Barriers to Diagnosis Access for Chagas Disease in Colombia

Abstract

Chagas disease is the leading cause of nonischemic cardiomyopathy in Latin America. Timely access to diagnosis and trypanocidal treatment and preventive tools for millions of infected people continues to be a challenge. The purpose of this study was to identify potential barriers for the diagnosis of Chagas disease in Colombia from the perspective of healthcare providers. Using a simultaneous mixed-methods study design, we analyzed trends in access to screening and diagnosis for Chagas disease in Colombia and assessed the national barriers to access. The main barriers to access at the national level included a limited governmental public health infrastructure for the diagnosis of Chagas disease and limited physician awareness and knowledge of the disease. Data indicate that 1.5% of total expected cases based on national prevalence estimates were reported. Few public health laboratories have the capacity to perform complementary tests for the diagnosis of Chagas disease and almost 6 months elapse between the requests of the tests and the confirmation of the disease. This study shows that infected people must overcome a number of barriers to achieve diagnosis. Reducing barriers to early diagnosis of Chagas disease is an important goal in the fight against the disease.

World neglected tropical diseases day

“…Other NTDs have not benefited nearly as much from access to essential medicines or other interventions. For instance, it is estimated that only 1-2% of patients living with Chagas disease receive access to diagnosis and treatment [13], while millions of people lack access to leprosy diagnosis and treatment [14]. This is likely true for many other conditions on the WHO list of NTDs.…”

Knowledge, behaviour and attitudes towards Chagas disease among the Bolivian migrant population living in Japan: a cross-sectional study

“…Multiple factors contribute to underdiagnosis such as lack of diagnostic tests available in the local healthcare system or minimal awareness among providers. 33 However, most of the studies explained the low rate of diagnosis by the implication of sociocultural factors on the representation of the disease. The most common factors are the stigmatisation and the normalisation of the disease.…”

The Cost of Lost Productivity due to Premature Chagas Disease-Related Mortality: Evidence from Colombia (2010-2017)

“…It is also worrying that the percentage of deaths from preventable Chagas disease continues to be high in the younger population. This is probably associated with the barriers to timely diagnosis that persist in the country and the difficulties associated with treatment [1,18,19]. This implies maintaining the early detection programs based on the evidence generated by the system [20,21].…”

“…Chagas disease remains a serious public health problem worldwide, where its economic and social repercussions are of great magnitude [1]. The infection is endemic in South America and emergent in Europe and the United States [2].…”