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Modelling inter-human transmission dynamics of Chagas disease: analysis and application

  • M. C. FABRIZIO (a1), N. J. SCHWEIGMANN (a2) and N. J. BARTOLONI (a1)

Summary

Transmission of Trypanosoma cruzi, the causal agent of Chagas disease, has expanded from rural endemic to urban areas due to migration. This so-called urban Chagas is an emerging health problem in American, European, Australian and Japanese cities. We present a mathematical model to analyse the dynamics of urban Chagas to better understand its epidemiology. The model considers the three clinical stages of the disease and the main routes of inter-human transmission. To overcome the complexities of the infection dynamics, the next-generation matrix method was developed. We deduced expressions which allowed estimating the number of new infections generated by an infected individual through each transmission route at each disease stage, the basic reproduction number and the number of individuals at each disease stage at the outbreak of the infection. The analysis was applied to Buenos Aires city (Argentina). We estimated that 94% of the new infections are generated by individuals in the chronic indeterminate stage. When migration was not considered, the infection disappeared slowly and R 0 = 0·079, whereas when migration was considered, the number of individuals in each stage of the infection tended to stabilize. The expressions can be used to estimate different numbers of infected individuals in any place where only inter-human transmission is possible.

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Corresponding author

* Corresponding author: Departamento de Métodos Cuantitativos y Sistemas de Información, Facultad de Agronomía, Universidad de Buenos Aires, Av San Martín 4453, C1417DSE, Buenos Aires, Argentina. E-mail: fabrizio@agro.uba.ar

