The Kiss of Death

Communities with 60 to 80 percent bug infestation rates also indicated similar infection rates. This suggests the hypothesis that at a nearly complete infestation rate, the parasite approximates this percentage.

Another study was completed to assess type of housing within the Department of Chuquisaca (see Table 6).

Table 6

CLASSIFICATION OF HOUSES IN FOUR COMMUNITIES OF SUCRE

(CRS-PROCOSI 1990:9)

COMMUNITY	Type I (Good)	Type II (Regular)	Type III (Bad)	TOTAL	Closed Houses
Puente Sucre	0	2	20	22	1
Choromomo	0	4	28	32	2
La Mendoza	0	3	63	66	2
T. Ackachila	0	9	53	62	3
TOTAL	0	18	164	182	8

Dwellings were categorized into three types: Type 1good, Type 2regular, and Type 3bad. Houses were classified into types according to such factors as having straw and mud roofs; adobe walls partially plastered or without plaster; presence of cracks in walls, foundation, and roof; no ceiling; dirt floors; and poor hygiene. This grouping was relatively easy to apply, because most houses fit into the bad category and none fit into the good category, with 18 regular and 164 (or 90 percent) bad (see Table 6). Unhealthy houses correlated closely with infestation rates, both being 90 percent. This being the case, in endemic areas, housing conditions alone could serve as indicators of infestation rates.

Baseline studies provided personnel with figures to evaluate progress and to what extent fumigation, house improvements, and housing hygiene lowered the infestation rates. After spraying and house improvements were completed, a new study of house infestation was done. Periodic surveys indicated that continued vigilance was essential to Chagas’ disease control. Since vinchucas kept colonizing homes if houses became run down, PBCM concluded that spraying was necessary every six months; however, this is costly.

Glossary

A

acute infection — Refers to initial infection with Trypanosoma cruzi, which may not be clinically apparent. If apparent, it is characterized by inflammation caused by the infiltration of mononuclear cells and may include fever, general malaise, swelling and soreness of the lymph nodes and spleen, and Romana’s sign. Acute phase begins four to twelve days following the introduction of the organism and ends after approximately two months (sometimes up to four months). This phase can be deadly for infants, who do not have fully developed immune systems.

adenosine triphosphate (ATP) — An enzyme found in all cells. When this substance is split by enzyme action, energy is produced. Triatomines effectively acquire this through blood meals.

African trypanosomiasis — Another name for African sleeping sickness caused by trypanosome parasites that are salivaria (travel from the mouth of the insect).

Altiplano — A high plain or plateau (12,500 feet) between the eastern and western ranges of Bolivia and Peru. It is where Aymara- and Quechua-speaking Andeans live.

amastigote — A stage of trypanosoma found in the host that lack long flagella. Amastigotes are round and smaller than trypomastigotes. They are intracellular, forming cysts in muscle and neuron tissue. Within this stage, trypanosomes reproduce into more amastigotes and trypomastigotes.

American trypanosomiasis — Another name for Chagas’ disease, caused by trypanosome parasites that are sterecoria (travel from the intestines and fecal matter).

antibody — A protein produced in the immune system that responds to a foreign substance or antigen. See Immunoglobin.

auxiliary nurses — Medical personnel who manage health posts in rural areas of Bolivia. They receive six months training in primary health care and emergency medicine.

ayllu — Distinguishable groups in the Andes whose solidarity is formed by religious and territorial ties (llahta ayllu), by permanent claim to land and lineage (jatun ayllu),