Chagas disease

Honduras has a high prevalence of Trypanosomacruzi infection. The purpose of this study was to assess the knowledge and attitudes of Chagas disease in 17 geographically proximal rural Honduran communities. These communities are under the same local health ministry and are served by yearly medical relief efforts. La Hicaca (LH), although impoverished, is wealthier than the surrounding villages (SV). A 15-item, interviewer-administered, convenience sample questionnaire was employed on adult patients attending a brigade clinic in LH and SV. Pearson χ² and Fisher's exact tests were used to compare knowledge and attitudes of Chagas disease, environmental risks, and access to treatment between LH and SV. One hundred and seventy-seven questionnaires were completed. The majority of respondents were aware of Chagas disease (90%, n=159). Only a minority of respondents understood disease transmission (2%, n=3). There was no significant difference in self-reported presence of the reduviid bug in homes in SV or LH (76% (n=85) vs 65% (n=42), p=0.11). In SV, 77% (n=74) of people had never been tested for Chagas, compared to 67% (n=42) in LH, p=0.90. Likewise, no significant difference was observed in perceived access to treatment between SV and LH (54% (n=50) vs 44% (n=24), p=0.23). Participants from SV perceived a higher risk of contracting Chagas disease than did people from LH (38% (n=40) vs 23% (n=23), p=0.05). Nearly all participants were interested in being tested for Chagas disease (90%, n=159) and in implementing preventative measures (98%, n=170). Prior studies reported differences in healthcare access across these communities. In contrast, these findings suggest that knowledge of Chagas disease and environmental risk factors are similar between communities, although SV respondents perceived a higher risk of disease transmission. These findings have implications for future education and prevention campaigns in the area.

To the Editor: The year 2009 was the 100th anniversary of Carlos Chagas's discovery of the disease caused by the parasite Trypanosoma cruzi, now known as Chagas disease. Spread by infected bugs called triatomines, the disease is endemic throughout much of Mexico and Central and South America. An estimated 8-11 million persons in Latin America have the disease (1). T. cruzi infection causes more public health problems with long-term consequences in Latin America than any other parasitic disease (2).

In Honduras, where Chagas disease is a serious health and environmental concern, prevention measures face the challenge of achieving widespread and long-term sustainable adoption by communities. The article integrates social network analysis and a gender-sensitive approach to understand the role of men and women in the implementation of a community-level intervention, based on the adoption of housing improvements to reduce the presence of the insect vector. A total of 108 people in the community of El Salitre were interviewed. Data were collected on socio-demographic characteristics, participation in project activities, communication and collaboration networks related to Chagas disease prevention, knowledge of Chagas disease, and adoption of housing improvements techniques. Communication mostly occurred between the same gender individuals and was associated with knowledge of Chagas disease. Socioeconomic status, Chagas disease knowledge, and collaboration with men were associated with women adopting housing improvements. For men, however, participation in project activities, formal education, and collaboration with women were associated with adoption. These findings suggest that men and women were driven by distinct concerns, interests, and motivations when adopting new Chagas disease prevention strategies. Participatory community interventions that seek to generate health knowledge and foster collaborations to reduce health risk should address gender differences.

Studies have indicated that US physicians may not consider Chagas disease when diagnosing immigrant patients from Chagas-endemic areas. The purpose of this study was to evaluate physician knowledge of Chagas disease in six Appalachian Ohio counties. Physician knowledge was assessed by self-administrated survey (n=105). Over 80% of physicians reported that their current knowledge of Chagas disease was limited or very limited, and 50% reported never considering Chagas disease diagnosis for their at-risk patients. Nearly 70% of physicians were unaware of the percentage of chronic Chagas patients that develop clinical disease, and 36% could not correctly identify the disease course. In addition, over 30% of physicians reported that no services were available within their practice to assist Spanish-speaking patients with limited English proficiency. A lack of physician awareness of Chagas disease, coupled with a lack of translation services, may create a barrier to care by decreasing the likelihood of identification of patients at risk for Chagas disease. The results of this study support the need for interventions to ensure proper diagnosis and treatment of Chagas disease in Hispanic immigrants in rural Appalachian Ohio.

Health literacy & Chagas disease knowledge: A cross-sectional study in Southern Loja Province, Ecuador

BackgroundChagas 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.MethodsThis 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.ResultsA 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.ConclusionsThis 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.