References

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Albajar-Viñas, P., Villa, L., Morote, S., Bernal, O., Bulla, D. and Rodrigues Coura, J. (2007). Organización y estructura de atención médica en la infección/enfermedad de Chagas. Lecciones aprendidas en 15 proyectos. In La enfermedad de Chagas a la puerta de los 100 años del conocimiento de una endemia ancestral (ed. Silveira, A. C.), pp. 97108. Organización Panamericana de la Salud/Fundación Mundo Sano, Buenos Aires, Argentina.
Andrade, A., Zickei, F., de Oliviera, R. M., Almeida y Silva, S., Luquetti, A., Travassos, L. R., Almeida, I. C., Andrade, S. S., Andrade, J. C. and Martelli, C. M. T. (1996). Randomised trial of efficacy of benznidazole in treatment of early Trypanosoma cruzi infection. Lancet 348, 14071413.
Barry, M. A., Weatherhead, J. E., Hotez, P. J. and Woc-Colburn, L. (2013). Childhood parasitic infections endemic to the United States. Pediatric Clinics of North America 60, 471485. doi: 10.1016/j.pcl.2012.12.011.
Bittencourt, A. L. (1976). Congenital Chagas disease. American Journal of Diseases of Children 130, 97103.
Busenberg, S. N. and Vargas, C. (1991). Chagas’ disease. Variable population size and demographic implications. In Mathematical Population Dynamics. Proceedings of the Second International Conference, pp. 283295. Marcel Dekker, New York, NY, USA.
Canals, M. and Cattan, P. E. (1992). Dinámica de la transmisión de la infección chagásica en Chile: modelo y simulación. Revista Medica Chile 120, 13591365.
Carlier, Y. and Torrico, F. (2003). Congenital infection with Trypanosoma cruzi: from mechanisms of transmission to strategies for diagnosis and control. Revista da Sociedade Brasileira de Medicina Tropical 36, 767771. doi: 10.1590/S0037-86822003000600024.
Carod-Artal, F. J., Vargas, A. P., Melo, M. and Horan, T. A. (2003). American trypanosomiasis (Chagas’ disease): an unrecognised cause of stroke. Journal of Neurology, Neurosurgery and Psychiatry 74, 516518.
Caswell, H. (2001). Matrix Populations Models, Construction, Analysis and Interpretation. Sinauer, Sunderland, MA, USA.
Censo Nacional de Población, Hogares y Viviendas (2001). Instituto Nacional de Estadística y Censos, Argentina. http://www.indec.mecon.ar/
Centro Nacional Red de Laboratorios (2007). Laboratorios que controlan sangre a transfundir. Administración Nacional de Laboratorios e Institutos de Salud, Argentina. http://www.anlis.gov.ar/inst/CNRL/Principal.htm
Cruz-Pacheco, G., Esteva, L. and Vargas, C. (2012). Control measures for Chagas disease. Mathematical Biosciences 237, 4960.
Das, P. and Mukherjee, D. (2006). Qualitative study of a model of Chagas’ disease. Mathematical and Computer Modelling 43, 413422. doi: 10.1016/j.mcm.2005.11.002.
De Kroon, H., Plaisier, A., Van Gronendael, J. and Caswell, H. (1986). Elasticity: the relative contribution of demographic parameters to population growth rate. Ecology 67, 14271431.
de Rissio, A. M., Scollo, K. and Cardoni, R. L. (2009). La transmisión madre-hijo del Trypanosoma cruzi en la Argentina. Medicina (Buenos Aires) 69, 529535.
Dias, J. P. C. (1995). Historia natural da doença de Chagas. Arquivos Brasileiros de Cardiologia 65, 359366.
Diekmann, O., Heesterbeek, J. A. P. and Metz, J. A. J. (1990). On the definition and computation of the basic reproduction ratio R 0 in models for infectious diseases in heterogeneous populations. Journal of Mathematical Biology 28, 365382.
Fabbro, D. L. (2007). Evaluación del tratamiento etiológico en adultos con Chagas crónico. Revista da Sociedade Brasileira de Medicina Tropical 40, 110.
Forsythe, G. E., Malcolm, M. A. and Moler, C. B. (1977). Computer Methods for Mathematical Computations. Prentice Hall, Englewood Cliffs, NJ, USA.
Freilij, H., Biancardi, M., Lapeña, A., Ballering, G., Moscatelli, G. and Altcheh, J. (2007). Enfermedad de Chagas en la edad pediátrica. In La enfermedad de Chagas a la puerta de los 100 años del conocimiento de una endemia ancestral (ed. Silveira, A. C.), pp. 6576. Organización Panamericana de la Salud/Fundación Mundo Sano, Buenos Aires, Argentina.
