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.
Highlights
Detection of acute conditions of neglected infectious diseases (NIDs) is hindered by low primary health care utilization as well as low priority and quality of health care services [1]
Through a retrospective lens we explore the latter through the health care seeking paths followed by acute cases which have been successfully diagnosed and prescribed for Chagas disease (CD) treatment
Some families were unaware that these symptoms could be a result of CD and these nonspecific symptoms led them to think they acquired other conditions, which influenced their method of care
Summary
Detection of acute conditions of neglected infectious diseases (NIDs) is hindered by low primary health care utilization as well as low priority and quality of health care services [1]. Recent estimates suggest that more than 5.7 million people are infected with CD, mostly socially and economically vulnerable populations [4] It produces 14,000 annual deaths in Latin America [5] and is a cause of morbidity (WHO, 2002), work disability, and increased health care costs [6]. Underreporting CD figures might be explained by several factors hindering diagnosis: the largely asymptomatic nature of disease, organizational and human resources factors at the health system level [1], and social and cultural factors at the patient level [12]. In other countries this has led to question the CD prevalence figures [13].
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