PMID- 32489799 OWN - NLM STAT- MEDLINE DCOM- 20210413 LR - 20231111 IS - 2211-8179 (Electronic) IS - 2211-8160 (Print) IS - 2211-8160 (Linking) VI - 15 IP - 1 DP - 2020 Mar 30 TI - WHF IASC Roadmap on Chagas Disease. PG - 26 LID - 10.5334/gh.484 [doi] LID - 26 AB - BACKGROUND: Chagas Disease is a neglected tropical disease caused by the protozoan Trypanosoma cruzi, with some of the most serious manifestations affecting the cardiovascular system. It is a chronic, stigmatizing condition, closely associated with poverty and affecting close to 6 million people globally. Although historically the disease was limited to endemic areas of Latin America recent years have seen an increasing global spread. In addition to the morbidity and mortality associated with the disease, the social and economic burdens on individuals and society are substantial. Often called the 'silent killer', Chagas disease is characterized by a long, asymptomatic phase in affected individuals. Approximately 30% then go on develop chronic Chagas cardiomyopathy and other serious cardiac complications such as stroke, rhythm disturbances and severe heart failure. METHODS: In a collaboration of the World Hearth Federation (WHF) and the Inter-American Society of Cardiology (IASC) a writing group consisting of 20 diverse experts on Chagas disease (CD) was convened. The group provided up to date expert knowledge based on their area of expertise. An extensive review of the literature describing obstacles to diagnosis and treatment of CD along with proposed solutions was conducted. A survey was sent to all WHF Members and, using snowball sampling to widen the consultation, to a variety of health care professionals working in the CD global health community. The results were analyzed, open comments were reviewed and consolidated, and the findings were incorporated into this document, thus ensuring a consensus representation. RESULTS: The WHF IASC Roadmap on Chagas Disease offers a comprehensive summary of current knowledge on prevention, diagnosis and management of the disease. In providing an analysis of 'roadblocks' in access to comprehensive care for Chagas disease patients, the document serves as a framework from which strategies for implementation such as national plans can be formulated. Several dimensions are considered in the analysis: healthcare system capabilities, governance, financing, community awareness and advocacy. CONCLUSION: The WHF IASC Roadmap proposes strategies and evidence-based solutions for healthcare professionals, health authorities and governments to help overcome the barriers to comprehensive care for Chagas disease patients. This roadmap describes an ideal patient care pathway, and explores the roadblocks along the way, offering potential solutions based on available research and examples in practice. It represents a call to action to decision-makers and health care professionals to step up efforts to eradicate Chagas disease. CI - Copyright: (c) 2020 The Author(s). FAU - Echeverria, Luis Eduardo AU - Echeverria LE AD - Department of Cardiology, Cardiovascular Foundation of Colombia, Floridablanca, CO. FAU - Marcus, Rachel AU - Marcus R AD - LASOCHA, Washington DC, US. AD - Medstar Union Memorial Hospital, Baltimore, MD, US. FAU - Novick, Gabriel AU - Novick G AD - Swiss Medical Group, Buenos Aires, AR. AD - Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, US. FAU - Sosa-Estani, Sergio AU - Sosa-Estani S AD - Drugs for Neglected Diseases initiative-Latin America, Rio de Janeiro, BR. FAU - Ralston, Kate AU - Ralston K AD - World Heart Federation, Geneva, CH. FAU - Zaidel, Ezequiel Jose AU - Zaidel EJ AD - Sanatorio Guemes, Buenos Aires, AR. AD - Pharmacology Department, School of Medicine, University of Buenos Aires, Buenos Aires, AR. FAU - Forsyth, Colin AU - Forsyth C AD - Drugs for Neglected Diseases initiative-Latin America, Rio de Janeiro, BR. FAU - RIbeiro, Antonio Luiz P AU - RIbeiro ALP AD - Internal Medicine Department, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, BR. AD - Hospital das Clinicas, UFMG, Belo Horizonte, BR. FAU - Mendoza, Ivan AU - Mendoza I AD - Central University of Venezuela, Caracas, VE. FAU - Falconi, Mariano Luis AU - Falconi ML AD - Cardiology Division, Italian Hospital of Buenos Aires, Buenos Aires, AR. AD - University Institute of the Italian Hospital of Buenos Aires, Buenos Aires, AR. FAU - Mitelman, Jorge AU - Mitelman J AD - Faculty of Medicine, University of Buenos Aires, Buenos Aires, AR. AD - School of Medicine, Barcelo University, Buenos Aires, AR. FAU - Morillo, Carlos A AU - Morillo CA AD - Department of Cardiac Sciences, Cumming School of Medicine Division of Cardiology, Libin Cardiovascular Institute, University of Calgary, Calgary, CA. AD - Southeastern Alberta Region, Alberta Health Services, Foothills Medical Centre, CA. FAU - Pereiro, Ana Cristina AU - Pereiro AC AD - Mundo Sano Foundation, Buenos Aires, AR. FAU - Pinazo, Maria Jesus AU - Pinazo MJ AD - ISGlobal, Hospital Clinic, University of Barcelona, Barcelona, ES. FAU - Salvatella, Roberto AU - Salvatella R AD - PAHO/WHO, Montevideo, UY. FAU - Martinez, Felipe AU - Martinez F AD - National University of Cordoba, Cordoba, AR. AD - DAMIC Institute/Rusculleda Foundation, Cordoba, AR. FAU - Perel, Pablo AU - Perel P AD - World Heart Federation, Geneva, CH. AD - Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London, GB. FAU - Liprandi, Alvaro Sosa AU - Liprandi AS AD - Sanatorio Guemes, Buenos Aires, AR. AD - Medical School of Cardiology, University of Buenos Aires, Buenos Aires, AR. FAU - Pineiro, Daniel Jose AU - Pineiro DJ AD - Faculty of Medicine, University of Buenos Aires, Buenos Aires, AR. FAU - Molina, Gustavo Restrepo AU - Molina GR AD - School of Medicine, CES University, Medellin, CO. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Review DEP - 20200330 PL - England TA - Glob Heart JT - Global heart JID - 101584391 SB - IM MH - Chagas Disease/epidemiology/*prevention & control MH - Global Health MH - Humans MH - Morbidity/trends MH - *Practice Guidelines as Topic MH - World Health Organization PMC - PMC7218776 OTO - NOTNLM OT - Chagas disease OT - cardiomyopathy OT - heart failure OT - neglected tropical disease COIS- MLF has received financial support for inscription to an international meeting from Philips/Agimed Argentina. RM previously worked in a consultancy role for Exeltis and Bayer. GM has received grants for global health research and projects from Novartis. LEE has received a research grant for work on Chagas cardiomyopathy from Roche. He is also a member of the steering committee of the PARACHUTE-HF trial. EDAT- 2020/06/04 06:00 MHDA- 2021/04/14 06:00 PMCR- 2020/03/30 CRDT- 2020/06/04 06:00 PHST- 2020/06/04 06:00 [entrez] PHST- 2020/06/04 06:00 [pubmed] PHST- 2021/04/14 06:00 [medline] PHST- 2020/03/30 00:00 [pmc-release] AID - 10.5334/gh.484 [doi] PST - epublish SO - Glob Heart. 2020 Mar 30;15(1):26. doi: 10.5334/gh.484.