Freilij, H., Biancardi, M., Lapeña, A., Ballering, G., Moscatelli, G. and Altcheh, J. (2010). Enfermedad de Chagas Congénita. In Chagas en el Siglo XXI. De la enfermedad a la problemática social (ed. Storino, R.), pp. 117125. Akadia Ed., Buenos Aires, Argentina.
Gascon, J., Bern, C. and Pinazo, M. J. (2010). Chagas disease in Spain, the United States and other non-endemic countries. Acta Tropica 115, 2227. doi: 10.1016/j.actatropica.2009.07.019.
Gürtler, R. E., Segura, E. L. and Cohen, J. E. (2003). Congenital transmission of Trypanosoma cruzi infection in Argentina. Emerging Infectious Diseases 9, 2932. doi: 10.3201/eid0901.020274.
Hartemink, N. A., Randolph, S. E., Davis, S. A. and Heesterbeek, J. A. P. (2008). The basic reproduction number for complex disease systems: defining R 0 for tick-borne infections. American Naturalist 171, 743754. doi: 10.1086/587530.
Heesterbeek, J. A. P. and Dietz, K. (1996). The concept of R 0 in epidemic theory. Statistica Neerlandica 50, 89110. doi: 10.1111/j.1467-9574.1996.tb01482.x.
Heffernan, J. M., Smith, R. J. and Wahl, L. M. (2005). Perspectives on the basic reproductive ratio. Journal of the Royal Society Interface 2, 281293. doi: 10.1098/rsif.2005.0042.
Inaba, H. and Sekine, H. (2004). A mathematical model for Chagas disease with infection-age-dependent infectivity. Mathematical Biosciences 190, 3969. doi: 10.1016/j.mbs.2004.02.004.
Jackson, Y. and Chappuis, F. (2011). Chagas disease in Switzerland: history and challenges. Eurosurveillance 16. pii: 19963.
Jackson, Y., Alirol, E., Getaz, L., Wolff, H., Combescure, C. and Chappuis, F. (2010). Tolerance and safety of Nifurtimox in patients with chronic Chagas disease. Clinical Infectious Diseases 51, 6975. doi: 10.1086/656917.
Kirchhoff, L. V. (1999). American trypanosomiasis (Chagas’ disease). In Tropical Infectious Diseases: Principles, Pathogens and Practice (ed. Guerrant, R. L., Waker, D. H. and Weller, P. F.), pp. 785796. Churchill Livingstone, Philadelphia, PA, USA.
Kirchhoff, L. V. (2011). Epidemiology of American trypanosomiasis (Chagas disease). Advances in Parasitology 75, 118.
Lazzari, J. (2007). Enfermedad de Chagas en el adulto. In La enfermedad de Chagas a la puerta de los 100 años del conocimiento de una endemia ancestral (ed. Silveira, A. C.), pp. 7796. Organización Panamericana de la Salud/Fundación Mundo Sano, Buenos Aires, Argentina.
Luquetti, A. O. (2007). El control de la transmisión transfusional. In La enfermedad de Chagas a la puerta de los 100 años del conocimiento de una endemia ancestral (ed. Silveira, A. C.), pp. 157166. Organización Panamericana de la Salud/Fundación Mundo Sano, Buenos Aires, Argentina.
Manzullo, E. and Dairraidou, M. (1991). Metodología del estudio longitudinal de la cardiopatía chagásica crónica. Revista Federación Argentina de Cardiología 20, 113121.
Martorano Raimundo, S., Massad, E. and Yang, H. M. (2010). Modelling congenital transmission of Chagas’ disease. Biosystems 99, 215222. doi: 10.1016/biosystems.2009.11.005.
Massad, E. (2008). The elimination of Chagas’ disease from Brazil. Epidemiology and Infection 136, 11531164. doi: 10.1017/S09502688007009879.
Médicos Sin Frontera (2005). Chagas: Una Tragedia Silenciosa. Ed. Losada., Buenos Aires.
Ministerio de Salud de la Nación (2006). Boletín Epidemiológico Anual: Zoonosis y Vectores. Ministerio de Salud. Presidencia de la Nación, Buenos Aires, Argentina.
Ministerio de Salud de la Nación (2009). Estadísticas Vitales. Serie 5-52. Ministerio de Salud. Presidencia de la Nación, Buenos Aires, Argentina.
Moncayo, A. and Ortiz, Y. (2006). An update in Chagas disease (human American trypanosomiasis). Annals of Tropical Medicine and Parasitology 100, 115.
Moya, P., Basso, B. and Moretti, E. (2005). Enfermedad de Chagas congénita: Aspectos epidemiológicos, clínicos, diagnósticos y terapéuticos. Experiencia de 30 años de seguimiento. Revista da Sociedade Brasileira de Medicina Tropical 38, 3340.
Muñoz, M. J., Murcia, L. and Segovia, M. (2011). The urgent need to develop new drugs and tools for treatment of Chagas disease. Expert Review of Anti-Infective Therapy 9, 57.
