| Autor: |
Pennington PM; Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala.; Center for Biotechnology Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala., Juárez JG; Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala.; Department of Entomology, Texas A&M University, College Station, Texas, United States of America., Arrivillaga MR; Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala., De Urioste-Stone SM; School of Forest Resources, University of Maine, Orono, Maine, United States of America., Doktor K; University of Miami, Jackson Memorial Hospital, Miami, Florida, United States of America., Bryan JP; Centers for Disease Control and Prevention Central America Regional Office, Guatemala City, Guatemala.; Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States of America., Escobar CY; Distrito de Salud de Comapa, Jutiapa, Ministerio de Salud PuÂblica y Asistencia Social de Guatemala., Cordón-Rosales C; Center for Health Studies, Universidad del Valle de Guatemala, Guatemala City, Guatemala. |
| Abstrakt: |
Chagas disease is a neglected tropical disease that continues to affect populations living in extreme poverty in Latin America. After successful vector control programs, congenital transmission remains as a challenge to disease elimination. We used the PRECEDE-PROCEED planning model to develop strategies for neonatal screening of congenital Chagas disease in rural communities of Guatemala. These communities have persistent high triatomine infestations and low access to healthcare. We used mixed methods with multiple stakeholders to identify and address maternal-infant health behaviors through semi-structured interviews, participatory group meetings, archival reviews and a cross-sectional survey in high risk communities. From December 2015 to April 2016, we jointly developed a strategy to illustratively advertise newborn screening at the Health Center. The strategy included socioculturally appropriate promotional and educational material, in collaboration with midwives, nurses and nongovernmental organizations. By March 2016, eight of 228 (3.9%) pregnant women had been diagnosed with T. cruzi at the Health Center. Up to this date, no neonatal screening had been performed. By August 2016, seven of eight newborns born to Chagas seropositive women had been parasitologically screened at the Health Center, according to international standards. Thus, we implemented a successful community-based neonatal screening strategy to promote congenital Chagas disease healthcare in a rural setting. The success of the health promotion strategies developed will depend on local access to maternal-infant services, integration with detection of other congenital diseases and reliance on community participation in problem and solution definition. |
