Trypanosoma cruzi (Kinetoplastida: Trypanosomatidae) in the Midwest: prevalence among vectors and medical provider awareness.

True bugs of the subfamily Triatominae may carry the protozoan Trypanosoma cruzi, the causative agent of Chagas disease. Endemic to South and Central America, the protozoan has been found in triatomines throughout the southern United States of America, yet it is unclear how far north Trypanosoma cruzi occurs in Triatoma species. The objective of this research was to determine if triatomines in the St. Louis metropolitan area carry this protozoan and to assess professionals across the One Health spectrum for knowledge of the vectors and Chagas disease. Triatomine bugs were collected using a variety of methods, and then processed using PCR and gel electrophoresis to determine if they were positive for Trypanosoma cruzi. In addition, a phone call survey measured knowledge of Chagas disease. Eleven Triatoma sanguisuga and one Triatoma lecticularia specimens were collected between July 2022 and October 2023. One triatomine collected was too desiccated to determine the species. Of the thirteen total specimens, 6 (46%) were positive for T. cruzi. The phone call survey yielded a response rate of 81% among 97 attempted calls. The professionals interviewed included 23 veterinarians, 19 pharmacists, 14 vector control specialists, 11 public health officials, 9 physicians, and 3 wildlife biologists. Of the 79 participants, 64% were unfamiliar with Chagas disease. This preliminary study showed that T. cruzi is prevalent among triatomines in the Midwest and that education across the One Health professional spectrum may increase knowledge among professionals.