Description of a newly discovered Triatoma infestans (Hemiptera: Reduviidae) Foci in Ibipeba, State of Bahia, Brazil

Abstract

Introduction

Chagas disease transmitted by the Triatoma infestans was eradicated from Brazil in 2006. However, reports of triatomine foci threaten the control of Chagas disease. The goal of this study was to determine T. infestans foci in the City of Ibipeba, State of Bahia.

Methods

Triatominae specimens were collected in Ibipeba and entomologic indicators were calculated using indices of domiciliary infestation, density, and colonization.

Results

T. infestans foci was discovery in Ibipeba, State of Bahia. Approximately 95% of the specimens were discovered inside dwellings, of which 34% were T. infestans. This species was also discovered forming a colony in tree bark in the peridomicile.

Conclusions

Triatoma infestans foci in peridomestic ecotopes in Ibipeba, BA, indicate increased the risk of transmission Chagas disease.

Triatoma infestans ; Chagas disease; Triatominae

Chagas disease remains a significant public health issue in many parts of the world despite its discovery one hundred years ago, and is estimated to account for more than 10,000 cases of deaths in 2008. In Latin America alone, it is estimated that 25 million people live in high-risk areas, and 7 to 8 million people have the disease¹,². The etiologic agent of Chagas disease is the protozoan Trypanosoma cruzi (Kinetoplastida: Trypanosomatidae), which is transmitted by insects of the subfamily Triatominae (Hemiptera: Reduviidae)³. In the past, Triatoma infestans was responsible for the highest number of Chagas disease cases⁴, and in 1983, the World Health Organization (WHO) conducted a vector control program to eradicate T. infestans by means of chemical control, dwelling improvements, and reeducation of the exposed population.

Following these efforts, Chagas disease transmitted by T. infestans or blood transfusion was eradicated by 2006⁵. However, residual vector foci remain in the States of Bahia, Minas Gerais, and Rio Grande do Sul⁴. T. infestans are the major vectors for Chagas disease because they are exclusively domestic, highly anthropophilic, and easily infected by T. cruzi. The wide distribution of T. infestans has been attributed to transport associated with human migration and enhanced species adaptation to the intradomicilliary environment, including sheltering within wall cracks, roofs, human apparel, under beds, and additional micro-habitats⁶. Additionally, studies have shown frequent human infection in areas of concentrated T. infestans⁷. Recently, a resident of Ibipeba observed the presence of a triatomine in his dwelling, raising important epidemiological questions regarding the immergence of triatomine foci and transmission of Chagas disease. The objective of this study was to identify Triatominae foci in Ibipeba, Bahia, and to collect and characterize each identified species.

This was a cross-sectional epidemiological study of data collected by the entomology team of the Epidemiological Surveillance Board of the Bahia State Bureau of Health (Diretoria de Vigilância Epidemiológica, Secretaria da Saúde do Estado da Bahia, DIVEP/SESAB) in November 2009. The research was conducted in the City of Ibipeba, after a resident identified a triatomine specimen in his dwelling located in the urban area of the city. The City of Ibipeba is located in the State of Bahia within the country of Brazil (Figure 1A and 1B). Ibipeba is in the mesoregion of Irecê and the physiographic area of Northern Chapada Diamantina (encompassing the entire Drought Polygon characterized as the cerrado biome). Triatomines were collected on an Amaralina farm (at an altitude of approximately 593m with the coordinates 11°61.297′ S, 42°11.283′ W).

FIGURE 1 -
Geographical location of the study ecotope. A) The map of South America indicates the location of our Triatominae species survey. The City of Ibipeba is in the State of Bahia, which is one of 26 states in Brazil. B) Image of the Ibipeba ecotope where Triatoma infestans was initially discovered.

Environments consisting of domestic units closed by doors (i.e., houses and annexes) were considered domestic ecotopes. Triatomines were discovered sheltering within infrastructure cracks of the domestic environments and under beds or behind objects placed along walls. The studied peridomestic ecotopes (where domestic or wild animals sleep or are bred) were in a radius of 50m from the dwellings. During the field research, triatomines were collected manually with tweezers and placed in individual flasks labeled with information regarding the place of collection⁸.

Entomological indicators were calculated according to standard equations: index of domiciliary infestation = (number of domiciliary units with triatomines / number of domiciliary units searched) × 100; index of domiciliary triatomine density = number of samples captured / number of domiciliary units searched; index of colonization = (number of domiciles with nymphs / number of houses inspected) × 100⁹.

