Current methods of Chagas disease control rely mainly on elimination of the domestic vector populations. Domestication of these insects has clearly been a recent event in evolutionary terms, associated with a series of genetic and phenetic changes, and this paper reviews current knowledge about the sequence of events leading to the domestication of species of Rhodnius that are important vectors of Chagas disease in the Andean pact and Central American countries. Available evidence suggests that species of Rhodnius have radiated from an ancestral source in the Amazon region, giving three main adaptive lines: southwards into the cerrados of Brazil, northwards into the llanos of Venezuela, and northwestwards through the Andean Cordillera into the Magdalena valley of Colombia. There has also been specialisation within the Amazon forest itself. The form of radiative adaptation is predicted from morphological and biogeographic characters, and subsequently supported by a series of morphometric and genetic markers including mtDNA sequence analysis.

Current methods of Chagas disease control rely mainly on elimination of the domestic vector populations. Domestication of these insects has clearly been a recent event in evolutionary terms, associated with a series of genetic and phenetic changes, and this paper reviews current knowledge about the sequence of events leading to the domestication of species of Rhodnius that are important vectors of Chagas disease in the Andean pact and Central American countries. Available evidence suggests that species of Rhodnius have radiated from an ancestral source in the Amazon region, giving three main adaptive lines: southwards into the cerrados of Brazil, northwards into the llanos of Venezuela, and northwestwards through the Andean Cordillera into the Magdalena valley of Colombia. There has also been specialisation within the Amazon forest itself. The form of radiative adaptation is predicted from morphological and biogeographic characters, and subsequently supported by a series of morphometric and genetic markers including mtDNA sequence analysis.

The migration of invasive vector species has contributed to the worldwide extension of infectious diseases such as dengue (Aedes aegypti) and chikungunya (Aedes albopictus). It is probably a similar behaviour for certain vectors of Chagas disease which allowed it to become a continental burden in Latin America. One of them, Triatoma rubrofasciata has also been spreading throughout the tropical and subtropical world. Here, the recent and massive peridomestic presence of T. rubrofasciata in Vietnam cities is reported, and tentatively explained, highlighting the need for improved entomological surveillance.

Rhodnius prolixus is one of the main vectors of Trypanosoma cruzi , causative agent of Chagas disease. In Central America, it was first discovered in 1915 in El Salvador, from where it spread northwest to Guatemala and Mexico, and southeast to Nicaragua and Costa Rica, arriving also in Honduras in the late 1950s. Indoor residual spraying (IRS) by the antimalaria services of Costa Rica prevented its spread southwards, and similar IRS programmes appear to have eliminated it from El Salvador by the late 1970s. In 1997, by resolution of the Ministers of Health of the seven Central American countries, a multinational initiative against Chagas disease (IPCA) was launched with one of the specific objectives being the elimination of R. prolixus from the region. As a result, more and more infested areas were encountered, and progressively sprayed using an IRS strategy already deployed against Triatoma infestans in the southern cone countries of South America. In 2008, Guatemala became the first of these countries to be formally certified as free of Chagas disease transmission due to R. prolixus . The other infested countries have since been similarly certified, and none of these has reported the presence of R. prolixus since June 2010. Further surveillance is required, but current evidence suggests that R. prolixus may now been eliminated from throughout the mesoamerican region, with a corresponding decline in the incidence of T. cruzi infections.

Background Sleeping sickness, transmitted by G. p. palpalis , is known to be present in the Ivory Coast. G. p. palpalis has recently been reported to occur in several places within the town of Abidjan, including: (i) the Banco forest, (ii) the Abobo Adjamé University campus and (iii) the zoological park. Could these three places be treated sequentially, as separate tsetse populations, or should they be taken as one area comprising a single, panmictic population? Methods The amount of gene flow between these places provides strategic information for vector control. It was estimated by the use of both microsatellite DNA and morphometric markers. The idea was to assess the interest of the faster and much less expensive morphometric approach in providing relevant information about population structure. Thus, to detect possible lack of insect exchange between these neighbouring areas of Abidjan, we used both genetic (microsatellite DNA) and phenetic (geometric morphometrics) markers on the same specimens. Using these same markers, we also compared these samples with specimens from a more distant area of south Ivory Coast, the region of Aniassué (186 km north from Abidjan). Results Neither genetic nor phenetic markers detected significant differentiation between the three Abidjan G. p. palpalis samples. Thus, the null hypothesis of a single panmictic population within the city of Abidjan could not be rejected, suggesting the control strategy should not consider them separately. The markers were also in agreement when comparing G. p. palpalis from Abidjan with those of Aniassué, showing significant divergence between the two sites. Conclusions Both markers suggested that a successful control of tsetse in Abidjan would require the three Abidjan sites to be considered together, either by deploying control measures simultaneously in all three sites, or by a continuous progression of interventions following for instance the "rolling carpet" principle. To compare the geometry of wing venation of tsetse flies is a cheap and fast technique. Agreement with the microsatellite approach highlights its potential for rapid assessment of population structure.

