The economic value of identifying and treating Chagas disease patients earlier and the impact on Trypanosoma cruzi transmission

Bartsch, Sarah M.; Avelis, Cameron M.; Asti, Lindsey; Hertenstein, Daniel L.; Ndeffo-Mbah, Martial L.; Galvani, Alison P.; Lee, Bruce Y.

doi:10.1371/journal.pntd.0006809

Cited by 34 publications

(27 citation statements)

References 68 publications

(50 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Antiparasitic treatment of chronic CD with BZN can slow the progression of the disease and prevent complications, however, this is associated with a high incidence of adverse events, especially in adults, and the benefits are uncertain for particular groups [15,[36][37][38]. As the reduction in parasitic burden and the clinical, social, and economic benefits outweigh the negative aspects of antiparasitic treatment of CD in the chronic phase, PHC is the ideal scenario to guarantee access to early diagnosis and timely treatment of the disease for the population [38,39,40]. However, PHC doctors must know the recommendations for treatment, in addition to knowing how to identify and manage adverse events [15,25,38].…”

Section: Discussionmentioning

confidence: 99%

Challenges in the care of patients with Chagas disease in the Brazilian public health system: A qualitative study with primary health care doctors

et al. 2020

View full text Add to dashboard Cite

Background Care to patients with Chagas disease (CD) is still a challenge for health systems in endemic and non-endemic countries. In the Brazilian public health system, the expansion of Primary Health Care (PHC) services to remote and disadvantaged areas has facilitated the access of patients with CD to medical care, however this is in a context where care gaps remain, with insufficient public funding and inadequate distribution of services. Considering the need for studies on care to patients with CD in different settings, this study explored the challenges of family doctors to provide care to patients with CD in an endemic region in Brazil with high coverage of public PHC services. Methods and findings This is a qualitative study. A focus group with 15 family doctors was conducted in a municipality participating in a multicenter cohort that monitors almost two thousand patients with CD in an endemic region in Brazil. The data were analyzed using a thematic content analysis technique. The family doctors pointed out the following challenges for care to patients with CD: unsatisfactory medical training (academic education not suitable for the clinical management of the disease, and lack of training on CD in PHC); uncertainties regarding antiparasitic treatment in the chronic phase of the disease; difficulty in patients’ access to specialized care when necessary, especially to the cardiologist; and trivialization of the disease by patients as a barrier to seeking care. Conclusion The access of CD patients to adequate medical care, even in regions with high coverage of public PHC services, still represents an important challenge for health systems. The results of this study may contribute to the development of strategies to improve the clinical management of CD in PHC.

show abstract

Section: Discussionmentioning

confidence: 99%

Challenges in the care of patients with Chagas disease in the Brazilian public health system: A qualitative study with primary health care doctors

et al. 2020

View full text Add to dashboard Cite

show abstract

“…The estimated economic burden of Chagas disease was calculated between 6,500 and 7,190 million dollars per year [24]. These figures would justify by themselves that governments and policy makers believed that investing on Chagas disease control measures can be a way to improve the health of the population and, at the same time, improve the country's economy [108,109]. For example, a costbenefit study of a congenital Chagas detection program conducted in Bolivia concluded that with an investment of 1.5% of the annual socioeconomic cost of all congenital In addition, institutional coordination will be fundamental at the transnational level in endemic areas as well as in non-endemic countries.…”

Section: Perspectives To Get Chagas Disease Un-orphanedmentioning

confidence: 99%

The senseless orphanage of Chagas disease

Alonso-Vega

Losada

Pinazo

et al. 2019

Expert Opinion on Orphan Drugs

View full text Add to dashboard Cite

Introduction: Chagas disease is caused by the parasite Trypanosoma cruzi. Endemic in 21 American countries, there are ~7 million people infected, of which 14,000 die every year. Despite this burden, Chagas remains an orphan disease as it mainly affects poor communities with low economic and political power. Areas covered: there are two drugs available to treat the infection, but both have safety and efficacy issues. Investment in new treatments and other control measures has been historically neglected. This trend is changing and there are novel perspectives to put an end to this senseless orphanage. Research and development agenda of new therapies, diagnostic tools and biomarkers have moved forwards during the last decade; and patients associations have been active in promoting awareness of the disease all along. Besides, the WHO recently declared April 14 th as the "World Chagas disease day", which will increase the visibility of the disease and attract attention internationally. Expert opinion: efforts must focus in the prevention of new infections, but also in the management of the millions already chronically infected. This will require of an integral approach where increasing the number of trained health workers and generalizing access to diagnosis and treatment will be fundamental.

show abstract

“…This department has reported outbreaks of oral transmission with the lethality of up to 50% and outbreaks associated with occupational exposure with a significant number of cases (20,21). Currently, Colombia has a program to interrupt the domiciliary vector transmission of T. cruzi by Rhodnius prolixus, which means that oral transmission may increase and, with this, the presence of acute cases (22,23).…”

mentioning

confidence: 99%

Clinical and Epidemiological Characterization of Acute Chagas Disease in Casanare, Eastern Colombia, 2012–2020

et al. 2021

View full text Add to dashboard Cite

Background: Chagas disease (CD), caused by the protozoan Trypanosoma cruzi, is considered a public health problem in Latin America. In Colombia, it affects more than 437,000 inhabitants, mainly in Casanare, an endemic region with eco-epidemiological characteristics that favor its transmission. The objective of this study was to describe the clinical and epidemiological characteristics of the cases of acute CD in Casanare, eastern Colombia, in the period 2012–2020.Methods: In the present study, 103 medical records of confirmed cases of acute CD were reviewed. The departmental/national incidence and fatality were compared by year; the climatological data of mean temperature, relative humidity, and precipitation per year were reviewed and plotted at IDEAM (Colombian Meteorology Institute) concerning the number of cases of acute CD per month, and it was compared with the frequency of triatomines collected in infested houses by community surveillance. Univariate, bivariate, and multivariate analyses were performed, comparing symptoms and signs according to transmission routes, complications, and age groups.Results: The incidence was 3.16 cases per 100,000 inhabitants, and the fatality rate was 20% in the study period. The most frequent symptoms included: fever 98.1%, myalgia 62.1%, arthralgia 60.2%, and headache 49.5%. There were significant differences in the frequency of myalgia, abdominal pain, and periorbital edema in oral transmission. The main complications were pericardial effusion, myocarditis, and heart failure in the group over 18 years of age. In Casanare, TcI Discrete Typing Unit (DTU) has mainly been identified in humans, triatomines, and reservoirs such as opossums and dogs and TcBat in bats. An increase in the number of acute CD cases was evidenced in March, a period when precipitation increases due to the beginning of the rainy season.Conclusions: The results corroborate the symptomatic heterogeneity of the acute phase of CD, which delays treatment, triggering possible clinical complications. In endemic regions, clinical suspicion, diagnostic capacity, detection, and surveillance programs should be strengthened, including intersectoral public health policies for their prevention and control.

show abstract

The economic value of identifying and treating Chagas disease patients earlier and the impact on Trypanosoma cruzi transmission

Cited by 34 publications

References 68 publications

Challenges in the care of patients with Chagas disease in the Brazilian public health system: A qualitative study with primary health care doctors

Challenges in the care of patients with Chagas disease in the Brazilian public health system: A qualitative study with primary health care doctors

The senseless orphanage of Chagas disease

Clinical and Epidemiological Characterization of Acute Chagas Disease in Casanare, Eastern Colombia, 2012–2020

Contact Info

Product

Resources

About