Prevention And Control Of Chagas Disease: Narrowing The Gap Between Policy And Practice. Case Study On Indigenous Communities In Santa Cruz, Bolivia.

Abstract

Chagas disease (CD) or America Trypanosomiases is a life-threatening disease caused by a protozoan parasite called Trypanosoma cruzi (T. Cruzi). As Table 1 shows, it is most commonly transmitted to humans via a vector known as vinchuca (bug) that lives in the cracks of poorly constructed houses (WHO 2013) (appendix A). Further, this illness is a well-known disease of the poor and one of the most neglected tropical diseases in the world (WHO 2014a).Hence, It is believed to affect almost exclusively rural and powerless people living in rural parts of low-income countries (Hunt 2007). The same way, the disease persists due to deeper poverty and inequalities within sectors (Manderson 2009). Bolivia represents the world's highest prevalence rate on Chagas disease and hosts the peak percentage on indigenous population (Ministerio de Salud 2008). Accordingly, they are commonly recognized as the poorest and most marginalized, facing numerous social and health inequalities (Hunt 2007) Although political commitment has been increasingly expressed towards Chagas, it remains a major public health in Bolivia. (Gazzinelli et al 2012). That adverts that despite various efforts, needs remain unmet on the ground. In the face of that, this study aims to help understand to what extent the National Program for Chagas Disease in Bolivia respond to the reality of indigenous communities. Challenges and barriers of NPCD to respond to healthcare needs will be presented and further discusses. Lastly, in the attempt to help narrow the gaps between policy and practice, recommendations will be suggested.