We present an overview of the two main strategies for the primary (vector control) and secondary (patient care) prevention of Chagas disease (CD). We identify major advances, knowledge gaps, and key research needs in both areas. Improved specific chemotherapy, including more practical formulations (e.g., paediatric) or combinations of existing drugs, and a better understanding of pathogenesis, including the relative weights of parasite and host genetic makeup, are clearly needed. Regarding CD vectors, we find that only about 10–20% of published papers on triatomines deal directly with disease control. We pinpoint the pitfalls of the current consensus on triatomine systematics, particularly within the Triatomini, and suggest how some straightforward sampling and analytical strategies would improve research on vector ecology, naturally leading to sounder control-surveillance schemes. We conclude that sustained research on CD prevention is still crucial. In the past, it provided not only the know-how, but also the critical mass of scientists needed to foster and consolidate CD prevention programmes; in the future, both patient care and long-term vector control would nonetheless benefit from more sharply focused, problem-oriented research.

Beginning as a silvatic enzoosis involving Trypanosoma cruzi and a range of small mammals and marsupials, human Chagas disease probably emerged as a sparse focal disease at different points in the Americas well before the Christian period. Subsequently spread through internal population migrations, the disease would have become more widespread where the insect vectors became associated with rural settlements. It appears to have spread most widely during the post-Colombian period, especially from the mid 19th to mid 20th centuries when the human infection appears to have peaked in incidence and prevalence. In historical terms, there are sparse indications of probable acute cases, chronic cardiopathy, and megacolon, but such conditions are difficult to diagnose accurately. In contrast, megaoesophagus seems a more specific marker of chronic Chagas disease, with a number of reports of its occurrence in various parts of Brazil, especially since the 18th century. The main impact of chronic Chagas disease corresponds primarily to the occurrence of chronic chagasic cardiopathy, and recognition and characterization of this has been the main stimulus for large-scale control interventions in the endemic countries since the 1950s.

Background: Among Chagas disease triatomine vectors, the largest genus, Triatoma, includes species of high public health interest. Triatoma dimidiata, the main vector throughout Central America and up to Ecuador, presents extensive phenotypic, genotypic, and behavioral diversity in sylvatic, peridomestic and domestic habitats, and non-domiciliated populations acting as reinfestation sources. DNA sequence analyses, phylogenetic reconstruction methods, and genetic variation approaches are combined to investigate the haplotype profiling, genetic polymorphism, phylogeography, and evolutionary trends of T. dimidiata and its closest relatives within Triatoma. This is the largest interpopulational analysis performed on a triatomine species so far.Methodology and Findings: Triatomines from Mexico, Guatemala, Honduras, Nicaragua, Panama, Cuba, Colombia, Ecuador, and Brazil were used. Triatoma dimidiata populations follow different evolutionary divergences in which geographical isolation appears to have had an important influence. A southern Mexican-northern Guatemalan ancestral form gave rise to two main clades. One clade remained confined to the Yucatan peninsula and northern parts of Chiapas State, Guatemala, and Honduras, with extant descendants deserving specific status. Within the second clade, extant subspecies diversity was shaped by adaptive radiation derived from Guatemalan ancestral populations. Central American populations correspond to subspecies T. d. dimidiata. A southern spread into Panama and Colombia gave the T. d. capitata forms, and a northwestern spread rising from Guatemala into Mexico gave the T. d. maculipennis forms. Triatoma hegneri appears as a subspecific insular form.Conclusions: The comparison with very numerous Triatoma species allows us to reach highly supported conclusions not only about T. dimidiata, but also on different, important Triatoma species groupings and their evolution. The very large intraspecific genetic variability found in T. dimidiata sensu lato has never been detected in a triatomine species before. The distinction between the five different taxa furnishes a new frame for future analyses of the different vector transmission capacities and epidemiological characteristics of Chagas disease. Results indicate that T. dimidiata will offer problems for control, although dwelling insecticide spraying might be successful against introduced populations in Ecuador.

