Como as ações de saúde pensam o homem e como o homem as repensa: uma análise antropológica do controle da doença de Chagas

Magnani, Claudia; Dias, João Carlos Pinto; Gontijo, Eliane Dias

doi:10.1590/s0102-311x2009000900009

Cited by 18 publications

(20 citation statements)

References 9 publications

(6 reference statements)

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“…In Bambuí, Brazil, patients experienced fear and social isolation upon receiving a diagnosis of CD, and felt abandoned by a public health system which focused on vector control over patient treatment. One patient stated it was better not to worry about the disease, since this would worsen its symptoms[49]. The same notion was conveyed by Bolivian patients in this study.…”

Section: Discussionsupporting

confidence: 70%

"I Cannot Be Worried": Living with Chagas Disease in Tropical Bolivia

Forsyth

2017

PLoS Negl Trop Dis

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BackgroundChagas disease (CD) profoundly affects the social and emotional dimensions of patients’ lives, and disproportionately impacts poor, marginalized populations in Latin America. Biomedical treatment for CD fails to reach up to 99% of the people affected, and in any case seldom addresses the emotional health or socioeconomic conditions of patients. This study examines patient strategies for coping with CD in the department of Santa Cruz, Bolivia.MethodologyIn this ethnographic study, semistructured interviews took place from March-June 2013 with 63 patients who had previously tested positive for CD. During the fieldwork period, participant observation was conducted and patient family members, providers, community members, and public health officials were consulted.Principal FindingsPatients often experienced emotional distress when diagnosed with CD, yet were generally unable to find biomedical treatment. Respondents stressed the need to avoid powerful emotions which would worsen the impact of CD symptoms. To manage CD, patients embraced a calm state of mind, described in Spanish as tranquilidad, which partially empowered them to return to a normal existence.ConclusionsIn the perceived absence of biomedical treatment options, patients seek their own means of coping with CD diagnosis. Rather than fatalism or resignation, patients’ emphasis on maintaining calm and not worrying about CD represents a pragmatic strategy for restoring a sense of normalcy and control to their lives. Programs focused on treatment of CD should remain mindful of the emotional and social impact of the disease on patients.

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Section: Discussionsupporting

confidence: 70%

"I Cannot Be Worried": Living with Chagas Disease in Tropical Bolivia

Forsyth

2017

PLoS Negl Trop Dis

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“…Studies that addressed experiences of Chagas disease from the sufferer's perspective showed how social groups described a variety of conceptions about the disease [21], [24], [35]–[37]: local communities do not only have knowledge and specific ways of thinking about “Chagas”, but people also syncretize different kinds of knowledge, producing new hybridized understandings.…”

Section: Resultsmentioning

confidence: 99%

“…Evaluating the first Chagas' preventive programs in Brazil, Magnani et al [35] concluded that the emphasis placed on disease contributed to a rapid and effective response: it provoked awareness of people's responsibility for health and their role in combating the vector, and led to new preventive practices. Nevertheless, prevention programs that neglected those already affected disregarded the meanings attributed to “Chagas”: new meanings, such as associations with death, fear, suffering, distrust, and despair, caused suffering and could affect health seeking behaviors.…”

Section: Resultsmentioning

confidence: 99%

Socio-Cultural Aspects of Chagas Disease: A Systematic Review of Qualitative Research

et al. 2013

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BackgroundGlobally, more than 10 million people are infected with Trypanosoma cruzi, which causes about 20 000 annual deaths. Although Chagas disease is endemic to certain regions of Latin America, migratory flows have enabled its expansion into areas where it was previously unknown. Economic, social and cultural factors play a significant role in its presence and perpetuation. This systematic review aims to provide a comprehensive overview of qualitative research on Chagas disease, both in endemic and non-endemic countries.Methodology/Principal FindingsSearches were carried out in ten databases, and the bibliographies of retrieved studies were examined. Data from thirty-three identified studies were extracted, and findings were analyzed and synthesized along key themes. Themes identified for endemic countries included: socio-structural determinants of Chagas disease; health practices; biomedical conceptions of Chagas disease; patient's experience; and institutional strategies adopted. Concerning non-endemic countries, identified issues related to access to health services and health seeking.ConclusionsThe emergence and perpetuation of Chagas disease depends largely on socio-cultural aspects influencing health. As most interventions do not address the clinical, environmental, social and cultural aspects jointly, an explicitly multidimensional approach, incorporating the experiences of those affected is a potential tool for the development of long-term successful programs. Further research is needed to evaluate this approach.

