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Chagas disease risk in Texas.

Sahotra Sarkar1, Stavana E Strutz, David M Frank

  • 1Section of Integrative Biology, University of Texas, Austin, Texas, United States of America. sarkar@mail.utexas.edu

Plos Neglected Tropical Diseases
|October 20, 2010
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Chagas disease poses a significant risk in Texas, particularly in the southern region, due to the presence of Triatoma vectors and Trypanosoma cruzi. This study highlights the urgent need for mandatory reporting and blood donor screening to address this public health concern.

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Area of Science:

  • Veterinary Public Health
  • Infectious Diseases
  • Spatial Epidemiology

Background:

  • Chagas disease, caused by Trypanosoma cruzi, is a significant public health issue in Latin America and is endemic in Texas.
  • Texas exhibits an autochthonous canine cycle, abundant Triatoma vectors, and established domestic/peridomestic cycles, creating a reservoir for the parasite.
  • Current gaps include the lack of mandatory Chagas disease reporting, blood donor screening, and unknown serological profiles in human and canine populations.

Purpose of the Study:

  • To conduct a formal risk assessment for Chagas disease in Texas, including the development of risk maps.
  • To identify areas with the highest risk for the establishment of autochthonous Chagas disease cycles.
  • To recommend actions to address the identified public health lacunae regarding Chagas disease in Texas.

Main Methods:

  • Ecological risk assessment using a maximum entropy algorithm with vector occurrence points and environmental layers.
  • Incidence-based relative risk computation at the county level using Bayesian models and T. cruzi incidence data.
  • Multi-criteria dominance analysis and a composite risk model integrating ecological and incidence data to identify high-risk counties.

Main Results:

  • Ecological risk models identified suitable habitats for Triatoma gerstaeckeri, T. lecticularia, and T. sanguisuga, with the highest ecological risk concentrated in south Texas.
  • Incidence-based risk was also concentrated in south Texas.
  • Both multi-criteria and composite risk models identified south Texas counties as having the highest risk, with additional risk noted in populous areas of north, east, and central Texas.

Conclusions:

  • Chagas disease should be designated as a reportable disease throughout Texas.
  • Mandatory blood donor screening and establishment of human/canine serological profiles are recommended, especially for south Texas.
  • A joint US-Mexico initiative is advised to combat Chagas disease in the trans-border region, with the methodology exportable to other contexts.