Following an infestation of dogticks in kennels housing dogs used for long-term studies of the pathogenesis of Chagas disease, we examined the effect of ivermectin treatment on the dogs, ticks, trypanosome parasites, and also on triatomine vectors of Chagas disease. Ivermectin treatment was highly effective in eliminating the ticks, but showed no apparent effect on the dogs nor on their trypanosome infection. Triatominae fed on the dogs soon after ivermectin treatment showed high mortality, but this effect quickly declined for bugs fed at successive intervals after treatment. In conclusion, although ivermectin treatment may have a transient effect on peridomestic populations of Triatominae, it is not the treatment of choice for this situation. The study also showed that although the dogticks could become infected with Trypanosoma cruzi, this only occurred when feeding on dogs in the acute phase of infection, and there was no evidence of subsequent parasite development in the ticks.

American Trypanosomiasis (Chagas' disease) due to Trypanosoma cruzi in the Amazon Region has become a target of scientific preoccupation in recent years because of the wide dispersion of infected vectors and intensive human migration into the region. An European Community and Latin America Triatominae Network international workshop held in July 2002 analyzed the general situation and the perspectives of human Chagas' disease in the area, concluding that although its occurrence remains sporadic, there is strong potential for the disease to spread, and a requirement for an integrated surveillance effort to be shared by all countries of the region.

O controle de triatomíneos é dificultado pela capacidade de reinvasão das casas por exemplares silvestres. Entre agosto/96 e dezembro/97 realizou-se, no Ceará, um estudo a respeito da reinfestação das casas após borrifação. Das 277 Unidades Domiciliares ­ UD ­ pesquisadas, 40,8% estavam infestadas (21,7% dos intradomicílios e 35,4% dos peridomicílios). Dos 433 triatomíneos capturados, 207 eram Triatoma brasiliensis (48,8% no intradomicílio, média de 1,8 insetos/casa) e 226 Triatoma pseudomaculata (97,3% no peridomicílio). Ocorre um único ciclo anual do T. brasiliensis, e dois ciclos anuais do T. pseudomaculata. Quatro meses após a borrifação, 9,7% das unidades domiciliares permaneciam positivas, principalmente no peridomicílio; 10,3% das UD foram positivas em todas as avaliações. O teste de suscetibilidade biológica à deltametrina revelou a persistência do inseticida no intradomicílio até nove meses após a borrifação. A prevalência global da infecção humana foi de 5,7%, tendo sido positivas cinco crianças menores de dez anos. Considerando-se a alta pressão de recolonização a partir de exemplares silvestres, propõe-se, como metodologia de controle, um sistema misto da avaliação tradicional e a vigilância epidemiológica.Vector control strategies against indigenous species is not easy, due to their capacity to reinvade treated premises from sylvatic ecotopes. Between August 1996 and December 1997 we conducted a study on reinfestation of houses after spraying in a county in the State of Ceará. Of 277 houses examined, 113 (40.8%) were infested (21.7% intradomiciliary and 35.4% peridomiciliary). Of the 433 Triatominae collected, 207 were Triatoma brasiliensis (49% of which intradomiciliary, with a mean of 1.8 insects/house) and 226 were Triatoma pseudomaculata (97% peridomiciliary). The age structure of the two indicated a univoltine development cycle for T. brasiliensis and two cycles per year for T. pseudomaculata. Four months after spraying with deltamethrin SC 25mg ia/m², 9.7% of the houses were still positive, mainly with peridomestic infestations. Intradomiciliary wall bioassays showed persistence of the insecticide up to 9 months after spraying. Considering the high potential for recolonization of treated premises from sylvatic foci, we propose an operational strategy combining traditional evaluations and community-based surveillance with increased selective interventions and community education.

