Health Care Seeking Behavior of Persons with Acute Chagas Disease in Rural Argentina: A Qualitative View

Abstract

Chagas disease (CD) is a tropical parasitic disease largely underdiagnosed and mostly asymptomatic affecting marginalized rural populations. Argentina regularly reports acute cases of CD, mostly young individuals under 14 years old. There is a void of knowledge of health care seeking behavior in subjects experiencing a CD acute condition. Early treatment of the acute case is crucial to limit subsequent development of disease. The article explores how the health outcome of persons with acute CD may be conditioned by their health care seeking behavior. The study, with a qualitative approach, was carried out in rural areas of Santiago del Estero Province, a high risk endemic region for vector transmission of CD. Narratives of 25 in-depth interviews carried out in 2005 and 2006 are analyzed identifying patterns of health care seeking behavior followed by acute cases. Through the retrospective recall of paths for diagnoses, weaknesses of disease information, knowledge at the household level, and underperformance at the provincial health care system level are detected. The misdiagnoses were a major factor in delaying a health care response. The study results expose lost opportunities for the health care system to effectively record CD acute cases.

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

“…Family doctors participating in our study also reported that in general, patients with CD could not relate the clinical manifestations to the disease, even though they knew the diagnosis. In Argentina the lack of information about CD also influenced the demand for care [ 46 ]. A study carried out in Spain pointed out that the low understanding of patients with CD in relation to the disease was not exclusively related to the patients' level of education, but also to the difficulties surrounding doctor-patient communication [ 47 ].…”

Evaluation of the Elecsys Chagas Assay for Detection of Trypanosoma cruzi-Specific Antibodies in a Multicenter Study in Europe and Latin America

“…A highly sensitive automated method to screen for Chagas disease, such as the Elecsys Chagas assay, could potentially increase the throughput of samples and will likely lead to improvements in diagnosis algorithms and, thus, in cost-effectiveness ( 28 ). Ultimately, the availability of improved assays for the detection of T. cruzi would be expected to better safeguard patients who require blood and organ donation and help to minimize misdiagnoses, which are major factors in delaying the appropriate health care response ( 21 ).…”

“We have already heard that the treatment doesn't do anything, so why should we take it?”: A mixed method perspective on Chagas disease knowledge, attitudes, prevention, and treatment behaviour in the Bolivian Chaco

“…A lack of knowledge of clinical manifestations and a long indeterminate phase before possible progression might also hamper early treatment seeking behaviour [17,42,43] and has been described as a factor for underdiagnosis when infected individuals move to non-endemic cities or countries [17,[44][45][46]. Of great concern is the sparse awareness of treatment efficacy within newborn and children as well as in women of fertile age [38].…”