02727nas a2200181   4500000000100000008004100001653001900042653002400061653003200085100001500117700001100132245010500143856008200248300000800330490000700338520218600345022001402531       2019                            d10aChagas disease10aPrimary Health Care10aPublic-private partnerships1 aPereiro AC1 aGold S00aBuilding an innovative Chagas disease program for primary care units, in an urban non- endemic city.  uhttps://bmcpublichealth.biomedcentral.com/track/pdf/10.1186/s12889-019-7248-5  a9040 v193 a<p><strong>BACKGROUND: </strong>On an absolute basis, Argentina is the country with the largest affected population with Chagas Disease (ChD). This constitutes a significant public health issue. As a consequence of Argentina's migratory patterns, there has been a significant increase of affected population in urban centers. An innovative project for early diagnosis and timely treatment of ChD was designed for Municipal Primary Care Facilities of La Plata City, a non- endemic area, in line with a proposal from the Pan-American Health Organization. The project was a public -private intervention. The objectives of this study were to demonstrate the feasibility of the primary healthcare level for early diagnosis and timely treatment of ChD; to design and implement a tailor made program and to innovate in a public-private association.</p>

<p><strong>METHODS: </strong>The healthcare barriers for early diagnosis and timely treatment for the population with ChD of La Plata were analyzed. The four dimensions described by Peters et al. (Ann N Y Acad Sci 1136:161-71, 2008) were used. The baseline was measured during a previous pilot project and the same items were evaluated at the end of 2017. The model from Damschroder et al. (Implement Sci 4:50, 2009) was used during the implementation process.</p>

<p><strong>RESULTS: </strong>With all the information gathered during this investigation, a "patient-centered" model was designed. During the program, 17,894 people were serologically tested for ChD, 1,394 were positive and 1,035 were treated. Additionally, 3,750 children from 46 public schools were evaluated for risk factors of ChD.</p>

<p><strong>CONCLUSIONS: </strong>This project showed the feasibility of the primary healthcare level for early diagnosis and timely treatment of ChD. Tailor made programs and public-private associations should be considered for vulnerable populations in emerging economies in order to enhance efforts and obtain better results. This program may be replicated in other countries of Latin America were Chagas is a main public health issue and, with the corresponding adaptations, for other neglected diseases as well.</p>
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