Chagas disease in north-west Argentina: infected dogs as a risk factor for the domestic transmission of Trypanosoma cruzi.

The association between household seroreactivity to Trypanosoma cruzi in dogs and children and T. cruzi infection rates in domestic Triatoma infestans was investigated in 1988-1989 in the rural community of Amamá, north-west Argentina, where house spraying with residual pyrethroids was carried out in 1985. Three years after spraying, a greater reduction of the average T. cruzi prevalence rate in dogs (from 83% to 40%) than in children (from 48% to 30%) was accompanied by a substantial decrease in vector infection rates from 51%-63% to 21%. At a household level, in homes with or without seroreactive children, the percentage of infected T. infestans was 4.5-4.7 times higher when seroreactive dogs were present (27.1%-34.8%) than when they were not (5.8%-7.7%; stratified relative risk [RR] = 4.58). The contribution of seroreactive children to bug infection rates was not significant (RR = 1.29). The combined effect of both seroreactive dogs and seroreactive children fitted equally well with additive or multiplicative transmission models. Bug infection rates showed an increasing trend with the number of seroreactive dogs and an inverse association with the age of the youngest seroreactive dog. Our study supports the hypothesis of a causal association between the presence and number of infected dogs and increased levels of T. cruzi transmission to domestic T. infestans.