Comparative evaluation of community interventions for the immigrant population of Latin American origin at risk for Chagas disease in the city of Barcelona

Abstract

Introduction Chagas disease presents bio-psycho-social and cultural determinants for infected patients, their family members, close friends, and society. For this reason, diagnosis and treatment require an active approach and an integral focus, so that we can prevent the disease from creating stigma and exclusion, as is actively promoting access to diagnosis, medical attention and social integration Methodology The study was conducted in the Metropolitan Area of Barcelona (Catalonia, Spain) from 2004 to 2017. After an increased detection rates of CHD in our region, the process of construction of community strategies started (2004-2013). Different community interventions with informational, educational, and communication components were designed, developed, implemented, and evaluated. The results of the evaluation helped to determine which intervention should be prioritized: 1) workshop; 2) community event; 3) in situ screening. Afterwards, those strategies were implemented (2014-2017). Results Each of the three strategies resulted in a different level of coverage, or number of people reached. The in situ screening interventions reached the highest coverage (956 persons, 58.98%).Clear differences exist (p-value<0.001) between the three strategies regarding the

Analytical Evaluation of Dried Blood Spot and Rapid Diagnostic Test as a New Strategy for Serological Community Screening for Chronic Chagas Disease

“…Community-based activities allow us to get closer to the population at risk and are necessary to overcome psycho-emotional and socio-anthropological barriers. At the same time, they offer an on-site diagnosis, which has been shown to be very effective in other studies conducted in Europe (Navarro et al, 2011;Repetto et al, 2015;Navarro et al, 2017;Da Costa-Demaurex et al, 2019;Goḿez i Prat et al, 2020).…”

“…Therefore, it is essential to improve access to CD diagnosis and treatment and community-based testing would be a good strategy ( Gómez i Prat et al, 2020 ). In this study, we evaluated two diagnostic procedures that could be applied in serological screening programs: sample collection through DBS and an RDT.…”

Roadblocks in Chagas disease care in endemic and nonendemic countries: Argentina, Colombia, Spain, and the United States. The NET-Heart project

“…In nonendemic countries, migrants at risk for CD face similar concerns [ 36 , 37 ]. People residing legally in Spain have access to universal healthcare through the National Health System, theoretically facilitating treatment, but barriers such as work schedules, legal issues, language barriers, unfamiliarity with rights, social exclusion, and direct and indirect discrimination hinder their care [ 38 ].…”

Mapping health behaviour related to Chagas diagnosis in a non-endemic country: Application of Andersen’s Behavioural Model

“…Screening sessions and treatment were offered in Bergamo (Italy) with health education and counselling through cultural mediators and the involvement of the Latin American Community, although only 30% of targeted population completed treatment due to the centralization of diagnosis and treatment to the city [ 54 ]. In Spain, the community interventions developed and evaluated in Barcelona (Catalonia) in collaboration with associations, multidisciplinary teams, communication networks and health services promoted access to diagnosis, medical attention and social integration [ 55 – 57 ]. Social and family support and advice, subjective assessment of health and aspects linked to culture and health have been approached through promotion of paediatric awareness and active case searches of children born from pregnant women with CD, the Expert Patient Programme for Chagas Disease, workshops, community events and in situ screening [ 55 , 57 , 58 ].…”