control non-domiciliated Triatoma dimidiata vector of Chagas disease. PLoS Negl Trop Dis 5: e1045.[Crossref] [Google Scholar]
  34. Vazquez-Prokopec GM, Cecere MC, Canale DM, Gurtler RE, Kitron U, , 2005. Spatiotemporal patterns of reinfestation by Triatoma guasayana (Hemiptera: Reduviidae) in a rural community of northwestern Argentina. J Med Entomol 42: 571581.[Crossref] [Google Scholar]
  35. Levy MZ, Kawai V, Bowman NM, Waller LA, Cabrera L, Pinedo-Cancino VV, Seitz AE, Steurer FJ, Cornejo Del Carpio JG, Cordova-Benzaquen E, Maguire JH, Gilman RH, Bern C, , 2007. Targeted screening strategies to detect Trypanosoma cruzi infection in children. PLoS Negl Trop Dis 1: e103.[Crossref] [Google Scholar]
  36. Levy MZ, Bowman NM, Kawai V, Plotkin JB, Waller LA, Cabrera L, Steurer F, Seitz AE, Pinedo-Cancino VV, Cornejo del Carpio JG, Cordova Benzaquen E, McKenzie FE, Maguire JH, Gilman RH, Bern C, , 2009. Spatial patterns in discordant diagnostic test results for Chagas disease: links to transmission hotspots. Clin Infect Dis 48: 11041106.[Crossref] [Google Scholar]
  37. Piesman J, Sherlock IA, Mota E, Todd CW, Hoff R, Weller TH, , 1985. Association between household triatomine density and incidence of Trypanosoma cruzi infection during a nine-year study in Castro Alves, Bahia, Brazil. Am J Trop Med Hyg 34: 866869. [Google Scholar]

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  • Received : 25 Jan 2011
  • Accepted : 14 Dec 2011
  • Published online : 01 Mar 2012

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