Artículo
Inequalities in the social determinants of Chagas disease in indigenous and creole people in the Argentine Chaco
Fecha de publicación:
06/2019
Editorial:
BioMed Central
Revista:
Parasites and Vectors
ISSN:
1756-3305
Idioma:
Inglés
Tipo de recurso:
Artículo publicado
Clasificación temática:
Resumen
Background: The social determinants of health (SDHs) condition disease distribution and the ways they are handled. Socio-economic inequalities are closely linked to the occurrence of neglected tropical diseases, but empirical support is limited in the case of Chagas disease, caused by the protozoan Trypanosoma cruzi. Herein we assessed the relationship between key structural SDHs and the risk of T. cruzi vector-borne transmission in rural communities of the Argentine Chaco occupied by creoles and an indigenous group (Qom). We used multiple correspondence analysis to quantify the household-level socio-economic position (social vulnerability and assets indices), access to health and sanitation services, and domestic host availability. We identified the most vulnerable population subgroups by comparing their demographic profiles, mobility patterns and distribution of these summary indices, then assessed their spatial correlation and household-level effects on vector domiciliary indices as transmission risk surrogates. Results: Qom households had higher social vulnerability and fewer assets than creoles, as did local movers and migrant households compared with non-movers. We found significantly positive effects of social vulnerability and domestic host availability on infected Triatoma infestans abundance, after adjusting for ethnicity. Access to health and sanitation services had no effect on transmission risk. Only social vulnerability displayed significant global spatial autocorrelation up to 1 km. A hotspot of infected vectors overlapped with an aggregation of most vulnerable households. Conclusions: This synthetic approach to assess socio-economic related inequalities in transmission risk provides key information to guide targeted vector control actions, case detection and treatment of Chagas disease, towards sustainability of interventions and greater reduction of health inequalities.
Archivos asociados
Licencia
Identificadores
Colecciones
Articulos(IEGEBA)
Articulos de INSTITUTO DE ECOLOGIA, GENETICA Y EVOLUCION DE BS. AS
Articulos de INSTITUTO DE ECOLOGIA, GENETICA Y EVOLUCION DE BS. AS
Citación
Fernandez, Maria del Pilar; Gaspe, Maria Sol; Gurtler, Ricardo Esteban; Inequalities in the social determinants of Chagas disease in indigenous and creole people in the Argentine Chaco; BioMed Central; Parasites and Vectors; 12; 184; 6-2019; 1-18
Compartir
Altmétricas