Detecting Areas of Potential High Prevalence of Chagas in Argentina

Abstract: A map of potential prevalence of Chagas disease (ChD) with high spatial disaggregation is presented. It aims to detect areas outside the Gran Chaco ecoregion (hyperendemic for the ChD), characterized by high affinity with ChD and high health vulnerability. To quantify potential prevalence, we developed several indicators: an Affinity Index which quantifies the degree of linkage between endemic areas of ChD and the rest of the country. We also studied favorable habitability conditions for Triatoma infestans, looking for areas where the predominant materials of floors, roofs and internal ceilings favor the presence of the disease vector. We studied determinants of a more general nature that can be encompassed under the concept of Health Vulnerability Index. These determinants are associated with access to health providers and the socio-economic level of different segments of the population. Finally we constructed a Chagas Potential Prevalence Index (ChPPI) which combines the affinity index, the health vulnerability index, and the population density. We show and discuss the maps obtained. These maps are intended to assist public health specialists, decision makers of public health policies and public officials in the development of cost-effective strategies to improve access to diagnosis and treatment of ChD.