Journal Article > CommentaryFull Text
PLoS Negl Trop Dis. 2013 October 31; Volume 7 (Issue 10); e2300.; DOI:10.1371/journal.pntd.0002300
Hotez PJ, Dumonteil E, Cravioto MB, Bottazzi ME, Tapia-Conyer R, et al.
PLoS Negl Trop Dis. 2013 October 31; Volume 7 (Issue 10); e2300.; DOI:10.1371/journal.pntd.0002300
Journal Article > ReviewFull Text
PLoS Negl Trop Dis. 2019 September 26; Volume 13 (Issue 9); e0007447..; DOI:10.1371/journal.pntd.0007447
Forsyth C, Meymandi S, Moss I, Cone J, Cohen RM, et al.
PLoS Negl Trop Dis. 2019 September 26; Volume 13 (Issue 9); e0007447..; DOI:10.1371/journal.pntd.0007447
BACKGROUND
Chagas disease (CD) affects over 300,000 people in the United States, but fewer than 1% have been diagnosed and less than 0.3% have received etiological treatment. This is a significant public health concern because untreated CD can produce fatal complications. What factors prevent people with CD from accessing diagnosis and treatment in a nation with one of the world's most advanced healthcare systems?
METHODOLOGY/PRINCIPAL FINDINGS
This analysis of barriers to diagnosis and treatment of CD in the US reflects the opinions of the authors more than a comprehensive discussion of all the available evidence. To enrich our description of barriers, we have conducted an exploratory literature review and cited the experience of the main US clinic providing treatment for CD. We list 34 barriers, which we group into four overlapping dimensions: systemic, comprising gaps in the public health system; structural, originating from political and economic inequalities; clinical, including toxicity of medications and diagnostic challenges; and psychosocial, encompassing fears and stigma.
CONCLUSIONS
We propose this multidimensional framework both to explain the persistently low numbers of people with CD who are tested and treated and as a potential basis for organizing a public health response, but we encourage others to improve on our approach or develop alternative frameworks. We further argue that expanding access to diagnosis and treatment of CD in the US means asserting the rights of vulnerable populations to obtain timely, quality healthcare.
Chagas disease (CD) affects over 300,000 people in the United States, but fewer than 1% have been diagnosed and less than 0.3% have received etiological treatment. This is a significant public health concern because untreated CD can produce fatal complications. What factors prevent people with CD from accessing diagnosis and treatment in a nation with one of the world's most advanced healthcare systems?
METHODOLOGY/PRINCIPAL FINDINGS
This analysis of barriers to diagnosis and treatment of CD in the US reflects the opinions of the authors more than a comprehensive discussion of all the available evidence. To enrich our description of barriers, we have conducted an exploratory literature review and cited the experience of the main US clinic providing treatment for CD. We list 34 barriers, which we group into four overlapping dimensions: systemic, comprising gaps in the public health system; structural, originating from political and economic inequalities; clinical, including toxicity of medications and diagnostic challenges; and psychosocial, encompassing fears and stigma.
CONCLUSIONS
We propose this multidimensional framework both to explain the persistently low numbers of people with CD who are tested and treated and as a potential basis for organizing a public health response, but we encourage others to improve on our approach or develop alternative frameworks. We further argue that expanding access to diagnosis and treatment of CD in the US means asserting the rights of vulnerable populations to obtain timely, quality healthcare.
Journal Article > CommentaryFull Text
PLoS Negl Trop Dis. 2017 January 5; Volume 11 (Issue 1); e0005148.; DOI:10.1371/journal.pntd.0005148
Picado A, Angheben A, Marchiol A, Alarcón de Noya B, Flevaud L, et al.
PLoS Negl Trop Dis. 2017 January 5; Volume 11 (Issue 1); e0005148.; DOI:10.1371/journal.pntd.0005148