Investigation of Chagas disease in four periurban areas in northeastern Brazil: epidemiologic survey in man, vectors, non-human hosts and reservoirs.

Chagas disease was investigated in four periurban areas of Ceará state, northeastern Brazil, through serological, parasitological and molecular methods in humans, reservoirs and vectors. A cross-sectional survey revealed a seroprevalence rate of 1.2% (13/1076 residents, six also proving positive through PCR). Trypanosoma cruzi infection was not detected in children under 10 years old. Triatoma pseudomaculata prevailed in the peridomiciles: 63 specimens, 69% (34/49) infected with trypanosomatids. Rhodnius nasutus was captured in Copernicia prunifera palm trees (n=280; 25.0% infected with trypanosomatids) and inside dwellings (n=8, all uninfected). Trypanosoma cruzi seropositive reservoirs, represented by Didelphis albiventris (n=27), Rattus rattus (n=24), Thrichomys laurentius (n=2), Mus musculus (n=1) and Monodelphis domestica (n=1), were identified. Among domestic dogs (n=96) seroprevalence reached 21.9%. Miniexon multiplex PCR assays characterized TcI in triatomines. Both TcI and TcII were detected in wild mammal hosts. We conclude that Trypanosoma cruzi circulates within a domestic zoonotic cycle, requiring continuous surveillance. Insecticide application to domiciles does not appear to prevent continuous reintroduction of wild triatomine specimens, presenting a challenge to authorities involved in Chagas disease control.