Key Chagas disease missing knowledge among at-risk population in Spain affecting diagnosis and treatment

Abstract

Background Chagas disease is endemic in Latin America and, over the last few decades, due to population movements, the disease has spread to other continents. Early diagnosis and treatment are critical in terms of improving outcomes for those living with Chagas disease. However, poor knowledge and awareness is one of barriers that affects access to Chagas disease diagnosis and treatment for the population at risk. Information regarding immigrants’ knowledge concerning Chagas disease control and prevention is insufficient in non-endemic countries and, therefore, this study sought to assess Chagas disease knowledge and awareness within the Bolivian community residing in Madrid. Methods This cross-sectional study was carried out in March–August 2017. A total of 376 Bolivians answered a structured questionnaire. A knowledge index was created based on respondents’ knowledge about transmission, symptoms, diagnosis, and place to seek treatment. Multivariate logistic regressions analyses were performed to assess the factors associated with respondents’ knowledge of Chagas disease. Results A total 159 (42.4%) of Bolivians interviewed about their knowledge of Chagas disease were men and 217 (57.6%) were women. Vinchuca was mentioned as mode of transmission by 71% of the Bolivians surveyed, while only 9% mentioned vertical transmission. Almost half of the Bolivians did not know any symptom of Chagas disease and only 47% knew that a specific blood test is necessary for diagnosis. Most of Bolivians were aware of the severity of Chagas disease, but 45% of Bolivians said that there is no cure for Chagas and 96% did not know any treatment. Based on the index of knowledge generated, only 34% of Bolivians had a good knowledge about Chagas disease transmission, symptoms, diagnosis and treatment. According to the multiple logistic regression analysis, knowledge regarding Chagas disease, diagnosis and treatment was significantly higher amongst older Bolivians who had secondary education at least, as well as amongst those who had already been tested for Chagas disease. Conclusions This study found that most of the Bolivian population living in Spain had poor knowledge about Chagas disease transmission, symptoms, diagnostic methods and treatment. A poor understanding of the disease transmission and management is one of the most important barriers when it comes to searching for early diagnosis and appropriate care.

Knowledge Production on Congenital Chagas Disease across Time, Borders and Disciplines: A Comprehensive Scoping Review

“…The “economic” studies include cost-benefit analyses of screening programs [ 50 , 51 ]. The five social science [ 52 , 53 , 54 , 55 , 56 ] papers fall within anthropology, sociology and interdisciplinary teams that include anthropologists. To be clear, there are significantly more social science articles on Chagas, but only these five specifically focus on the topic of congenital Chagas or have a significant portion of the article dedicated to congenital Chagas according to our inclusion criteria.…”

Community-based screening of Chagas disease among Latin American migrants in a non-endemic country: an observational study

“…On the other hand, more than half the Bolivian participants showed poor knowledge on Chagas disease, in line with similar results published recently by Ronay-Barja et al . [ 23 ] in Madrid and other authors in Spain and Europe, who also report that most people with Chagas disease are from Bolivia [ 15 , 46 , 47 ]. This highlights the need for continuing community-based interventions in order to improve Chagas disease awareness within the population at risk.…”

“…To assess the factors associated with the participants’ level of knowledge about Chagas disease, a knowledge index was calculated according to the study published by Romay‑Barja et al [ 23 ]. To create the knowledge index, we selected five facts about Chagas disease that we considered respondents should know: it can be transmitted by triatomines [ vinchuca s (kissing bugs)] (1 point) or from mother to child (1 point); cardiac involvement is a main consequence of the disease (1 point); digestive disorders constitute the main symptom (1 point); and affected people can be asymptomatic (1 point).…”

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

“…This fact, together with the lack of knowledge about vertical transmission, is a very relevant aspect in non-endemic countries and is also very worrisome, because it could produce a feeling of invulnerability in non-endemic regions. In fact, previous studies showed a low knowledge about CD transmission, signs and symptoms, diagnosis and treatment in Bolivian population in non-endemic countries [ 5 , 18 , 19 , 40 – 42 ]. In addition, diagnosis and treatment hesitancy in children is also a relevant aspect because it is known that this population group has the best treatment outcomes and fewer side effects [ 1 ].…”