Pilot Chagas Disease Control Program

Assisting Ecuador's Loja Province

Research and Community Education Make a Difference in Outcomes

Approximately 70 percent of the territory of Ecuador consists of tropical and subtropical areas. The climate and sociological-political-economic conditions of this region predispose the population for a number of vector-transmitted diseases, such as Chagas disease, malaria and dengue fever. Work previously conducted in Loja province has demonstrated high domiciliary and peridomiciliary infestation with Triatomine insects in five communities. In 2005 and 2006, a Pilot Control Program was launched in 58 communities. The results after one year were assessed in 2006 in 10 of those and showed a remarkable reduction in triatomine infestation. As preparations are being made for a province-wide control program, it is important to identify the triatomine infestation in other areas and to verify the effectiveness of the interventions proposed. In addition, it is important to determine the acute cases and to understand the effects of this disease in local mortality and morbidity.

Besides learning about the biology of the triatomine species present in these region, it is important to determine the knowledge, aptitudes and practices (KAP) of the population regarding these insects and other risk factors for Chagas disease, and the acceptability of the intervention strategies implemented. These data becomes the baseline for an extensive educational campaign aimed at the villagers and personnel of local and national institutions.

Community education activities are conducted along with the research efforts. These include discussions with the household members, distribution of printed material and interactive meetings with the members communities at large. Emphasis is placed on development of videos that will be used throughout the province for further community education, as well as technical training of community health workers and control program personnel. In order in increase the effectiveness of these materials and community participation in the long-term project, local community members and personnel from the control agencies will be invited to participate in the video.

The logistical arrangements to conduct research in these geographic areas are difficult to establish due the inadequate infrastructure. Maximization of resources by the use of multidisciplinary teams in combination with the involvement of local governmental and nongovernmental agencies, health care institutions and community members are crucial for the acquisition of useful data. However, the coupling of the research with community education and development programs and basic health care (provided by the local health care system) can have a major impact in improving the health status of the people in the study areas.