The Drugs for Neglected Diseases initiative (DNDi) and the Casanare Departmental Health Secretariat have announced the successful results of a programme for the elimination of barriers to the diagnosis and treatment of Chagas disease in several municipalities in Colombia. The programme, which was launched two years ago, led to an increase of 1300% in the number of people screened in Támara and Nunchía. For those who had access to diagnostic testing, the wait time to receive their results was reduced from one year to less than one month, on average. Approximately 20% of people who had access to diagnosis during the two-year period tested positive for the disease.
“There are many barriers to access to diagnosis and treatment of Chagas disease. However, the numbers show that it is possible to improve access and promote important changes in health care with simple measures and current resources,” said Dr Andrea Marchiol, Medical Manager of DNDi‘s Chagas access projects for Latin America.
The improved access is the result of close collaboration between DNDi, the Ministry of Health and Social Protection, the National Health Institute, the Orinoquía Regional Hospital (HORO), and the Departmental Health Secretariat.
After identifying the main barriers hindering access to diagnosis and treatment of Chagas in Colombia, an integral health care path was designed, focusing on people living with the disease. This simplified the process by transferring diagnosis and treatment to primary care centres, which are closer to communities. For this change to be effective, local capacities in the health care system and the community were strengthened. The project was implemented in the municipalities of the Boyacá, Santander, and Arauca departments, as well as in Nunchía and Támara, in collaboration with the respective health secretariats.
According to data from the World Health Organization (WHO), Chagas disease affects more than 6 million people globally, particularly in Latin America. Without timely treatment, this silent disease can affect vital organs such as the heart, causing severe damage to health. Chagas is transmitted through contact with the contaminated feces of the insect known as the “kissing bug”. This typically occurs after this vector bites a person. Chagas can also be transmitted by an infected pregnant woman to her baby, by eating contaminated foods, or through blood transfusion or organ transplant. In Colombia, it is estimated that 4.8 million people are at risk of contracting the disease, 436,000 are infected, and 130,000 have some type of heart damage as a consequence of the disease. However, it is estimated that only 1.2% of the population at risk has been screened, and only 0.4% of those have received treatment against the parasite.
Another significant change brought by the programme is that younger people have better access to diagnosis. This is important because the sooner the disease is detected, the more effective the treatment can be.
“The requisition of diagnostic tests was based only on the symptoms. Now the doctor’s perspective has started to change, and they think about Chagas not only in terms of its symptoms, but also in terms of the risks. Since Chagas is a silent disease, if we only look for symptoms, we fail to identify many affected people,” said Dr Rafael Herazo, Chagas access project medical consultant.
“After two years, we are no longer talking about a pilot. Now we have an institutionally consolidated process with positive impact on the health of the populations affected by Chagas disease. Our task now is to scale the implementation of the healthcare path at the departmental level,” added Dr Fernando Torres, Head of the Programme for vector-transmitted diseases in the Casanare department
A not-for-profit research and development organization, DNDi works to deliver new treatments for neglected patients, in particular those suffering with Chagas disease, sleeping sickness (human African trypanosomiasis), leishmaniasis, filarial infections, mycetoma, pediatric HIV, and hepatitis C. Since its inception in 2003, DNDi has delivered eight new treatments. DNDi’s strategy for Chagas disease consists of three pillars: improving diagnostic and therapeutic tools through innovation in research & development, fostering collaboration and strengthen capacity in endemic countries through a scientific platform, and increasing patients’ access to diagnosis and treatment.
Alessandra Vilas Boas
Photo credit: Felipe Abondano – DNDi