Chagas disease, caused by Trypanosoma cruzi, has become increasingly relevant in non-endemic countries due to migration. Spain hosts large Latin American communities, making physicians' awareness key for timely diagnosis and treatment. We aimed to assess knowledge of Chagas disease among physicians nationwide and to identify barriers to its clinical management. We conducted a nationwide cross-sectional online survey of practising physicians in Spain (1 June-30 September 2025). The self-administered online questionnaire was developed through expert consensus and an extensive review of relevant literature and included demographic and professional data, 31 knowledge items across five domains (transmission, clinical presentation, screening, diagnosis, and treatment), as well as questions addressing perceived barriers. Knowledge was classified into five categories from very low to very high, with difficulty indices calculated per item. Associations used χ 2, Kruskal-Wallis, or Spearman tests; independent predictors were examined with multivariable ordinal logistic regression. Of 745 respondents (65.5% female; mean age 39.0 years [SD 11.7]; mean practise duration 12.8 years [SD 11.0]), knowledge was moderate in 55.8%, high in 32.6%, very high in 2.1%, low in 8.6%, and very low in 0.8%. Highest scores occurred in Infectious Diseases, Microbiology, and Internal Medicine; lowest score in Geriatrics. Higher knowledge was associated with perceiving clinical relevance (adjusted odds ratio [aOR] 2.51, 95% CI 1.79-3.53), specific training in the past 5 years (aOR 1.96, 1.32-2.90), and speciality (Internal Medicine, aOR 3.02, 1.96-4.65); less frequent nationality inquiry was associated with lower knowledge (frequently aOR 0.41, 0.23-0.72; occasionally 0.56, 0.35-0.89). Clinically relevant gaps were identified in diagnostic and therapeutic domains: fewer than half of physicians correctly identified PCR as the preferred diagnostic method in the acute phase or in immunocompromised patients, and only 63.1% recognised benznidazole or nifurtimox as first-line therapy. In contrast, awareness of congenital screening was high (94.0%). Main perceived barriers were low population risk perception and insufficient training. Physicians showed moderate knowledge of Chagas disease, with important gaps in diagnosis and treatment. Targeted, large-scale educational initiatives supported by institutions are urgently needed to strengthen awareness and clinical preparedness in non-endemic settings with significant Latin American migrant populations.

Chagas disease affects an estimated 300,000 people in the United States, and as many as 300 congenital infections are estimated to occur annually. The level of knowledge about Chagas disease among obstetricians-gynecologists in the United States has not been assessed. The American College of Obstetricians and Gynecologists surveyed a representative sample of 1,000 members about Chagas disease. Among 421 respondents, 68.2% (95% confidence interval [CI] = 63.5-72.6) described their knowledge level about Chagas disease as "very limited." Only 8.8% (95% CI = 6.2-12.0) knew the risk of congenital infection, and 7.4% (95% CI = 5.1-10.4) were aware that both acute and chronic maternal infections can lead to congenital transmission. The majority of respondents (77.9%; 95% CI = 73.5-81.9) reported "never" considering a diagnosis of Chagas disease among their patients from endemic countries. Most of those who did consider the diagnosis did so "rarely." Knowledge of Chagas disease among obstetricians-gynecologists in the United States is limited. Greater awareness may help to detect treatable congenital Chagas cases.

There are few studies evaluating awareness of Chagas disease among healthcare professionals attending migrants from Latin America or working in Chagas-endemic areas. The objective of this study was to design and validate instruments for assessing knowledge about Chagas disease among healthcare students and residents as well as students and professionals of social and other health science disciplines. Two validated scales have been developed: the 10-item Chagas Level of Knowledge Scale for healthcare professionals (ChaLKS-Medical) and the 8-item ChaLKS-Social&Health for potential aid workers from those fields. Both scales were considered adequate in terms of readability, internal consistency, construct validity, and discriminant validity. The mean number of correct answers on the ChaLKS-Medical among respondents from non-healthcare versus healthcare sectors was 1.80 versus 7.00 (P < 0.001). The scores on the ChaLKS-Social&Health also discriminated between the knowledge levels in these two groups (1.76 versus 6.78, P < 0.001). Knowledge among medical/pharmacy students and residents on the ChaLKS-Medical was acceptable and different (mean: 5.8 and 7.4, respectively; P < 0.001). Respondents' knowledge of Chagas disease was greater in those who had previously received information on the disease; this was true in both respondents from the healthcare sector (mean correct answers, ChaLKS-Medical: 7.2 versus 4.3, P < 0.001) and in potential aid workers (mean correct answers, ChaLKS-Social&Health: 5.1 versus 1.1, P = 0.001). The metric properties of both scales are adequate for their use in supporting aid operations in Chagas-endemic countries or in providing health and social care to migrant populations in non-endemic countries.

