Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Dec 15;3(12):e567.
doi: 10.1371/journal.pntd.0000567.

Chagas Disease, Migration and Community Settlement Patterns in Arequipa, Peru

Affiliations
Free PMC article

Chagas Disease, Migration and Community Settlement Patterns in Arequipa, Peru

Angela M Bayer et al. PLoS Negl Trop Dis. .
Free PMC article

Abstract

Background: 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.

Methodology/principal findings: 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.

Conclusions/significance: 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.

Conflict of interest statement

The authors have no competing interests.

Figures

Figure 1
Figure 1. Photographs of the pueblo joven Guadalupe and pueblo tradicional Quequeña.
Figure 2
Figure 2. Map of study and non-study communities.
Figure 3
Figure 3. Timeline of reported presence (+) or absence (o) of vectors in study communities.

Similar articles

See all similar articles

Cited by 26 articles

See all "Cited by" articles

References

    1. World Health Organization Expert Committee. Control of Chagas Disease. Brasilia, Brazil.: 2002.
    1. Maguire JH. Trypanosoma. In: Gorbach S, Bartlett J, Blacklow N,, editors. Infectious Diseases 2nd ed. Philadelphia: Lippincott, Williams & Wilkins; 2004. pp. 2327–2334.
    1. Organización Panamericana de la Salud. Estimación cuantitativa de la enfermedad de Chagas en las Américas. Montevideo, Uruguay.: 2006.
    1. Remme JHF, Feenstra P, Lever PR, Médici A, Morel C, et al. Tropical Diseases Targeted for Elimination: Chagas Disease, Lymphatic Filariasis, Onchocerciasis, and Leprosy. In: Jamison DT, Breman JG, Measham AR,, et al., editors. Disease Control Priorities in Developing Countries. New York: The World Bank and Oxford University Press; 2006. pp. 433–449.
    1. Dias JC, Silveira AC, Schofield CJ. The impact of Chagas disease control in Latin America: A review. Mem Inst Oswaldo Cruz. 2002;97:603–12. - PubMed

Publication types

Feedback