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“…Por ello, su importancia ha sido reconocida por la OMS, ya que tienen en cuenta las realidades sociales y culturales de las poblaciones afectadas e incorporan de manera integral sus intereses y necesidades en los sistemas de vigilancia y control (81). En tales estrategias, se ha recurrido a diversas metodologías cualitativas que incluyen entrevistas individuales y grupales, etnografía y observación (65,82).…”

Section: Conclusionesunclassified

Triatoma dimidiata in Colombia. Distribution, ecology and its epidemiological importance

et al. 2017

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Contribución de los autores:Óscar Quirós-Gómez: concepción y diseño del estudio, recolección y resumen de información bibliográfica y escritura del manuscrito Nicolás Jaramillo: recolección de información bibliográfica y escritura del manuscrito Víctor M. Angulo: análisis e interpretación de datos Gabriel Parra-Henao: concepción y diseño del estudio, análisis e interpretación de datos y escritura del manuscrito Todos los autores participaron en la revisión del manuscrito. Triatoma dimidiata es un importante vector de la enfermedad de Chagas en Centroamérica y en los países del norte de Suramérica. En Colombia, tiene una amplia distribución y su presencia se ha reportado en 14 departamentos de las regiones Andina, Caribe, de los Llanos Orientales y del Alto Magdalena, en las cuales ocupa diferentes ecótopos naturales y artificiales. La especie está clasificada como secundaria para la transmisión de Trypanosoma cruzi; sin embargo, su presencia en el ambiente silvestre, peridoméstico y doméstico en la región Andina, y su capacidad de movilizarse entre ellos, le han permitido escapar al control basado en la aspersión con piretroides y ello resalta su importancia en el mantenimiento de la transmisión del parásito debido a la potencial reinfestación de las viviendas. La comprensión de las relaciones de T. dimidiata con su hábitat, así como el empoderamiento de la comunidad, contribuyen al desarrollo de sistemas de control efectivos y perdurables. El propósito de esta revisión fue describir la distribución, los factores de riesgo, la ecología, las características entomológicas y los hábitats de las poblaciones de T. dimidiata en Colombia, y proponer alternativas de intervención acordes con las características particulares de esta especie. Triatoma dimidiata in Colombia: Distribution, ecology and epidemiological importanceTriatoma dimidiata is an important vector of Chagas disease in Central America and countries of northern South America. In Colombia, it has a wide geographical distribution with reported presence in 14 departments in the Andean, Caribbean, Eastern plains and Upper Magdalena regions, where it occupies different natural and artificial ecotopes. The species is considered a secondary vector in the transmission of Trypanosoma cruzi. Its presence in wild, peridomestic and intradomiciliary habitats in the Andean region, coupled with its ability to move between them, has allowed it to escape the control based on pyrethroids spraying, highlighting its importance in maintaining transmission of the parasite through the potential reinfestation of homes. Understanding the relation of T. dimidiata and its habitats, as well as the empowerment of communities, will contribute to the development of effective and lasting control systems. The purpose of this review was to describe the distribution, risk factors, ecology, entomological features and habitats of T. dimidiata populations in Colombia, and to propose alternative interventions in agreement with the specific characteristics of the species.

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Como as ações de saúde pensam o homem e como o homem as repensa: uma análise antropológica do controle da doença de Chagas

Cited by 18 publications

References 9 publications

"I Cannot Be Worried": Living with Chagas Disease in Tropical Bolivia

"I Cannot Be Worried": Living with Chagas Disease in Tropical Bolivia

Socio-Cultural Aspects of Chagas Disease: A Systematic Review of Qualitative Research

Triatoma dimidiata in Colombia. Distribution, ecology and its epidemiological importance

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