This study consists of a broad review on what is known and what should be improved regarding knowledge of Chagas disease, not only through analysis on the main studies published on the topics discussed, but to a large extent based on experience of this subject, acquired over the past 50 years (1961-2011). Among the subjects covered, we highlight the pathogenesis and evolution of infection by Trypanosoma cruzi, drugs in use and new strategies for treating Chagas disease; the serological tests for the diagnosis and the controls of cure the infection; the regional variations in prevalence, morbidity and response to treatment of the disease; the importance of metacyclogenesis of T. cruzi in different species of triatomines and its capacity to transmit Chagas infection; the risks of adaptation of wild triatomines to human dwellings; the morbidity and need for a surveillance and control program for Chagas disease in the Amazon region and the need to prioritize initiatives for controlling Chagas disease in Latin America and Mexico and in non-endemic countries, which is today a major international dilemma. Finally, we raise the need for to create a new initiative for controlling Chagas disease in the Gran Chaco, which involves parts of Argentina, Bolivia and Paraguay.

Understanding the at-risk population's perception of Chagas disease is essential for its effective prevention and control. A cross-sectional survey of knowledge, attitudes, and practices toward Chagas disease was conducted with Bolivians in a highly endemic region of Bolivia and Latin American migrants in London. In total, 175 participants completed the survey: 100 Bolivians in a highly endemic village in Santa Cruz, Bolivia and 75 Latin American migrants in London (of whom 31 were from Bolivia). All participants from the endemic village and all Bolivian migrants in London knew of Chagas disease, whereas only 25% of other Latin American migrants had heard of it (P <0.001). In London, Bolivians had more knowledge of Chagas disease than those from other Chagas-endemic countries. In Bolivia only, better understanding of Chagas disease was associated with educational attainment. Only 4% of participants overall were aware of the risk of vertical transmission. Few Latin American migrants in London had previously been tested for Chagas disease, and most were not aware of how to access testing. Migration and level of endemicity may shape individuals' understanding of as well as attitudes and practices toward Chagas disease. A better understanding of these factors can guide effective prevention and control program development in both endemic and non-endemic settings.

Chagas disease is one of the most important tropical infections in the world and mainly affects poor people. The causative agent is the hemoflagellate protozoan Trypanosoma cruzi, which circulates among insect vectors and mammals throughout the Americas. A large body of research on Chagas disease has shown the complexity of this zoonosis, and controlling it remains a challenge for public health systems. Although knowledge of Chagas disease has advanced greatly, there are still many gaps, and it is necessary to continue generating basic and applied research to create more effective control strategies. The aim of this review is to provide up-to-date information on the components of Chagas disease and highlight current trends in research. We hope that this review will be a starting point for beginners and facilitate the search for more specific information.

Knowledge of Chagas Disease among Elementary School Students in Two Areas Rural and Urban of the Southern Huasteca of San Luis Potosi, Mexico

Fundamentals: Migration movements between countries have enabled the extension of Chagas disease to non-endemic countries such as Spain, where only recently there has been awareness of this emerging global disease and procedures have been put in place for its management. The objective of this study is to determine the level of knowledge of Chagas disease, its symptoms, means of transmission and places where seropositive residents in Valencia (Spain) may seek medical assistance. Methods: Observational cross-sectional study of 96 Bolivian migrants living in Valencia (Spain). The sample was randomly selected and taking advantage of the bolivian elections in 2014. A specific epidemiological survey was conducted and screening blood tests were carried out using ELISA and confirmatory diagnosis by indirect immunofluorescence. After the bivariate analysis, logistic regression models were created to determine the variables that accounted for the lack of knowledge of the disease.Results: The prevalence of Chagas was 35.4%. However, 24% of the total sample and 26.1% of seropositive participants do not know about the disease and 70.8% of participants do not know about the symptoms of the disease. While 58.3% (41.1% of seropositive participants) ignore what the means of transmission in non-endemic countries are and 47.1% do not know where to seek medical attention. This ignorance is predominant in participants over 45 years of age and with lower levels of education.Conclusions: There is an important lack of knowledge of the disease which, along with the issue of a high prevalence, elevates Chagas disease into being a potential public health problem which requires specific control and preventive measures.

Community participation is the main strategy to sustainability of Chagas disease entomological surveillance. The purpose of this study was to evaluate the level of knowledge on triatomine insects and Chagas disease among the residents from eight localities of Diamantina, in Minas Gerais, with a view to observing any associations between their knowledge and infestations by triatomines. In order to evaluate this knowledge, questionnaires were used containing both closed and open questions. They were applied to 583 residents who were ten years old or over. To establish if they could recognize the triatomine insect, they were given samples to look at. The responses to the closed questions were analyzed with reference to any frequencies of and associations with infestations involving this insect. The responses to the questions were organized into different thematic areas and were descriptively analyzed. Although the resident's ability to recognize the triatomine insect was not associated with the infestation of the localities, the residents in the areas that had higher infestations showed that they had a good knowledge of the available support services and the need to send the insects to them. We did not observe any associations between triatomine infestations and knowledge of Chagas disease. The results of this study can provide guidance on education that can be given by the health services to the community in order to encourage them to provide notifications of the triatomine insects.