Minneman Rebecca M, Hennink Monique M, Nicholls Andrea, Salek Sahar S, Palomeque Francisco S, Khawja Amina, Albor Lauren C, Pennock Chester C, Leon Juan S
Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
J Parasitol Res. 2012;2012:295034. doi: 10.1155/2012/295034. Epub 2012 Dec 30.
Background. The lack of testing and treatment of Chagas disease (CD), caused by Trypanosoma cruzi, amongst infected immigrants in the USA increases the risk of serious health complications and transmission (congenital or via blood transfusions). Goal. Our goal was to identify the barriers to testing and treatment of CD and understand the process of seeking healthcare amongst Latino immigrants in Georgia. Methods. In this qualitative study, eleven focus group discussions were conducted with 82 Latino immigrants, including migrant farm workers. Grounded theory was used to collect and analyze the data to develop an inductive conceptual framework to explain the context and process of seeking healthcare for CD amongst this at-risk population. Results. Participants were not aware of CD. Three healthcare seeking behaviors were identified: delaying treatment, using traditional remedies, and using either mainstream or alternative health providers. Behaviors and motivations differed by gender, and the use of licensed medical providers was considered a last resort due to the cost of healthcare, loss of earnings while seeking care, and fear of diagnosis with fatal illness. Discussion. Providing free or low cost services, mobile clinics, and education regarding CD is critical to increase testing and treatment of CD in the US.
背景。在美国，感染克氏锥虫所致恰加斯病（CD）的移民缺乏检测和治疗，这增加了严重健康并发症及传播（先天性或通过输血传播）的风险。目标。我们的目标是确定CD检测和治疗的障碍，并了解佐治亚州拉丁裔移民寻求医疗保健的过程。方法。在这项定性研究中，对包括流动农场工人在内的82名拉丁裔移民进行了11次焦点小组讨论。运用扎根理论收集和分析数据，以建立一个归纳概念框架，来解释这一高危人群中CD寻求医疗保健的背景和过程。结果。参与者对CD并不了解。确定了三种寻求医疗行为：延迟治疗、使用传统疗法以及使用主流或替代医疗服务提供者。行为和动机因性别而异，由于医疗保健成本、就医时收入损失以及害怕被诊断出患有致命疾病，使用有执照的医疗服务提供者被视为最后的手段。讨论。提供免费或低成本服务、流动诊所以及关于CD的教育对于增加美国CD的检测和治疗至关重要。
