Report on Activities and Results of the National Chagas Program

(with support from JICA and Pro-Mesas/IRDC, 2004)

Full Text (in Spanish, 35 pp, PDF, 1041 Kb: contents below translated for user orientation)
Introduction   |   Summary
1. Background
2. Chagas Disease in Honduras
2.1 Situation
2.2 Distribution
2.3 Principal Vectors
3. Organizational & Functional Framework
3.1 The Performance of the National Chagas Program
3.2 Principal Functions of the National Chagas Program
3.3 Strategies
3.4 Technical Cooperation and Funding
3.5 Expected Results & Indicators, 2003–2010
3.6 Expected Results & Process Indicators, 2004
4. Principal Strategies & Results, 2004
4.1 Entomological Exploration
4.2 Entomological Confirmation & Survey
4.2.1 Confirmation for R. prolixus
4.2.2 Confirmation for T. dimidiata
4.3 Spraying
4.4 Serological Diagnosis
4.4.1 Serological Exploration via Rapid Testing
4.4.2 Serological Survey
5. Information, Education & Communication (IEC)
6. Equity of Access to Case Treatment
7. Arranging the Environment
8. Human-Resource Development
9. Financial Operations
10. Perspectives for 2005
Bibliography

- Anti-Chagas Activities, Honduras
- IPCA subregional initiative
- PAHO Chagas Page
- National Chagas Program (PNCh), Honduras

Introduction   |   Summary

This report focuses on the activities planned and carried out in 2004 under the management of the National Program for Chagas Disease (Programa Nacional de Chagas / PNCh) of Honduras. The report was prepared by the National Technical Group (Grupo Técnico Nacional / GTN) together with professional and technical staff from the Secretary of Health, national and international support agencies, and institutions from the health sector. The GTN-Chagas is comprised of Dr. Concepción Zúniga, Coordinator of the PNCh; Mr. Michio Kojima, Coordinator of the JICA Chagas Project; Dr. Delmin Cury, Communicable Disease Consultant, PAHO-Honduras and Technical Secretary of the IPCA subregional initiative; Dr. Gilles de Margérie, Health Advisor at Pro-Mesas/IRDC; Dr. Carlos Ponce Garay, Coordinator of the Central Reference Laboratory for Chagas Disease (CSF); Lic. Elisa Mayén, Research Assistant at CSF; Mr. Lombardo Ardón, Coordinator of the World Vision-IDRC Project; and Ing. José Rubén Gómez, Consultant for Pro-Mesas/PNCh. It contains an executive summary and the following chapters corresponding to background, situation of Chagas disease in Honduras, performance of the PNCh, progress and achievements in 2004, technical cooperation, and the national and international funding and future prospects.

The framework for preparing this 2004 report is the approach used by the Initiative of Central American Countries to Interrupt Vectoral and Transfusional Transmission of Chagas Disease (Iniciativa de los Países de Centro América para la Interrupción de la Transmisión Vectorial y Transfusional de la Enfermedad de Chagas / IPCA), the National Strategic Plan (Plan Estratégico Nacional de Chagas/PEN-Chagas/PENCHAGAS), and the 2003 report on the activities carried out and reported by the Japan International Cooperation Agency (JICA).

Observations, suggestions and more information should be sent to Dr. Concepción Zúniga Valeriano, PNCh Coordinator, 5^to piso, Edificio 1 Anexo a la Secretaría de Salud, Esquina opuesta a farmacia Regis Centro, Tegucigalpa MDC. Telefax: (+504) 237-6944.

Summary

Chagas Disease or American Trypanosomiasis was discovered in Brazil in 1909 by Dr. Carlos Chagas and is endemic in the majority of Latin American countries. In Honduras, the disease constitutes a public-health problem: estimates show 300,000 people being infected by Trypanosoma cruzi, the etiological agent of the disease, and a prevalence rate calculated at 6% among the general population. The presence of the vectors that transmit the disease is closely related to the poor condition of the dwellings, thus putting at greater risk the most vulnerable populations of Honduras.

Chagas disease is transmitted through the vampire insects of the subfamily Triatominae. The main vectors in Honduras are Rhodnius prolixus and Triatoma dimidiata, known commonly as 'biting bedbugs' (chinches picudas), of epidemiological importance due to their great capacity to adapt, live, and to be fed in the same environment inhabited by the humans or in its immediate surroundings. The principal reservoir is the opossum Didelphys marsupials, known in Honduras as the 'tacuazín' or 'guazalo.'

In compliance with resolutions of the World Health Organization (WHO) and agreements made at the Meetings of the Health Sector of Central America (Reuniones del Sector de Salud de Centro América / RESSCAD), Honduras put together its Strategic Plan for Chagas Disease 2003–2007 (PEN-Chagas/PENCHAGAS), an instrument designed under the sectoral approach and based on the objectives and scope set down by the subregional initiative IPCA, aimed at reaching the goal of interrupting the vectoral and transfusional transmission of Chagas disease by 2010.

The National Chagas Program is the agency at the Secretary of Health responsible for establishing technical guidelines and for leading, planning, carrying out, and evaluating the components and activities for vector control, diagnosis, case management, and epidemiological surveillance through the National Strategic Plan. These functions are performed in a decentralized way by the Departmental Health Bureaus. To fulfill these responsibilities, the PNCh receives permanent technical support from PAHO and, since 2003, technical and financial assistance for its activities from the Japan International Cooperation Agency (JICA) and the Canadian International Development Agency (CIDA) as well.

With regard to the objective of improving housing as part of the aforementioned National Strategic Plan against Chagas Disease, part of the management objectives of the PNCh is to work with institutions from the health sector devoted to the construction and improvement of rural dwellings, e.g. the Our Roots Program (Nuestras Raíces) of the Honduran Social Investment Fund (Fondo Hondureño de Inversión Social / FHIS), which coordinates its activities with support from nongovernmental organizations (NGOs), among which are World Vision-Honduras, the Technical Council for the Integral Development of Honduras (COTEDIH), CARE, and the Liorna Foundation in Spain, among others.