Improving access to Chagas disease diagnosis and etiologic treatment in remote rural communities of the Argentine Chaco through strengthened primary health care and broad social participation

COLAIANNI I; FREILIJ HECTOR; COLAIANNI I; FREILIJ HECTOR; SARTOR P; BUA, JACQUELINE; SARTOR P; BUA, JACQUELINE; CARDINAL MARTA VICTORIA; GURTLER RICARDO; CARDINAL MARTA VICTORIA; GURTLER RICARDO

PLOS NEGLECTED TROPICAL DISEASES

PUBLIC LIBRARY SCIENCE

Lugar: San Francisco; Año: 2017 vol. 11 p. 5336 - 5336

1935-2727

AbstractBackgroundRural populations in the Gran Chaco region have large prevalence rates of Trypanosoma cruzi infection and very limited access to diagnosis and treatment. We implemented an innovative strategy to bridge these gaps in 13 rural villages of Pampa del Indio held under sustained vector surveillance and control.MethodologyThe non-randomized treatment program included participatory workshops, capacitystrengthening of local health personnel, serodiagnosis, qualitative and quantitative PCRs, a 60-day treatment course with benznidazole and follow-up. Parents and healthcare agents were instructed on drug administration and early detection and notification of adverse drugrelated reactions (ADR). Healthcare agents monitored medication adherence and ADRs at village level. Principal findingsThe seroprevalence of T. cruzi infection was 24.1% among 395 residents up to 18 years of age examined. Serodiagnostic (70%) and treatment coverage (82%) largely exceeded local historical levels. Sixty-six (85%) of 78 eligible patients completed treatment with 97% medication adherence. ADRs occurred in 32% of patients, but most were mild and manageable