O controle de triatomíneos é dificultado pela capacidade de reinvasão das casas por exemplares silvestres. Entre agosto/96 e dezembro/97 realizou-se, no Ceará, um estudo a respeito da reinfestação das casas após borrifação. Das 277 Unidades Domiciliares UD pesquisadas, 40,8% estavam infestadas (21,7% dos intradomicílios e 35,4% dos peridomicílios). Dos 433 triatomíneos capturados, 207 eram Triatoma brasiliensis (48,8% no intradomicílio, média de 1,8 insetos/casa) e 226 Triatoma pseudomaculata (97,3% no peridomicílio). Ocorre um único ciclo anual do T. brasiliensis, e dois ciclos anuais do T. pseudomaculata. Quatro meses após a borrifação, 9,7% das unidades domiciliares permaneciam positivas, principalmente no peridomicílio; 10,3% das UD foram positivas em todas as avaliações. O teste de suscetibilidade biológica à deltametrina revelou a persistência do inseticida no intradomicílio até nove meses após a borrifação. A prevalência global da infecção humana foi de 5,7%, tendo sido positivas cinco crianças menores de dez anos. Considerando-se a alta pressão de recolonização a partir de exemplares silvestres, propõe-se, como metodologia de controle, um sistema misto da avaliação tradicional e a vigilância epidemiológica.

The Southern Cone Initiative against Chagas' disease, was launched in 1991. The aim was to interrupt the transmission of Chagas disease by elimination of domestic populations of the major vector, Triatoma infestans, and by improved screening of blood donors. As a result of these activities, a marked reduction in the risk of transfusional transmission can now be seen throughout the programme area. In addition to specific legislation concerning the quality of transfused blood, a series of national and regional reference laboratories have been set up with the help of PAHO in order to improve the quality of pre-transfusional serodiagnosis. Results indicate a progressive reduction in the overall infection prevalence of blood donors, and show that the age-prevalence curve has shifted towards older age-groups. In this paper we analyse the changes in infection prevalence in the Southern Cone countries, drawing attention to the situation in Bolivia which has the highest indices of infection and lowest levels of coverage by the control programme. In this situation chemoprofylaxis of blood prior to transfusion may be recommended in accordance with PAHO criteria. In the medium term however, interruption of human Chagas disease transmission may be expected over most of the Southern Cone region, as long as the control activities are continued and consolidated through effective epidemiological surveillance.

The entire life cycle of Rhodnius domesticus, fed weekly on mice, was studied under controlled conditions. Aspects related to hatching, life time, mortality, feeding behaviour and fecundity for each stage of the insect life-cycle were evaluated. The hatching rate observed in 100 eggs was 57% and the mean time of hatching was 15.6 days. Forty-six nymphs (80.7%) completed the cycle and the mean time from NI to adult was 93.8 days. The average span in days for each stage was 12.4 for NI, 9.8 for NII, 14.2 for NIII, 16.8 for NIV and 25.0 NV. the number of bloodmeals in each nymphal stage varied from 1 to 3. The mortality rate was 12.3% for NI, 3.5% for NII and 1.7% for NIII and NV nymphs. The mean number of eggs laid per female in a 9-month period was 333.1. Average adult survival rates were 287.6 + 133 and 328 + 73 days for males and females respectively.

Integrando os objetivos principais da iniciativa dos 6 Países do Cone Sul para a eliminação da doença de Chagas, a partir de 1991, foram intensificadas as ações de controle das atividades hemoterápicas, em paralelo com o combate intensivo ao Triatoma infestans, principal vetor da doença da Região. Através das atividades específicas e também como produto direto do controle vetorial, nota-se importante diminuição dos riscos da transmissão transfusional do Trypanosoma cruzi nas áreas trabalhadas. Além de legislação específica sobre a qualidade da hemoterapia, implementaram-se laboratórios nacionais e regionais de referência, com a assistência da OPS, objetivando-se uma boa sorologia pré-transfusional dos doadores, cuja cobertura tem aumentado. Observa-se ainda uma progressiva diminuição na prevalência da infeção chagásica entre doadores e também um progressivo deslocamento dos doadores infetados para grupos etários mais elevados, como fruto do controle vetorial e do próprio descarte de doadores soro-positivos em doações anteriores. São analisados dados e tendências do problema pelos Países, sendo mais preocupante a situação da Bolívia, com maiores taxas de prevalência e menores de cobertura do programa, ali sendo indicadas ações de quimioprofilaxia, conforme os critérios da OMS. Antevê-se a médio prazo o controle da transmissão da doença de Chagas humana na maior parte da Região, desde que cumpridas corretamente as etapas do programa em andamento, devidamente consolidadas através de efetiva vigilância epidemiológica.