02474nas a2200253 4500000000100000008004100001260001200042653001900054653002500073653002200098653003100120653001800151100001400169700001500183700001200198700001400210700001400224700001500238245012600253856025900379490000600638520156200644022001402206 2020 d c06/202010aChagas disease10adisease notification10ahealthcare access10aneglected topical diseases10apublic policy1 aSiriano L1 aMarchiol A1 aCerto M1 aCubides J1 aForsyth C1 ade Sousa F00aMandatory Notification of Chronic Chagas Disease: Confronting the Epidemiological Silence in the State of Goiás, Brazil. uhttp://scholar.google.com/scholar_url?url=https://www.mdpi.com/2414-6366/5/2/92/pdf&hl=en&sa=X&d=7163390127246067159&scisig=AAGBfm259vhGpl0T2WpT-7KLfa7qDbS_2A&nossl=1&oi=scholaralrt&hist=K3bRSt0AAAAJ:2161513689718542624:AAGBfm0-TLeJQwbCtxyVJD-1Iic8Q6XLcQ0 v53 a

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.

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