The multidimensional comprehension of Chagas disease. Contributions, approaches, challenges and opportunities from and beyond the Information, Education and Communication field

Abstract

Chagas is a complex, multidimensional phenomenon in which political, economic, environmental, biomedical, epidemiological, psychological, and sociocultural factors intersect. Nonetheless, the hegemonic conceptualisation has long envisioned Chagas as primarily a biomedical question, while ignoring or downplaying the other dimensions, and this limited view has reinforced the disease's long neglect. Integrating the multiple dimensions of the problem into a coherent approach adapted to field realities and needs represents an immense challenge, but the payoff is more effective and sustainable experiences, with higher social awareness, increased case detection and follow-up, improved adherence to care, and integrated participation of various actors from multiple action levels. Information, Education, and Communication (IEC) initiatives have great potential for impact in the implementation of multidimensional programs of prevention and control successfully customised to the diverse and complex contexts where Chagas disease persists.

Urban vectors of Chagas disease in the American continent: A systematic review of epidemiological surveys

“…From a biomedical perspective, Chagas disease is caused by infection with the parasite Trypanosoma cruzi and affects mammals, including humans [1]. Transmission of T. cruzi can occur by multiple pathways: vector-borne, oral (food-borne), through blood/blood products, pregnant person-to-child (congenital or vertical), organ transplantation and laboratory accidents [2].…”

Population movements, borders, and Chagas disease

“…A multidimensional approach (3) allows addressing both Chagas with migrants and health teams linked to them, facilitating work in diverse sociocultural environments, in heterogeneous territories and institutions, and with different social actors and political scenarios. The sociocultural diversities associated with human mobility should be embodied in intercultural approaches that critically reflect on hegemonic medical practices; that is, those that favor the questioning of historical colonial frameworks and ethnocentric practices that prevent addressing diversity in global health contexts.…”

“…(2) Such paradox questions any attempt to approach the problem from a reductionist or universal perspective and urges the need to incorporate multidimensional views that recognise the numerous complexities, articulations and intersections that occur at local, regional and global levels. (3) For these reasons, in this article we will refer to 'Chagas' as an alternative to the classical denomination of 'Chagas disease', with a broader meaning to include also the psychological, socioeconomic, anthropological, and other aspects that affect people infected by Trypanosoma cruzi (most of whom will never develop the disease), their relatives and societies.…”

que vivimos en el sur porque hay más monte

“…La problemática del Chagas -como la mayoría de las enfermedades tropicales desatendidasestá inextricablemente vinculada a procesos socioeconómicos, culturales, políticos, históricos y ambientales (Ventura García, et al, 2013). Sin embargo, sólo recientemente, en el mayor reconocimiento de su multidimensionalidad y complejidad (Sanmartino, et al, 2021), ha habido un interés en investigación sobre la comprensión social del tema, es decir, en torno a los saberes, conocimiento y perspectivas de la población que vive en zonas de riesgo o que son afectadas por el Trypanosoma cruzi, el agente causal. En este sentido resalta que varios estudios en Latinoamérica han dado cuenta de que la relación causal de transmisión entre un parásito, el insecto vector y la enfermedad, así como la construcción del sentido de riesgo, no siempre es directa, sino que está mediada por las perspectivas del contexto en el cual se sitúan (Ventura García, et al, 2013;Salm, Gerstch 2019;Rosecrans, et al, 2014).…”