Triatomine Infestation in Guatemala: Spatial Assessment after Two Rounds of Vector Control

Jennifer Manne Department of Global Health and Population, Harvard University School of Public Health, Boston, Massachusetts; Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Institute for International Cooperation, Japanese International Cooperation Agency, Tokyo, Japan; Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Computational Epidemiology Group, Children's Hospital Boston, Boston, Massachusetts

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Jun Nakagawa Department of Global Health and Population, Harvard University School of Public Health, Boston, Massachusetts; Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Institute for International Cooperation, Japanese International Cooperation Agency, Tokyo, Japan; Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Computational Epidemiology Group, Children's Hospital Boston, Boston, Massachusetts

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Yoichi Yamagata Department of Global Health and Population, Harvard University School of Public Health, Boston, Massachusetts; Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Institute for International Cooperation, Japanese International Cooperation Agency, Tokyo, Japan; Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Computational Epidemiology Group, Children's Hospital Boston, Boston, Massachusetts

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Alexander Goehler Department of Global Health and Population, Harvard University School of Public Health, Boston, Massachusetts; Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Institute for International Cooperation, Japanese International Cooperation Agency, Tokyo, Japan; Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Computational Epidemiology Group, Children's Hospital Boston, Boston, Massachusetts

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John S. Brownstein Department of Global Health and Population, Harvard University School of Public Health, Boston, Massachusetts; Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Institute for International Cooperation, Japanese International Cooperation Agency, Tokyo, Japan; Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Computational Epidemiology Group, Children's Hospital Boston, Boston, Massachusetts

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Marcia C. Castro Department of Global Health and Population, Harvard University School of Public Health, Boston, Massachusetts; Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Institute for International Cooperation, Japanese International Cooperation Agency, Tokyo, Japan; Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts; Computational Epidemiology Group, Children's Hospital Boston, Boston, Massachusetts

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In 2000, the Guatemalan Ministry of Health initiated a Chagas disease program to control Rhodnius prolixus and Triatoma dimidiata 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*(d) 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.

Author Notes

*Address correspondence to Jennifer Manne, Department of Global Health and Population, Harvard School of Public Health, 665 Huntington Ave., Boston, MA 02115. E-mail: jmanne@post.harvard.edu

Financial support: This research was supported by the David Rockefeller Center for Latin American Studies at Harvard University as well as the Michael Von Clemm Family Fellowship and the Andrew Spielman Memorial Travel Fellowship of the Harvard School of Public Health.

Authors' addresses: Jennifer Manne and Marcia Castro, Department of Global Health and Population, Harvard School of Public Health, Boston, MA, E-mails: jmanne@post.harvard.edu and mcastro@hsph.harvard.edu. Jun Nakagawa, Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan, E-mail: junnakagawa@hotmail.com. Yoichi Yamagata, Institute for International Cooperation, Japan International Cooperation Agency, Tokyo, Japan, E-mail: yamagata_yoichi@hotmail.com. Alexander Goehler, Department of Radiology, Massachusetts General Hospital, Boston, MA, E-mail: agoehler@partners.org. John S. Brownstein, Department of Pediatrics, Harvard Medical School, Boston, MA, E-mail: John.Brownstein@childrens.harvard.edu.

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