@article{96399,
  keywords = {Infectious Diseases, Public Health, Environmental and Occupational Health},
  author = {Miranda-Arboleda AF and Zaidel EJ and Marcus R and Pinazo M and Echeverria LE and Saldarriaga C and Sosa Liprandi Á and Baranchuk A and SHARP collaboration },
  editor = {Buscaglia CA},
  title = {Roadblocks in Chagas disease care in endemic and nonendemic countries: Argentina, Colombia, Spain, and the United States. The NET-Heart project},
  abstract = {<jats:sec id="sec001">
<jats:title>Background</jats:title>
<jats:p>Chagas disease (CD) is endemic in Latin America; however, its spread to nontropical areas has raised global interest in this condition. Barriers in access to early diagnosis and treatment of both acute and chronic infection and their complications have led to an increasing disease burden outside of Latin America. Our goal was to identify those barriers and to perform an additional analysis of them based on the Inter American Society of Cardiology (SIAC) and the World Heart Federation (WHF) Chagas Roadmap, at a country level in Argentina, Colombia, Spain, and the United States, which serve as representatives of endemic and nonendemic countries.</jats:p>
</jats:sec>
<jats:sec id="sec002">
<jats:title>Methodology and principal findings</jats:title>
<jats:p>This is a nonsystematic review of articles published in indexed journals from 1955 to 2021 and of gray literature (local health organizations guidelines, local policies, blogs, and media). We classified barriers to access care as (i) existing difficulties limiting healthcare access; (ii) lack of awareness about CD and its complications; (iii) poor transmission control (vectorial and nonvectorial); (iv) scarce availability of antitrypanosomal drugs; and (v) cultural beliefs and stigma. Region-specific barriers may limit the implementation of roadmaps and require the application of tailored strategies to improve access to appropriate care.</jats:p>
</jats:sec>
<jats:sec id="sec003">
<jats:title>Conclusions</jats:title>
<jats:p>Multiple barriers negatively impact the prognosis of CD. Identification of these roadblocks both nationally and globally is important to guide development of appropriate policies and public health programs to reduce the global burden of this disease.</jats:p>
</jats:sec>},
  year = {2021},
  journal = {PLOS Neglected Tropical Diseases},
  volume = {15},
  pages = {e0009954},
  publisher = {Public Library of Science (PLoS)},
  issn = {1935-2735},
  doi = {10.1371/journal.pntd.0009954},
}