02583nas a2200325   4500000000100000008004100001653002600042653002500068653003800093653001800131653001100149653003400160653004200194653001200236653001900248100002100267700001200288700001100300700001300311700001400324700001500338700001300353700001100366245009100377856011600468300001000584490000600594520164300600022001402243       2013                            d10aSocioeconomic Factors10aQualitative Research10aPatient Acceptance of Health Care10aLatin America10aHumans10aHealth Services Accessibility10aHealth Knowledge, Attitudes, Practice10aCulture10aChagas disease1 aVentura-Garcia L1 aRoura M1 aPell C1 aPosada E1 aGascón J1 aAldasoro E1 aMuñoz J1 aPool R00aSocio-cultural aspects of Chagas disease: a systematic review of qualitative research.  uhttp://www.plosntds.org/article/fetchObject.action?uri=info:doi/10.1371/journal.pntd.0002410&representation=PDF  ae24100 v73 a<p><strong>BACKGROUND: </strong>Globally, more than 10 million people are infected with Trypanosoma cruzi, which causes about 20 000 annual deaths. Although Chagas disease is endemic to certain regions of Latin America, migratory flows have enabled its expansion into areas where it was previously unknown. Economic, social and cultural factors play a significant role in its presence and perpetuation. This systematic review aims to provide a comprehensive overview of qualitative research on Chagas disease, both in endemic and non-endemic countries.</p>

<p><strong>METHODOLOGY/PRINCIPAL FINDINGS: </strong>Searches were carried out in ten databases, and the bibliographies of retrieved studies were examined. Data from thirty-three identified studies were extracted, and findings were analyzed and synthesized along key themes. Themes identified for endemic countries included: socio-structural determinants of Chagas disease; health practices; biomedical conceptions of Chagas disease; patient's experience; and institutional strategies adopted. Concerning non-endemic countries, identified issues related to access to health services and health seeking.</p>

<p><strong>CONCLUSIONS: </strong>The emergence and perpetuation of Chagas disease depends largely on socio-cultural aspects influencing health. As most interventions do not address the clinical, environmental, social and cultural aspects jointly, an explicitly multidimensional approach, incorporating the experiences of those affected is a potential tool for the development of long-term successful programs. Further research is needed to evaluate this approach.</p>
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