The initial reference point for investigation of Triatominae foci was the dwelling first reported to house a triatomine specimen. From this reference point, 9 locations were surveyed in Ibipeba. The initial T. infestans specimen (Figure 2A) discovered in Ibipeba was identified using an entomological key⁶ at the entomology laboratory of the 21^st Regional Health Board in Irecê. Images shown in Figure 2B demonstrate traces of triatomine feces on intradomicile walls that corresponded to the presence of specimens identified in that area. The image in Figure 2C indicates that wild animals, as armadillo, were bred in the peridomicile where triatomine specimens were identified. Figure 2D demonstrates a tree trunk (Leucaena leucocephala) located approximately 50 m from a rural residence (Amaralina farm in Ibipeba) where T. infestans nymphs and adults were identified.

FIGURE 2 -
Discovery of Triatoma infestans at the study ecotope. A) Image of an adult Triatoma infestans specimen captured inside a dwelling in Ibipeba. B) Image depicting traces of triatomine feces on a dwelling wall. C) Wild animal breeding in the peridomicile of a dwelling in Ibipeba. D) Image demonstrating the tree bark where Triatoma infestans nymphs were discovered in association with rodents.

Three triatomine species were discovered in the intradomicile and peridomicile regions of study ecotopes as shown in Table 1. The species were T. infestans (183 specimens), Triatoma sordida (176 specimens), and Triatoma pseudomaculata (13 specimens). The calculated indices of domiciliary infestation, domiciliary density, and colonization were 14%, 1.32, and 1%, respectively. Overall, 280 domiciliary units were surveyed and triatomine were discovered in 39 of the units. T. pseudomaculata and T. sordida adult specimens and T. infestans adult and nymph specimens were found in three of the dwellings.

TABLE 1 -
Number of collected triatomine species in Ibipeba, Bahia, Brazil according to ecotope.

Species	Ecotope				Total
	intradomicile		peridomicile
	n	%	n	%
Triatoma infestans	16	8.7	167	92.3	183
Triatoma pseudomaculata	13	100.0	0	0.0	13
Triatoma sordida	174	98.8	2	1.2	176
Total	203	54.5	169	45.5	372

Over the last 5 years, initiatives such as the T. infestans Eradication Program (Programa de Erradicação do Triatoma infestans (PETi)), which use insecticides to target T. infestans, have been conducted throughout Brazil. These initiatives and large-scale entomological surveys carried out since 1975 have shown extensive distribution of T. infestans (711 Brazilian cities with domestic infestation)¹⁰. In 1983, approximately 190,000 specimens of T. infestans were collected during surveys, while by 1993, only 83 cities reported T. infestans infestation. In 1998, the number of specimens decreased to 485, and in 2007, only 205 specimens were captured from 21 dwellings in 13 cities¹¹.

Although the State of Bahia and Brazil as a whole were considered free from T. cruzi transmission by T. infestans and blood transfusions in 1995 and 2006⁵, respectively, interventions to control spread of Chagas disease must continue. This is due to the presence of other transmitting species (e.g., Panstrongylus megistus, Rhodnius prolixus, Triatoma brasiliensis, Triatoma maculata, T. pseudomaculata, and T. sordida) that colonize human environments in many areas of Brazil.

Although T. sordida and T. pseudomaculata are less likely to transmit Chagas disease when compared to T. infestans, these species are a continual risk for the emergence of new cases of the disease. Furthermore, a recent survey conducted in 2009 in Macaúbas, Bahia, discovered that Triatoma lenti adults and nymphs also carried an isolated T. cruzi strain¹³. Additionally, a serological survey carried out in Mulungu do Morro, Bahia, suggested the existence of vector transmission of T. cruzi¹⁴. These studies demonstrate that vector transmission persists despite breakthroughs in the control of Chagas disease. These findings question the efficacy of insecticide use and indicate a possible resistance to alpha-cypermethrin 20% SC, an insecticide recommended by the Ministry of Health¹¹ for domestic use.

The results from this study demonstrate the presence of T. infestans, T. pseudomaculata, and T. sordida in Ibipeba, Bahia, for the first time. Discovery of T. infestans specimens in a tree trunk located in the peridomicile (50 m from a dwelling) is a novel finding, as there are few reports of similar observations in Brazil¹². This finding indicates the possibility of T. infestans colonies infesting the extradomicile, thus undermining intervention and control programs only intended to control the vector in the peri- and intradomicile. Importantly, this study demonstrates that vectors could infest dwellings in subhuman conditions. This indicates the need for public authority involvement in controlling infestation beyond the typical range of the health sector.

