The eco-epidemiology of Chagas disease in Panama: A preliminary study

Chagas disease, a neglected tropical disease transmitted by Triatominae, currently affects between 8-12 million people throughout Central and South America. Though endemic throughout much of its range, Chagas disease disproportionately affects poor communities and its prevalence varies greatly both between and within countries. In the Republic of Panama, seroprevalence of Chagas disease in humans has been found to range from 2-6%, while infection can range from 12-75% in the primary vector, Rhodnius pallescens (Hemiptera: Reduviidae).  Though there are several other potential vector species in Panama, their contribution to disease transmission is currently unknown. This project combined epidemiological surveys of communities across a land use gradient in central Panama with entomological surveys of triatomines in the same areas. Household surveys explored social and behavioral factors, such as living conditions, education level, socioeconomic status, vector control methods, and knowledge about the disease, to better understand what factors may contribute to transmission risk in  urban versus rural land use areas. Additionally, survey participants collected insects found in and around their homes to explore what species may be coming into contact with humans in the peridomestic setting. Multiple species of triatomine were collected from houses as well as many other (non-triatomine) insects. Epidemiological surveys suggest that social and behavioral factors, including knowledge of the disease and vector, vary both between and within urban and rural areas.  Taken together these results indicate both socioeconomic and entomological factors related to the transmission of Chagas disease vary with human land use.