Community Based Chagas Disease Research in Ecuador
Ongoing 2001 - 2013
 

Directed by Mario J. Grijalva, Ph.D.

- up to 15 credit hours -
(approximate dates, subject to change and cancellation)
Non-credit option available

Rationale

Approximately 70% of the territory of Ecuador consists of tropical and subtropical areas. The climate and sociological-political-economic conditions of this region predispose the population for a number of vector-transmitted diseases, such as Chagas' disease, malaria and dengue fever. Work previously conducted in several regions of the country has demonstrated high domiciliary and peridomiciliary infestation with Triatomine insects. In addition, the activities have shown seroprevalence among the population of tropical and subtropical areas and the presence of Trypanosoma cruzi in wild and domestic vertebrate reservoirs. Despite these findings, few acute and chronic cases are diagnosed within the public and private health care sectors.

Ongoing multidisciplinary research is being conducted year round by our group in Ecuador. The research is jointly organized by OU's Tropical Disease Institute (TDI) and the Center for Infectious Disease Research (CIEI) at Catholic University of Ecuador.

Activities at CIEI include:

• Isolation, characterization (molecular and cellular) and maintainance of parasite strains

• Biological and physiological studies of triatomines

• Immunological research in vitro

• Blood bank screening programs (Quality assurance)

Activites in the field include:

Specific field activities:

Geographical Information System:

• Census of the population

• Community Mapping using Geo-positioning system (GPS)

• Census of available infrastructure (electricity, health care, water, school, etc)

• Database management

• Geo-Spatial Analysis

Epidemiological and sociological study:

• Knowledge, Aptitudes and Practices (KAP)

• Housing surveys

Entomological survey (triatomines):

• Intra-domiciliary, peri-domiciliary and sylvatic triatomine search

• Parasite isolation from triatomine feces

• PCR analysis of blood and tissue samples

Parasitological Studies

• Parasite isolation and charactarization

• Parasitological diagnosis

• Parasite in vitro studies

Ecological Studies

• Ecological modeling

• Environmental risk factors for triatomine infestation

• Transmission cycle studies

Clinical studies:

• ECGs, Echocardiograms

• Various health assessment indicators

• Blood collection (finger prick and venipuncture) will be conducted in a subset of the population.

• Immuno chromatography, ELISA, agglutination and Western blot for Chagas disease will be conducted

• Determination of local capabilities at the provincial, county and local levels for detection, diagnosis and treatment of Chagas disease in Loja Province.

Community education:

• An education team will shadow each entomological team and will conduct house by house educational activities to the household members.

• Seminars, discussions and round tables will be conducted with the participation of targeted groups of community members such as mothers, school children and community leaders in each community

• Educational videos will be produced using footage from each community and will be shown at town hall meetings

• Educational technical videos will be produced to train community health workers, entomological community volunteers, ministry of health workers, etc.

• Educational videos will be produced for training of health officials at the provincial and national level.

• Video spots will be produced for public health service announcements to be aired by regional TV stations

Activities are conducted through a close collaboration with the Ecuadorian Ministry of Health and the National Chagas Control Program in fulfillment of the commitments made by Ecuador to the Andean Countries and Amazonic Countries Chagas control initiatives.

The logistical arrangements to conduct research in these geographic areas are difficult to establish due the inadequate infrastructure. Maximization of resources by the use of multidisciplinary teams in combination with the involvement of local governmental and non-governmental agencies, health care institutions and community members are crucial for the acquisition of useful data. However, the coupling of the research with community education and development programs and basic health care (provided by the local health care system) can have a major impact in improving the health status of the people in the study areas.

Opportunities for involvement

Students, faculty, professionals and community members interested in contribute to this long term effort can participate via the following mechanisms:

International Research Training Course in Ecuador: Chagas Disease. Summer 2013

Short-term Internships as Volunteer Research Assistant with the Center for Infectious Disease Research in Quito. Year round enrollment upon request. Duration: 1 to 6 months. Conditions: unpaid positions supervised by CIEI faculty and staff. Contact Dr. Grijalva for more information.

Long -term internships as Research Assistant with the Center for Infectious Disease Research in Quito: Year round enrollment upon request. Duration: more than 6 months. Conditions: Paid positions (full time, part time) supervised by CIEI faculty and staff. Contact Dr. Grijalva for more information.