Organización Mundial de la Salud (2006). Estimación cuantitativa de la enfermedad de Chagas en las Américas. Department of Control of Neglected Tropical Diseases, Washington, DC, USA.
Organización Mundial de la Salud (2010). Enfermedad de Chagas: control y eliminación. Informe de Secretaría. http://apps.who.int/gb/ebwha/pdf_files/WHA63/A63_17-sp.pdf
Perez-Ayala, A., Perez-Molina, J. A., Norman, F., Navarro, M., Monge-Mallo, B., Flores, M., Cañavate, C. and Lopez-Velez, R. (2011). Chagas disease in Latin American migrants: a Spanish challenge. Clinical Microbiology and Infection 17, 11081113. doi: 10.1111/j.1469-0691.2010.03423.x.
Perez-Molina, J., Perez-Ayala, A., Moreno, S., Fernández-Gonzalez, M. C., Zamora, J. and López-Velez, R. (2009). Use of benznidazole to treat chronic Chagas’ disease: a systematic review with a meta-analysis. Journal of Antimicrobial Chemotherapy 64, 11391147. doi: 10.1093/jac/dkp357.
Perez-Molina, J., Perez-Ayala, A., Parola, P., Jackson, Y., Odolini, S. and Lopez-Velez, R. (2011). EuroTravNet: imported Chagas disease in nine European countries, 2008 to 2009. Euro Surveillance 16, pii: 19966.
Pinazo, M. J., Guerrero, L., Posada, E., Rodriguez, E., Soy, D. and Gascon, J. (2012). Benznidazole-relate adverse drug reactions and the relationship to serum drug concentrations in patients with chronic Chagas disease. Antimicrobial Agents and Chemotherapy 57, 390395. doi: 10.1128/AAC.01401_12.
Rodriguez Coura, J. and Albajar Viñas, P. (2010). Chagas disease: a new worldwide challange. Nature 465, S6S7. doi: 10.1038/nature09221.
Schmunis, G. (1999). Riesgo de la enfermedad de Chagas a través de transfusiones en las Américas. Medicina (Buenos Aires) 59, 125134.
Schmunis, G. A. and Yadon, Z. E. (2010). Chagas disease: a Latin American health problem becoming a world health problem. Acta Tropica 115, 1421.
Sosa-Estani, S. (2007). Aspectos asistenciales e inserción de la enfermedad de Chagas en Atención Primaria de la Salud. In La enfermedad de Chagas a la puerta de los 100 años del conocimiento de una endemia ancestral (ed. Silveira, A. C.), pp. 109116. Organización Panamericana de la Salud/Fundación Mundo Sano, Buenos Aires, Argentina.
Sosa-Estani, S., Segura, E. L., Ruiz, A. M., Velazquez, E., Porcel, B. and Yampotis, C. (1998). Chemotherapy with benznidazole in children in indeterminate stage of Chagas disease. American Journal of Tropical Medicine and Hygiene 59, 526529.
Storino, R. (2010 a). Etapas clínicas de la enfermedad de Chagas. In Chagas en el Siglo XXI. De la enfermedad a la problemática social (ed. Storino, R.), pp. 127136. Akadia Ed., Buenos Aires, Argentina.
Storino, R. (2010 b). Nosología general de la enfermedad de Chagas. In Chagas en el Siglo XXI. De la enfermedad a la problemática social (ed. Storino, R.), pp. 1122. Akadia Ed., Buenos Aires, Argentina.
Storino, R. M., Jörg, M. E. and Auger, S. (2003). Atención médica del paciente chagásico. Manual práctico. Un enfoque biológico, antropológico y social. Ed. Ediprof., Buenos Aires, Argentina.
Van den Driessche, P. and Watmough, J. (2002). Reproduction numbers and sub-threshold endemic equilibria for compartmental models of disease transmission. Mathematical Biosciences 180, 2948.
Velasco-Hernández, J. (1991). An epidemiological model for dynamics of Chagas disease. Biosystems 26, 127134.
Velasco-Hernández, J. (1994). A model for Chagas disease involving transmission by vectors and transfusion. Theoretical Population Biology 46, 131.
World Health Organization (2002). Control of Chagas’ disease. WHO Technical Report. Geneva, Switzerland.
World Health Organization (2009). Control and Prevention of Chagas disease in Europe. WHO Technical Report. Geneva, Switzerland.
World Health Organization (2011). Informal Consultation on Chagas Disease in the Western Pacific. Meeting Report, Nagasaki, Japan.
Yadon, Z. E. and Schmunis, G. A. (2009). Congenital Chagas disease: estimating the potential risk in the United States. American Journal of Medicine and Hygiene 81, 927933.
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