Chagas screening and treatment among Bolivians living in Madrid, Spain: The need for an official protocol.

María Romay-Barja,Teresa Blasco-Hernández,Teresa Boquete,Obdulia Martinez,Débora Álvarez-Del Arco,Agustín Benito,Marlene González

doi:10.1371/journal.pone.0213577

María Romay-Barja, Teresa Blasco-Hernández + Show 5 more

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https://doi.org/10.1371/journal.pone.0213577

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Abstract

BackgroundIt is estimated that around 52,000 people live with Chagas in Spain, but only 10% have been diagnosed. Migrants from Bolivia bear the burden of Chagas infection in Spain. However, little is known about their current management of Chagas diagnosis and treatment patterns. This study aimed to assess the Chagas related disease perception and health behaviour of Bolivians living in Madrid.Methods and principal findingsFor a first time, a cross-sectional survey about Chagas’ knowledges and practices was carried out in Madrid, Spain. A total of 376 Bolivians were interviewed about their Chagas health-seeking behaviour. Differences between men and women were assessed Most of Bolivians living in Madrid have access to the public health services. 44% of Bolivians included in the survey had a Chagas screening test done. However, while women did their test for Chagas mostly at hospital (59.2%), men also used the community campaigns (17.5%) and blood banks (14.3%). The prevalence reported among Bolivians tested was 27.7%. Unfortunately, more than half of those reporting a positive test for Chagas did not begin or completed treatment. Only 45.7% of positives reported having had their children tested for Chagas.ConclusionsDespite the increase in the number of Chagas diagnoses done in Madrid, the number of Bolivians who tested positive and then started or completed treatment remains very low. The fact that most Bolivians’ access to the health system is through the primary healthcare services should be considered for improving management of cases and follow-up of treatment adherence. Local and national protocol establishing guidelines for the screening and treatment of Chagas disease would help improving case detection and management at all levels of the healthcare system.

Highlights

Differences between men and women were assessed Most of Bolivians living in Madrid have access to the public health services. 44% of Bolivians included in the survey had a Chagas screening test done
Despite the increase in the number of Chagas diagnoses done in Madrid, the number of Bolivians who tested positive and started or completed treatment remains very low
Chagas disease is endemic in 21 continental Latin American countries, where almost 6 million people are infected with Trypanosoma cruzi,[1]

Summary

Introduction

Chagas disease is endemic in 21 continental Latin American countries, where almost 6 million people are infected with Trypanosoma cruzi,[1]. Considered one of the main neglected tropical diseases in Latin America, Chagas disease has crossed borders to North America and Europe, due to population mobility, where an estimated 120,000 people currently live with [2,3,4]. Presenting in two phases, Chagas disease manifests with an initial acute phase lasting two months, with high parasitemia, and is mostly asymptomatic. It is estimated that around 52,000 people live with Chagas in Spain, but only 10% have been diagnosed. Migrants from Bolivia bear the burden of Chagas infection in Spain.

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