Detection

DETECTION

IN SITU SCREENING FOR CHAGAS DISEASE

In 2008 we began attending the Bolivian Homeland Festival in Badalona, Catalonia, Spain.

The first few times we offered information about Chagas disease and, for those who wanted to be tested, we made appointments for a later date at the healthcare facilities of the Drassanes-Vall d’Hebron Tropical Medicine and International Health Unit, Catalan Institute of Health (USIDVH).

In 2014, after several years and after witnessing the positive reception of our work by the Bolivian community, we began to perform in situ screenings in Barcelona. We normally do this work in the context of the Bolivian Homeland Festival but in recent years we have also worked in other contexts, such as concerts with Bolivian bands like Los Kjarkas (2017).

MULTIDISCIPLINARY TEAM FOR AN INTERDISCIPLINARY COMMUNITY INTERVENTION:

People that make up the multidisciplinary team:

Healthcare professionals, community health representatives, peer educators, and community multipliers (members of ASAPECHA). 

Developmental phases of the interdisciplinary work:

Recruitment and preparation


The event is chosen and the event organizers are contacted. The necessary logistics for the event are organized: personnel (healthcare professionals, ASPECHA members, and community multipliers) and educational materials. The mobile blood sampling unit is also brought to the event. 

Information and recruitment for evaluation

An information stand is set up at the event, at which the community health representatives and community multipliers inform passersby about their work and about Chagas disease. The people are given surveys to evaluate their existing knowledge of the disease. Those who wish to be tested are brought to the mobile unit, where the healthcare professionals examine them. 

Scheduling and screening

Blood samples are taken from the willing participants and processed by the USIDVH laboratory. The participants are informed that they will receive a call from USIDVH about their results and may be asked to schedule an appointment at the health center. 

Results and monitoring

The blood samples are processed at the USIDVH microbiology laboratory. Follow-up care for the participants is given based on their results:

- When the test is negative, the participant is contacted by phone and informed of the negative result.

- When a test result is inconclusive (one positive test and one negative test), an appointment is scheduled with the participant to take another blood sample.

- If the test result is positive, the participant is given an appointment at USIDVH for additional testing to determine the extent of cardiac and digestive damage, along with anti-parasite treatment and overall monitoring.

RESULTS OF THE 2017 INTERVENTION

Analyzing these interventions is important because 1) it helps to determine the rate of underdiagnosis in the population that is most susceptible to Chagas disease among those who attended two Bolivian cultural events in Barcelona; 2) it helps to describe the demographic characteristics of the people who were examined; and 3) it helps to analyze the detection results and give them greater meaning.

The participants were recruited through community health representatives. The participants were given a questionnaire to assess their previous understanding of Chagas disease. The in situ screening was offered to all participants who hadn’t been screened in the past. Those who chose not to be examined were asked for the reason behind their decision. The results were entered into a database and underwent statistical analysis using STATA v14.

In 2017 we conducted 635 interviews. 95% of the subjects reported prior knowledge of Chagas disease. 271 subjects were examined: 71.2% women and 28.8% men, of which 87.8% were of Bolivian origin. The prevalence of Chagas disease in those examined was 8.9%. In situ community healthcare interventions are shown to be essential to facilitate access to diagnosis.

See publications for more information.

COORDINATING INSTITUTIONS:

 

COLLABORATING INSTITUTIONS:

Blood and Tissue Bank of Catalonia, Healthy World Foundation, Consulate General of Bolivia in Spain

RELATED PUBLICATIONS

A Community-Based Intervention for the Detection of Chagas Disease in Barcelona, Spain

Jordi Gómez i Prat, Paula Peremiquel-Trillas, Isabel Claveria Guiu, Estefa Choque, Inés Oliveira Souto, Núria Serre Delcor, Elena Sulleiro, Mateu Espasa, Conxita Pastoret, Juan José de los Santos, Hakima Ouaarab, Pedro Albajar Viñas & Carlos Ascaso Terren

Cribado in situ de la enfermedad de Chagas con una intervención comunitaria: ¿puede mejorar la accesibilidad al diagnóstico y al tratamiento?

Hakima Ouaarab Essadek, Isabel Claveria Guiu, Johanna Caro Mendivelso, Elena Sulleiro, Conxita Pastoret, Miriam Navarro, Irene Barrabeig, Jordi Gómez i Prat