Community-based actions in consulates: a new paradigm for opportunities for systematic integration in Chagas disease detection

Abstract

Abstract Research has shown that multidimensional approaches to Chagas disease (CD), integrating its biomedical and psycho-socio-cultural components, are successful in enhancing early access to diagnosis, treatment and sustainable follow-up. For the first time, a consulate was selected for a community-based CD detection campaign. Two different strategies were designed and implemented between 2021 and 2022 at the Consulate General of Bolivia and a reference health facility in Barcelona. Strategy 1 consisted in CD awareness-raising activities before referring those interested to the reference facility for infectious disease screening. Strategy 2 offered additional in-situ CD screening. Most of the 307 participants were Bolivian women resident in Barcelona. In strategy 1, 73 people (35.8% of those who were offered the test) were screened and 19.2% of them were diagnosed with CD. Additionally, 53,4% completed their vaccination schedules and 28.8% were treated for other parasitic infections (strongyloidiasis, giardiasis, eosinophilia, syphilis). In strategy 2, 103 people were screened in-situ (100% of those who were offered the test) and 13.5% received a CD diagnosis. 21,4% completed their vaccination schedule at the reference health facility and 2,9% were referred for iron deficiency anemia, strongyloidiasis or chronic hepatitis C. The location of the screening, together with the presence of community-based participants, fueled trust and increased CD understanding. Each of the strategies assessed had different benefits. Opportunities for systematic integration based on community action in the official workplace of representatives of their own country may enhance early access to diagnosis, care and disease prevention.