Interrupting transmission of Chagas disease to humans

The proposed objectives of the WHO 2030 Roadmap include: verification of interruption of domiciliary vectorial transmission in Latin America; and, everywhere, verification of interruption of transfusional, organ transplantation and congenital transmissions.

Depending on the geographical area, WHO recommends the following main approaches to prevention of transmission:

• spraying of houses and surrounding areas with residual insecticides;
• house improvements and house cleanliness to prevent vector infestation;
• personal preventive measures such as bednets, good hygiene practices in food preparation, transportation, storage and consumption;
• development of contextualized information, education and communication activities for various actors and scenarios about preventative measures;
• screening of blood donors and referral to the health system the ones identified at risk of infection;
• testing of organ, tissue or cell donors and receivers and referral to the health system the ones identified at risk of infection.
  

Sustaining the achievements and completing the agenda of eliminating Chagas disease as a public health problem, including in areas of low endemicity, will depend on retaining political interest and committing the requisite resources. Specific tasks WHO is dealing with include:

• tackling the persistence of the transmission and disease in regions where control had been in progress, such as the Gran Chaco region and a few areas in Central America;
• responding to the emergence of Chagas disease in regions previously considered free of transmission or house infestation by vector insects – such as the Amazon basin or areas of the Western Pacific – mainly due to increasing population and transport mobility worldwide;
• controlling the autochthonous vectors of domiciliary cycles and vectors in endemic areas where control efforts are lagging or where focus is on insecticide resistance, such as the Gran Chaco region;
• enhancing technical cooperation with a comprehensive approach to controlling vector-borne transmission by native triatomine bugs, such as Triatoma dimidiata in Central America;
• forging institutional progress and effective actions of the Sub-regional Initiatives of Prevention, Control and Attention of Chagas disease; as well as horizontal technical cooperation among countries through the technical support of PAHO and WHO;
• scaling-up screening of blood, blood products and organs prior transfusion and transplantation; and testing and treating girls, women of reproductive age, newborns and siblings of infected mothers without previous antiparasitic treatment.