BACKGROUND: Chagas disease, a parasitic infection caused by Trypanosoma cruzi, is a neglected disease endemic to Latin America. Currently, approximately 6–7 million people worldwide are infected. Although Chagas disease is not considered endemic to the United States (US), official estimates put the number of cases at about 300,000 people. However, screening for Chagas disease is not common in the US. This project assessed the barriers, challenges, and opportunities to implementing screening for Chagas disease in primary care settings.
METHODS: This project consisted of: 1) a literature review comparing and contrasting Chagas disease screening programs in endemic and non-endemic countries, and 2) semi-structured individual and group interviews with 43 healthcare providers (HCPs) who care for patients at-risk for Chagas disease. Interviews included questions around feasibility of implementing Chagas disease screening in their professional settings and probed on preferences for professional education such as format, length, and mode. Interviews were carried out between April 2021 and January 2022.
RESULTS: According to the literature review, no single program for Chagas disease screening works perfectly. However, analyzing both endemic and non-endemic country programs revealed successful components that could be applied to the US context. From the interviews, the majority of participants reported knowing little about Chagas disease, matching the current literature. Most HCPs interviewed were interested in incorporating screening for Chagas disease into their practice but had some concerns. For example, HCPs are already required to screen for several diseases so Chagas disease screening would need to be incorporated into existing workflows. Finally, many HCPs reported that official guidelines from the Centers for Disease Control and Prevention or professional organizations would be enough for them to begin screening. The results informed the creation of a handbook for implementing Chagas disease screening.
CONCLUSION: There are many barriers and challenges to implementing routine screening for Chagas disease in primary care settings in the US. However, there is also interest among HCPs in learning more and addressing the gap in screening. Advocacy is also needed to address the lack of national and professional guidelines around screening for Chagas disease.
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/49178 |
| Date | 23 August 2024 |
| Creators | Carrion, Malwina Niemierko |
| Contributors | Hamer, Davidson H. |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
| Rights | Attribution-NonCommercial-ShareAlike 4.0 International, http://creativecommons.org/licenses/by-nc-sa/4.0/ |
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