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

Abstract

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.

2 nd Brazilian Consensus on Chagas Disease, 2015

“…Multiple bio-ecological, socio-cultural, and political factors have been implicated in this process (10) , demanding an increased need for human and social sciences research concerning the disease (43) . In 2005, it was estimated that there were a total of 501,036 Brazilians in the United States, with a prevalence of infection by T. cruzi of 1.02% (17) , or 5,106 cases (44) .…”

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

“…La enfermedad de Chagas ocurre en contextos caracterizados por determinados factores socioculturales, políticos, económicos, ambientales e históricos directamente relacionados con la dispersión de los triatominos (65). Las condiciones socioeconómicas son determinantes para la infestación domiciliaria y, en algunos estudios, se ha reportado que la probabilidad de encontrar individuos de T. dimidiata es 4,3 a 10 veces mayor en viviendas con condiciones socioeconómicas deficientes que en aquellas con buenas condiciones (17).…”

“…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).…”

A motorized vehicle-mounted sprayer as a new tool for Chagas disease vector control

“…Although its historical-geographical distribution has been strongly reduced, this species still persists in the Gran Chaco eco-region of Argentina, Bolivia and Paraguay where it represents an important health problem 2,3,4 . Its persistence is strongly linked to poverty and various socio-political, ecological and biological determinants 5,6,7 .…”