Community-based surveillance of Chagas Disease: Characterization and use of Triatomine Information Posts (TIPs) in a high-risk area for triatomine reinfestation in Latin America.

backgroundIn Brazil, vector surveillance with public participation is a prioritized action in the primary prevention of Chagas Disease (CD). It is anchored in the implementation of Triatomine Information Posts (TIPs), spaces recognized by health surveillance for receiving insects suspected of being triatomines. For the first time in the scientific literature, a study is dedicated to characterizing TIPs operationally, structurally, and functionally, as well as understanding the factors that hinder their sustainability. METHODOLOGY: The study was conducted in one of the most vulnerable regions for CD in the Americas. Using mixed approaches applied to health, an electronic form was sent to the municipal coordinators of endemic diseases to characterize the implementation, operational status, and description of TIPs. Data from an information system were accessed to analyze their productivity. Lastly, five focus groups were conducted to capture the perception of the endemic disease coordinators regarding TIPs. PRINCIPAL

findings100% of the municipalities did not maintain documentary records of the use and productivity of TIPs, 40% of municipalities had never implemented a TIP; of those implemented, more than 30% were deactivated, with a significant portion located in rural areas. TIPs located in areas shared with Primary Health Care facilities showed lower deactivation rates. Key factors hindering the functioning and sustainability of TIPs included the population's lack of awareness about them, the need for increased publicity of these locations, a shortage of qualified professionals, TIP distribution in hard-to-access areas, and the absence of feedback on insect examinations to residents. CONCLUSIONS/SIGNIFICANCE: A scenario of heterogeneous distribution was revealed in the implementation/functioning of TIPs, as well as low public engagement and usage. There is an urgent need for health systems to be organized to regulate surveillance with public participation and to conduct awareness campaigns aimed at preventing future household reinfestations by triatomines and the resurgence of CD transmission in endemic areas.