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. 2020 Jun 5;5(2):92.
doi: 10.3390/tropicalmed5020092.

Mandatory Notification of Chronic Chagas Disease: Confronting the Epidemiological Silence in the State of Goiás, Brazil

Liliane da Rocha Siriano  1 , Andrea Marchiol  2 , Marina Pereira Certo  2 , Juan-Carlos Cubides  3 , Colin Forsyth  2 , Fabrício Augusto de Sousa  1
Affiliations

Mandatory Notification of Chronic Chagas Disease: Confronting the Epidemiological Silence in the State of Goiás, Brazil

Liliane da Rocha Siriano et al. Trop Med Infect Dis. .

Abstract

Objectives: This paper presents the results of the design and implementation process for the policy of compulsory notification of chronic Chagas disease in the Brazilian state of Goiás (Resolution No. 004/2013-GAB/SES-GO).

Methods: The narrative was based on information provided by key actors that were part of the different stages of the process, built on contextual axes based on participants' reflections about the establishment of the most accurate and coherent notification mechanisms.

Results: The notification policy addressed the absence of historical data from patients in the state Chagas program, an increase in cases identified through serology, and weaknesses in vector control. Two key challenges involved human resources capacity and dissemination to public agencies and health care workers. Effective training and communication processes were key ingredients for successful implementation.

Conclusions: The lack of public health measures aimed at the epidemiological surveillance of chronic Chagas cases constitutes a significant barrier for patients to access appropriate diagnosis, management and follow-up, and hampers the planning of necessary activities within health systems. The implementation of the notification policy in Goiás allows authorities to determine the real magnitude of Chagas disease in the population, so that an appropriate public health response can be mounted to meet the needs of affected people, thereby ending the epidemiological silence of Chagas disease.

Keywords: Chagas disease; disease notification; healthcare access; neglected topical diseases; public policy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Main information axes for interviews on notification of chronic Chagas disease in Goiás.
Figure 2
Figure 2
Main actors involved in the initiative to create the notification policy for chronic Chagas disease.
Figure 3
Figure 3
The current process of case notification of chronic Chagas disease in Goiás.
Figure 4
Figure 4
Recommendations and lessons learned from the implementation of notification of chronic Chagas disease in Goiás.
See this image and copyright information in PMC

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