Knowledge, Attitudes and Practices of Chagas a Neglected Tropical Disease in Rural Communities of the Colombian Caribbean, CHAGCOV Study

Acta Parasitologica (2024) 69:1148–1156 https://doi.org/10.1007/s11686-024-00833-y ORIGINAL PAPER Knowledge, Attitudes and Practices of Chagas a Neglected Tropical Disease in Rural Communities of the Colombian Caribbean, CHAGCOV Study Margarita M Ochoa-Diaz1,2 · Daniela Orozco-Garcia1,2 · Ronald S. Fernandez-Vasquez1,2 · Melisa Eyes-Escalante3,4 Received: 1 June 2023 / Accepted: 4 March 2024 / Published online: 9 April 2024 © The Author(s) 2024 Abstract Purpose Chagas disease (CD) a Neglected Tropical Diseases is an important public health issue in countries where is still endemic, included in the Sustainable Development Goals (SDG). Traditionally restricted to rural areas with diverse routes of transmissions from vectorial to oral with acute manifestations but being more common diagnosed in chronic stages. The aim of this investigation was to characterize the Knowledge, Attitudes and Practices (KAP) related to Chagas disease (CD) in two rural settlements of the Colombian Caribbean with previous records of the disease and/or the parasite. Methods A cross-sectional descriptive study was made in two rural settlements in Colombia and surveillance instrument was developed to measure Knowledge, Attitudes and Practices (KAP) related to Chagas disease (CD). Results In a population with > 60% women and access to social security around 66.5%; 81,6% were homeowners with access to water and electricity > 90% but only 9% of sewerage. The level of knowledge about CD was around 62% but lack of specificity about comprehension of transmission routes (74,6%), and symptoms (85,3%) were found; concluding that 86% of the surveyed sample had very poor level of knowledge about the disease despite preventive campaigns carried out in the two communities studied. Conclusions Despite of a low frequency of CD in this Caribbean areas, the presence of vector, risk factors plus poor level of knowledge about the disease justify that public health intervention strategies should be implemented and monitored over time to maintain uninterrupted surveillance of Chagas Disease. Keywords Chagas Disease · Neglected Tropical Disease · Sustainable Development Goals · Colombia Introduction Margarita M Ochoa-Diaz, Daniela Orozco-Garcia, Ronald S. Fernandez-Vasquez, Melisa Eyes-Escalante authors contributed equally to this work. Margarita M Ochoa-Diaz 1 School of Medicine, Universidad del Sinú Seccional Cartagena, 130001 Cartagena, Colombia 2 Research Group GIBACUS, Tropical Medicine, Cartagena, Colombia 3 School of Biology, Tropical Medicine Doctorate, Universidad del Atlántico, Barranquilla, Colombia 4 Research Group Biodiversidad del Caribe Colombiano, Barranquilla, Colombia 13 Chagas disease (CD) is considered an important public health issue in countries where is still endemic, additionally belongs to the Sustainable Development Goals (SDG), specifically SDG number 3 with regard to the health component [1]. CD or American Trypanosomiasis is an anthropozoonoses belonging to the group of Neglected Tropical Diseases (NTD) that annually infects approximately 7 million people and remains endemic in 21 Latin American countries [2, 3]. This infection, initially was restricted to rural areas and due to intense urbanization and migratory phenomena, has increasingly taken over urbanized scenarios. The routes of transmission are diverse, ranging from vectorial transmission through contact with feces of the vector of the Triatominae genus infected by the Trypanosoma cruzi (T. cruzi) Acta Parasitologica (2024) 69:1148–1156 parasite; ingestion of food contaminated with feces of the infected vector; through contaminated transfusions; via congenital transmission or through transplants not screened for infection. Thus, if infection occurs, it can have manifestations which can be acute or chronic, sometimes going unnoticed by the health system [3–5] The purpose of the following research was to characterize the Knowledge, Attitudes and Practices (KAP) in relation to Chagas disease in two rural settlements of the Colombian Caribbean with previous records of the disease and/or the parasite [6]. Materials and methods This was a cross-sectional descriptive study. The research project also named “CHAGCOV project” because was performed during post-COVID took place in two rural settlements in the Colombian Caribbean region. The first one was a village in the Department of Atlántico named Corrales de San Luis (coordinates 10º52 × 27´´N74º58 × 43´´O), described by local research activities as a site of triatomine and T. cruzi circulation with no reports of positive cases of Chagas disease at the time of this research. Similarly, the municipality of Villanueva (coordinates 10º26 × 39´´N75º16 × 29´O) in the Department of Bolivar, was investigated, Villanueva had previous reports of orally transmitted Chagas cases [6, 7]. The target population age of the study was people over one (1) year old, being resident of the selected municipality. All the data was collected during 2021by an administered questionary to every recruited individual. All the dwellings of the selected populations were surveyed. Once the aim of the study was explained to the members of the house and after signing the informed consent form (individual or the responsible adult), the data collection instrument (administered questionary) was applied by the research member, remembering that the parent should answer the questions in the case o < 8 years old kids The structure of the instrument (survey) consisted initially of sociodemographic data (age, origin, sex, schooling, social security, occupation), variables related to household composition (number of inhabitants, basic sanitation); housing structure (construction material, use of repellents, domestic animals); knowledge of Chagas disease (7 questions on the disease, 7 questions on the vector); and the question of identification of positive cases in the community. Finally, the level of knowledge was rated as “Excellent”, “Fair” or Very Poor according to the responses obtained and the score applied of the answers. All information was collected by health professionals. Informed consent was obtained for all patients who agreed to participate. All the information collected was recorded in an electronic database and analyzed with Epi-Info v. 7.1 1149 CDC® software. The information collected was analyzed by descriptive statistics according to its nature, using statistical significance for all analyses as ≤ 0,05. Quantitative variableswill be explained by measures of central tendency (mean, media, mode). Parametric and no parametric test will be performed according the nature of the variables and its distribution (normality). Results Sociodemographic Characterization of the Population A total of 272 inhabitants of both municipalities were included. In general, 65.8% of those surveyed were women, with an average age of 27 (interquartile range -RIC- 17–39) years, 92.7% were Colombian nationals and predom (...truncated)