Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Madrid, Spain.
Red de Investigación Colaborativa en Enfermedades Tropicales, RICET, Madrid, Spain.
PLoS One. 2020 Mar 13;15(3):e0230120. doi: 10.1371/journal.pone.0230120. eCollection 2020.
Approximately 120,000 people live with Chagas disease in Europe, 43% of whom are living in Spain. Early diagnosis and treatment are critical to improve outcomes for those living with Chagas, and also for the prevention of ongoing transmission. The decision to be tested for Chagas is affected by a range of factors. Studies have highlighted the need to consider the wider social determinants of healthcare seeking behaviour related to Chagas. In Madrid, 44% of Bolivians undergo Chagas screening, which is a higher rate than other European regions, but studies concerning the factors which determine testing have not been performed. This study aimed to assess, for a first time, the factors associated with screening for Chagas among Bolivians living in Madrid trying to help in developing strategies and health recommendations.
This was a cross-sectional survey about knowledge of Chagas and practices of Bolivians living in Madrid, Spain. A structured questionnaire was administered to 376 participants regarding Chagas health-seeking behaviour. Determinants were assessed by multiple logistic regressions adjusted by sex.
After adjusting for others variables and sex, the factors shown to be associated with Chagas screening were to have between 35 and 54 years of age; coming from a department with high prevalence of Chagas (OR 2.17 95% CI 0.99-4.76); received information about Chagas in Spain (OR 2.44 95% CI 1.32-4.51); and received any advice to do the test, especially if the advice came from a professional.
Health authorities should coordinate and promote strategies addressed to diagnose and treat Chagas taking into account all factors associated with screening. Our study suggests that professional advice appears to be the cornerstone to encourage Bolivians to undergo Chagas screening in Madrid. It is time to change the burden of the decision of being screened from the patient to the doctor. Being diagnosed for Chagas needs to become an institutional strategy.
在欧洲，约有 12 万人患有恰加斯病，其中 43%居住在西班牙。早期诊断和治疗对于改善恰加斯病患者的预后以及预防疾病的持续传播至关重要。是否接受恰加斯病检测的决定受到多种因素的影响。研究强调需要考虑与恰加斯病相关的医疗保健寻求行为的更广泛社会决定因素。在马德里，44%的玻利维亚人接受了恰加斯病筛查，这一比例高于其他欧洲地区，但尚未对决定检测的因素进行研究。本研究旨在首次评估居住在马德里的玻利维亚人筛查恰加斯病的相关因素，以帮助制定相关策略和健康建议。
这是一项关于居住在马德里的玻利维亚人对恰加斯病的认知和实践的横断面调查。我们向 376 名参与者发放了一份关于恰加斯病卫生保健行为的结构化问卷。通过多变量逻辑回归分析调整性别因素来评估决定因素。
在调整其他变量和性别因素后，与恰加斯病筛查相关的因素包括年龄在 35-54 岁之间；来自恰加斯病高发地区（OR 2.17 95%CI 0.99-4.76）；在西班牙获得过恰加斯病相关信息（OR 2.44 95%CI 1.32-4.51）；以及获得过任何检测建议，尤其是来自专业人士的建议。
卫生当局应协调并推广针对诊断和治疗恰加斯病的策略，同时考虑与筛查相关的所有因素。我们的研究表明，专业建议似乎是鼓励马德里的玻利维亚人接受恰加斯病筛查的关键。现在是将筛查决定的负担从患者转移到医生的时候了。恰加斯病的诊断需要成为一项机构策略。
