Human Trypanosoma cruzi infection risk is driven by eco-social interactions in rural communities of the Argentine Chaco

摘要: Abstract The transmission of Trypanosoma cruzi to humans is determined by multiple ecological, socio-economic and cultural factors acting at different scales. Their effects on the human risk infection with T. have often been examined separately or using a limited set ecological socio-demographic variables. Herein, we integrated social dimensions disease spatial distribution patterns vector (Triatoma infestans) in rural communities Argentine Chaco composed mainly indigenous people (90% Qom) creole minority. Prior implementation control intervention, estimated seroprevalence among 1,929 local residents cross-sectional study was 29.0%, twice as large Qom than creoles. Using generalized linear mixed models, increased 60% each additional infected triatomine 40% seropositive household co-inhabitant; significantly increasing vulnerability (a multidimensional index poverty), decreased host availability sleeping quarters. A significant negative interaction between relative abundance infestans indicated that vulnerable were exposed higher even low infected-vector abundances. Household mobility within area reduced domiciliary abundance, possibly due less consistent exposures. Nonetheless, rates movers non-movers not different. Human clustered larger scale, hotspots matching areas vulnerability. These results map shows high-priority for targeted interventions oriented suppress house (re)infestations, treat children, thus reduce burden future disease. Author summary Chagas one main neglected tropical diseases (NTDs) affecting Latin America where vectors still occurs. Access diagnosis treatment remaining challenges sustainable endemic areas. In this study, determinants component identify individuals, households geographic sectors infection. We found compared creoles, poverty). also modulated effect vectors: vulnerable-household lower more variable exposure over time. showed areas, which can be used designing cost-effective serological screening strategies adapted resource-constrained