Chagas disease vector control strategies: where we are and where we should go from here

The methods used to control triatomine vectors of Trypanosoma cruzi, the causal agent of Chagas disease, include the implementation of cultural and mechanical practices, as well as biological and chemical control. For decades, the use of third generation pyrethroids such as deltamethrin, beta-cypermethrin, lambda-cyhalothrin and beta-cyfluthrin, has been the most used method due to their fast and effective action for triatomine elimination. However, despite significant control efforts, Chagas disease has not been controlled, due to the large number of wild hosts of the parasite and the diver- sity of vector species. Analyzing the literature available on the topic, we outline that strategies for controlling triatomines should be reframed within the Integrated Vector Management and One Health approaches, combining the most effective and sustainable methods, reducing economic, social, and environmental costs, thus fostering affordable control actions in poor and marginalized regions of the Americas.