Chagas disease, migration and community settlement patterns in Arequipa, Peru.

<h4>Background</h4>Chagas disease is one of the most important neglected tropical diseases in the Americas. Vectorborne transmission of Chagas disease has been historically rare in urban settings. However, in marginal communities near the city of Arequipa, Peru, urban transmission cycles...

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Main Authors: Angela M Bayer, Gabrielle C Hunter, Robert H Gilman, Juan G Cornejo Del Carpio, Cesar Naquira, Caryn Bern, Michael Z Levy
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2009-12-01
Series:PLoS Neglected Tropical Diseases
Online Access:https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0000567&type=printable
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author Angela M Bayer
Gabrielle C Hunter
Robert H Gilman
Juan G Cornejo Del Carpio
Cesar Naquira
Caryn Bern
Michael Z Levy
author_facet Angela M Bayer
Gabrielle C Hunter
Robert H Gilman
Juan G Cornejo Del Carpio
Cesar Naquira
Caryn Bern
Michael Z Levy
author_sort Angela M Bayer
collection DOAJ
description <h4>Background</h4>Chagas disease is one of the most important neglected tropical diseases in the Americas. Vectorborne transmission of Chagas disease has been historically rare in urban settings. However, in marginal communities near the city of Arequipa, Peru, urban transmission cycles have become established. We examined the history of migration and settlement patterns in these communities, and their connections to Chagas disease transmission.<h4>Methodology/principal findings</h4>This was a qualitative study that employed focus group discussions and in-depth interviews. Five focus groups and 50 in-depth interviews were carried out with 94 community members from three shantytowns and two traditional towns near Arequipa, Peru. Focus groups utilized participatory methodologies to explore the community's mobility patterns and the historical and current presence of triatomine vectors. In-depth interviews based on event history calendars explored participants' migration patterns and experience with Chagas disease and vectors. Focus group data were analyzed using participatory analysis methodologies, and interview data were coded and analyzed using a grounded theory approach. Entomologic data were provided by an ongoing vector control campaign. We found that migrants to shantytowns in Arequipa were unlikely to have brought triatomines to the city upon arrival. Frequent seasonal moves, however, took shantytown residents to valleys surrounding Arequipa where vectors are prevalent. In addition, the pattern of settlement of shantytowns and the practice of raising domestic animals by residents creates a favorable environment for vector proliferation and dispersal. Finally, we uncovered a phenomenon of population loss and replacement by low-income migrants in one traditional town, which created the human settlement pattern of a new shantytown within this traditional community.<h4>Conclusions/significance</h4>The pattern of human migration is therefore an important underlying determinant of Chagas disease risk in and around Arequipa. Frequent seasonal migration by residents of peri-urban shantytowns provides a path of entry of vectors into these communities. Changing demographic dynamics of traditional towns are also leading to favorable conditions for Chagas disease transmission. Control programs must include surveillance for infestation in communities assumed to be free of vectors.
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spelling doaj-art-abfd481605bb4c979489dd99b9e8fe2f2025-08-20T03:19:59ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352009-12-01312e56710.1371/journal.pntd.0000567Chagas disease, migration and community settlement patterns in Arequipa, Peru.Angela M BayerGabrielle C HunterRobert H GilmanJuan G Cornejo Del CarpioCesar NaquiraCaryn BernMichael Z Levy<h4>Background</h4>Chagas disease is one of the most important neglected tropical diseases in the Americas. Vectorborne transmission of Chagas disease has been historically rare in urban settings. However, in marginal communities near the city of Arequipa, Peru, urban transmission cycles have become established. We examined the history of migration and settlement patterns in these communities, and their connections to Chagas disease transmission.<h4>Methodology/principal findings</h4>This was a qualitative study that employed focus group discussions and in-depth interviews. Five focus groups and 50 in-depth interviews were carried out with 94 community members from three shantytowns and two traditional towns near Arequipa, Peru. Focus groups utilized participatory methodologies to explore the community's mobility patterns and the historical and current presence of triatomine vectors. In-depth interviews based on event history calendars explored participants' migration patterns and experience with Chagas disease and vectors. Focus group data were analyzed using participatory analysis methodologies, and interview data were coded and analyzed using a grounded theory approach. Entomologic data were provided by an ongoing vector control campaign. We found that migrants to shantytowns in Arequipa were unlikely to have brought triatomines to the city upon arrival. Frequent seasonal moves, however, took shantytown residents to valleys surrounding Arequipa where vectors are prevalent. In addition, the pattern of settlement of shantytowns and the practice of raising domestic animals by residents creates a favorable environment for vector proliferation and dispersal. Finally, we uncovered a phenomenon of population loss and replacement by low-income migrants in one traditional town, which created the human settlement pattern of a new shantytown within this traditional community.<h4>Conclusions/significance</h4>The pattern of human migration is therefore an important underlying determinant of Chagas disease risk in and around Arequipa. Frequent seasonal migration by residents of peri-urban shantytowns provides a path of entry of vectors into these communities. Changing demographic dynamics of traditional towns are also leading to favorable conditions for Chagas disease transmission. Control programs must include surveillance for infestation in communities assumed to be free of vectors.https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0000567&type=printable
spellingShingle Angela M Bayer
Gabrielle C Hunter
Robert H Gilman
Juan G Cornejo Del Carpio
Cesar Naquira
Caryn Bern
Michael Z Levy
Chagas disease, migration and community settlement patterns in Arequipa, Peru.
PLoS Neglected Tropical Diseases
title Chagas disease, migration and community settlement patterns in Arequipa, Peru.
title_full Chagas disease, migration and community settlement patterns in Arequipa, Peru.
title_fullStr Chagas disease, migration and community settlement patterns in Arequipa, Peru.
title_full_unstemmed Chagas disease, migration and community settlement patterns in Arequipa, Peru.
title_short Chagas disease, migration and community settlement patterns in Arequipa, Peru.
title_sort chagas disease migration and community settlement patterns in arequipa peru
url https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0000567&type=printable
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