The role of the first level of health care in the approach to Chagas disease in a non-endemic country.,PLOS Neglected Tropical Diseases

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The role of the first level of health care in the approach to Chagas disease in a non-endemic country.
PLOS Neglected Tropical Diseases ( IF 3.4 ) Pub Date : 2019-12-16 , DOI: 10.1371/journal.pntd.0007937
Laura Iglesias-Rus ₁ , María Romay-Barja _{1,

2} , Teresa Boquete _{1,

2} , Agustín Benito _{1,

2} , Teresa Blasco-Hernández _{1,

2}

Affiliation

BACKGROUND Chagas disease has crossed South America's borders and in recent years has spread to regions that were not previously affected. Early diagnosis and treatment of Chagas disease improves the clinical prognosis and prevents vertical transmission. Taking into account the lack of evidence of how primary care services manage Chagas disease in a non-endemic country, this study assessed Chagas disease knowledge, attitudes and practices among primary health care professionals. METHODS AND PRINCIPAL FINDINGS Between 2017 and 2019, eight focus groups were formed with 41 family physicians and 40 nurses from healthcare centers in Madrid, Spain, and 70 field notes were collected during non-participant observation. The family physicians and nurses showed a lack of general knowledge about Chagas disease, and they did not identify the country of origin to request the blood test. The family physicians and nurses thought that the population did not talk broadly about Chagas disease because of the stigma or shame. The role of nurses was more focused on vaccination status and chronic disease follow-up, and family physicians assumed a facilitating role to send patients to different hospital facilities. Communication between primary care professionals and the hospital is a barrier frequently experienced by family physicians. CONCLUSIONS The diagnosis of CD in non-endemic countries continues being an important challenge for health systems. The results obtained with the study of the knowledge, attitudes and practices at primary care through a qualitative approach allows to obtain evidence that could help to develop strategies for the screening of CD in a protocolized way in order to avoid that the diagnosis depends exclusively on the request of the patient.

中文翻译：

在一个非流行国家中，第一级卫生保健在应对南美锥虫病中的作用。

背景技术南美锥虫病已经越过南美洲的边界，并且近年来已经扩散到先前未受影响的地区。南美锥虫病的早期诊断和治疗可改善临床预后并防止垂直传播。考虑到缺乏关于非流行国家初级保健服务如何管理南美锥虫病的证据，本研究评估了初级保健专业人员中南美锥虫病的知识，态度和做法。方法和主要发现在2017年至2019年期间，由西班牙马德里医疗中心的41位家庭医生和40位护士组成了八个焦点小组，在非参与者观察期间收集了70个现场笔记。家庭医生和护士对查加斯病缺乏了解，他们没有确定要求进行血液检查的原籍国。家庭医生和护士认为，由于耻辱或耻辱，人们没有广泛谈论恰加斯病。护士的角色更多地集中在疫苗接种状况和慢性病的随访上，家庭医生承担了将患者送往不同医院设施的促进作用。初级保健专业人员与医院之间的沟通是家庭医生经常遇到的障碍。结论在非流行国家，对CD的诊断仍然是卫生系统的一项重要挑战。通过对知识的研究获得的结果，

更新日期：2019-12-17

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