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V^th Meeting of the Andean Chagas Initiative (IPA)

(Lima, Peru, 6–7 May 2004)

Final Report
(in Spanish, 35 pp, PDF, 1838 Kb: chapter headings translated below for user orientation):
1. Background
2. Opening Session
3. Introduction: Basic Orientation, Agenda, Objectives, Organization
4. Chagas Situation in Colombia, Control Status
5. Chagas Situation in Ecuador, Control Status
6. Chagas Situation in Peru, Control Status
7. Chagas Situation in Venezuela, Control Status
8. Presentation on Latin American Network for Vector Control (RELCOV)
9. Presentation on Chagas Diseases Interventions Activities (CDIA)
10. Influential Factors in Triatomine Resistance to Insecticides
11. Chagas Vector Biology in Northern Peru. Subnetwork ECLAT*. Testing on Rhodnius ecuadoriensis Elimination
12. Control Strategies and Priority Criteria for the Andean Subregion
13. Level of Compliance with the Recommendations of the IV^th Meeting of the Intergovernmental Commission of the Andean Initiative to Control Vectoral and Transfusional Transmission of Chagas Disease, Guayaquil, 2003
14. Conclusions of the V^th Meeting of the Intergovernmental Commission of the Andean Initiative to Control Vectoral and Transfusional Transmission of Chagas Disease
15. Decisions Made at the V^th Meeting of the Intergovernmental Commission of the Andean Initiative to Control Vectoral and Transfusional Transmission of Chagas Disease
16. Recommendations of the V^th Meeting of the Intergovernmental Commission of the Andean Initiative to Control Vectoral and Transfusional Transmission of Chagas Disease
17. List of Participants

About IPA

Other Subregional Initiatives
- INCOSUR (Southern Cone)
- IPCA (Central America)
- AMCHA (Amazon)

- PAHO Chagas Page
- Tropical Disease Research:
PAHO/TDR   |   WHO/TDR **

*Abbreviations:
* ECLAT = European Community Latin American Network for Research on the Biology and Control of Triatominae.
** TDR = Special Programme for Research and Training in Tropical Diseases (UNDP/World Bank/UNICEF/WHO).

Objetives   |   Conclusions   |   Recommendations   |   Decisions

Objectives

1. Analyze the situation of Chagas' disease in the countries that form the Andean subregion. Define intervention strategies in accordance with entomological, epidemiological, and cost-effectiveness criteria.
2. Agree on lines of action related to vector control among the countries of the subregion.
3. Strengthen ties and integration among the National Surveillance and Control Programs in the countries of the Andean subregion.

Conclusiones

1. The objectives of this V^th Meeting were reached. The epidemiological situation in the four countries that integrate the Andean Initiative was analyzed, with a view to control activities. A workshop was held on intervention strategies, to define them on the basis of entomological and epidemiological criteria. Lines of action joint were agreed upon and ties of integration were strengthened.
2. Participating in the meeting were governmental delegates from Ecuador, Peru and Venezuela; the corresponding information to Colombia was not from official sources in that country.
3. The epidemiological situation and state of the national control programs justify the importance and continuity of the Initiative and of these annual follow-up meetings to evaluate its achievements. Although different degrees of goal attainment do exist, notable progress has taken place in the countries in recent years in the areas of vector control, serological and entomological surveys, diagnostics and access to etiological treatment.
4. The technical capabilities available in the countries should be shared and taken advantage of horizontally, since experience has been accumulated over a number of years that could potentially as an empowering element for national efforts. Venezuela particularly can offer to negotiate with the Gabaldón Institute to develop and carry out technical training courses in Chagas control.
5. The workshop that was designed to analyze and agree on standardized instruments for setting vector control strategies based on entomological, epidemiological, and environmental criteria, calls for holding a final technical meeting to adjust methodological details.
6. The phenomenon of T. infestans' resistance to the insecticides has been in evidence in some places in northern Argentina and southern Bolivia, though this does not compromise the success of vector-control strategies.
7. This meeting reaffirms the validity of the conclusions, decisions, and recommendations of the IV^th Meeting held in Guayaquil, particularly of the need to recognize Chagas disease as a priority national public-health problem. In this regard, the Initiative insists on the need to articulate and coordinate policy efforts and allocate national and international resources to its prevention and control.
8. The Initiative recognizes, values, and appreciates the efforts and cooperation carried out by member countries, Universities, the Chagas Disease Intervention Activities project (CDIA), and the Latin American Network for Vector Control (RELCOV).

Recommendations

1. Incorporate into the agenda of the next meeting those aspects still not developed or fulfilled or insufficiently debated, such as the scope and precision of the Initiative objectives proposed at the previous meeting in Guayaquil and boxes 2–9 and 11–17 of the Recommendations.
2. Given the existing epidemiological similarities among the countries that make up the Andean and Central American Initiatives, it would be very useful for the two Initiatives to share experiences.
3. T. infestans' resistance to insecticides is a phenomenon that should be monitored by the countries as routine activity in their chemical interventions, particularly when these programs have intensified their coverage and continuity over time. This monitoring should be done as a whole in accordance with existing and validated protocols. The Initiative suggests utilizing the services of the Pests and Insecticides Research Center (CIPEIN-Argentina) as a reference center for the Andean countries on this subject. In the same vein, the IPA Executive Secretariat is asked to make contact with the International Center for Training in Medical Research (CIDEIM) in Cali, Colombia, to consult on its availability.
4. In addition to recognizing progress achieved in access to treatment on the part of Colombia, Peru, and Venezuela, the Initiative recommends that Ecuador intensify its efforts to make the health registry and guarantee a free drug supply.
5. Request from national programs the systematization of their research needs so that these can then be submitted to TDR/WHO for consideration within the framework of the guidelines set for technical and financial support, giving priority to ecological, biological, and vector-behavior studies.
6. Regarding the continuing search for technical expertise in control programs, the Initiative insists on the need for it to make recommendations to national programs to help maximize their efforts in intra- and extrasectoral articulation processes, in order to better integrate control plans (Ministries of Education, Housing, Environment and Agriculture; NGOs; universities, research Institutes, etc.).
7. In addition to what was already ratified on blood banks during the previous meeting in Guayaquil, and given the multiplicity of diagnostic kits for serological screening for blood transfusions, the Initiative recommends that Peru and Ecuador assure the quality to the reagents utilized in their health-service networks.

Decisions

• Hold the VI^th Meeting of Intergovernmental Commission in t Bogotá, in May 2005, for which the Executive Secretariat of the Initiative is empowered to ask for permission from the Government of Colombia.
• Hold the final technical meeting on risk approaches for vector-control interventions during the last week of June in Guayaquil, with coordination, technical cooperation, and financial assistance from the countries, PAHO, and the Chagas Disease Intervention Activities (CDIA) project.

Government Delegates