CONFLICT OF INTEREST

The authors declare that there is no conflict of interest.

ACKNOWLEDGMENTS

We wish to thank the entomology team of the 21^st Diretoria Regional de Saúde in Irecê (DIRES), the civil servant Adão Tomaz de Oliveira who coordinates the Chagas Disease Control Program at DIRES, and the endemic disease control agents of Ibipeba for their dedication and care during our survey study.

REFERENCES

• ¹
  Coura JR, Viñas PA. Chagas disease: a new worldwide challenge. Nature/Outlook. Chagas disease 2010; S6-S7.
• ²
  World Health Organization (WHO). Chagas disease (American trypanosomiasis). WHO; 2013. Available at: http://www.who.int/mediacentre/factsheets/fs340/en/#.
  » http://www.who.int/mediacentre/factsheets/fs340/en/#
• ³
  Chagas C. Nova Tripanozomíase humana: estudos sobre a morfologia e o ciclo evolutivo do Schizotrypanum cruzi n. gen., n. sp., agente etiológico de nova entidade mórbida do homem. Mem Inst Oswaldo Cruz 1909; 1:159-218.
• ⁴
  Ministério da Saúde. Secretaria de Vigilância em Saúde. Doença de Chagas. Guia de Vigilância Epidemiológica. Brasília: Ministério da Saúde; 2010.
• ⁵
  Dias JCP. Doenças de Chagas: sucessos e desafios. Cad Saude Publica 2006; 22:2020-2021.
• ⁶
  Lent H, Wygodzinsky P. Revision of the Triatominae (Hemiptera, Reduviidae) and their significance as vectors of Chagas' disease. Bull Am Mus Nat Hist 1979; 163:123-520.
• ⁷
  Passos ADC, Silveira AC. Síntese dos resultados dos inquéritos nacionais. Rev Soc Bras Med Trop 2011; 44 (supl II):47-50.
• ⁸
  Gonçalves GR, Alves Pereira FC, Lima IP, Cavalcante RR. Distribuição geográfica, infestação domiciliar e infecção natural de triatomíneos (Hemiptera: Reduviidae) no Estado do Piauí, Brasil, 2008. Revista Pan-Amazônica de Saúde 2010; 1:57-64.
• ⁹
  Organización Panamericana de la Salud (OPS). Guía para el Muestreo en Actividades de Vigilancia y Control Vectorial de la Enfermedad de Chagas; 2003.
• ¹⁰
  Moncayo A, Silveira AC. Current epidemiological trends for Chagas disease in Latin America and future challenges in epidemiology, surveillance and health policy. Mem Inst Oswaldo Cruz 2009; 104 (supl I):17-30.
• ¹¹
  Ministério da Saúde. Gerência Nacional de Doença de Chagas, Brasília: Ministério da Saúde; MS; 2007. Available at: http://portal.saude.gov.br/portal/arquivos/pdf/consenso_chagas.pdf.
  » http://portal.saude.gov.br/portal/arquivos/pdf/consenso_chagas.pdf
• ¹²
  Silva MBA, Barreto AVMS, Silva HA, Galvão C, Rocha D, Jurberg J, et al. Synanthropic triatomines (Hemiptera, Reduviidae) in the state of Pernambuco, Brazil: geographical distribution and natural Trypanosoma infection rates between 2006 and 2007. Rev Soc Bras Med Trop 2012; 45:60-65.
• ¹³
  Mendonça VJ, Ribeiro AR, Araujo RF, Oliveira J, Rosa JA. Estudo populacional de Triatoma lenti e Triatoma melanocephala e caracterização de duas cepas de Trypanosoma cruzi isoladas a partir de exemplares das duas espécies coletados no estado da Bahia. In: Anais XLVI Congresso da Sociedade Brasileira de Medicina Tropical, Foz do Iguaçu/PR; 2010.
• ¹⁴
  Aras R, Gomes I, Veiga M, Melo A. Transmissão vetorial da doença de Chagas em Mulungu do Morro, Nordeste do Brasil. Rev Soc Bras Med Trop 2003; 36:359-363.

Publication Dates

• Publication in this collection
  Jul-Aug 2014

History

• Received
  21 Oct 2013
• Accepted
  22 Jan 2014