Abstract
Aims
Chagas disease continues to be a problem in indigenous communities of the Paraguayan Central Chaco because of the high infection prevalence. The study area presents great environmental and biological diversity, high temperatures, low rainfall, poverty and rapid vector reinfestation. This descriptive study analyzed the demographic and socioeconomic profiles and knowledge, beliefs and attitudes toward Chagas disease in four indigenous communities.
Methods
A household survey was used as an instrument for gathering information from 270 families as well as a survey of social networks, in-depth interviews and focus groups with key informants and four participatory diagnoses.
Results
A high percentage of the studied population did not know about the disease (72%), but 80% of them identified the presence of the main vector in their homes. They had poor knowledge of the vector as an annoying bug to be eliminated (19%) and did not relate it to the disease. Half of the population thinks that there is no risk of contracting the disease, which could be curable (52.7%). Work activities were linked to Mennonite groups, and solidarity cooperation and mutual aid with exchanges of favors, mainly related to food, were common.
Conclusion
There is no knowledge about Chagas disease in these communities because of different factors, including not associating symptoms with the disease, the predominance of ethnic languages, which limit the education process, and lack of access to public health. National Chagas Program efforts should be complemented by other programs with health education and improved learning conditions based on a comprehensive approach according to the rights and specific cultural characteristics of these populations.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bourdieu P (1999) La miseria del mundo. Akal, Madrid
Dell’Arciprete A, Braunstein J, Touris C, Dinardi G, Llovet I, SSosa-Estani S (2014) Cultural barriers to effective communication between Indigenous communities and health care providers in Northern Argentina: an anthropological contribution to Chagas disease prevention and control. Int J Equity Health 13:6. https://doi.org/10.1186/1475-9276-13-6
DGEEC (2014) Pueblos Indígenas en el Paraguay. Resultados Finales de Población y Viviendas 2012. III Censo Nacional de Población y Viviendas para Pueblos Indígenas. http://www.dgeec.gov.py/Publicaciones/Biblioteca/indigena2012/Pueblos%20indigenas%20en%20el%20Paraguay%20Resultados%20Finales%20de%20Poblacion%20y%20Viviendas%202012.pdf. Accessed 10 October 2018
Dias JCP (2006) The treatment of Chagas disease (South American Trypanosomiasis). Ann Intern Med 144:772–774. https://doi.org/10.7326/0003-4819-144-10-200605160-00012
Donovan SD, Stevens M, Sanogo K, Masroor N, Bearman G (2014) Knowledge and perceptions of Chagas disease in a rural Honduran community. Rural Remote Health 14(3):2845 https://www.ncbi.nlm.nih.gov/pubmed/25204581
Fogel R (2006) La Cuestión Socioambiental en el Paraguay. Centro de Estudios Rurales Interdisciplinarios (CERI), Asunción
Gorla DE, Vargas Ortiz R, Catalá SS (2015) Control of rural house infestation by Triatoma infestans in the Bolivian Chaco using a microencapsulated insecticide formulation. Parasit Vectors 8:255. https://doi.org/10.1186/s13071-015-0762-0
Gürtler RE (2009) Sustainability of vector control strategies in the Gran Chaco Region: current challenges and possible approaches. Mem Inst Oswaldo Cruz:52–59. https://doi.org/10.1590/S0074-02762009000900009
Cortez MR, Monteiro FA, Noireau F (2010) New insights on the spread of Triatoma infestans from Bolivia—implications for Chagas disease emergence in the southern cone. Infect Genet Evol 10:350–353
Molina I, Salvador F, Sánchez-Montalvá A (2016) Actualización en enfermedad de Chagas. Enferm Infecc Microbiol Clin 34(2):132–138. https://doi.org/10.1016/j.eimc.2015.12.008
ONU (2008) La situación de los pueblos indígenas del mundo. DPI/2551/B — 0964061 — Produced by January 2010. Accessed 28 Sept 2018
PAHO (2018) Paraguay interrupts vector transmission of Chagas in the home. https://www.paho.org/hq/index.php?option=com_content&view=article&id=14546:paraguay-logro-interrumpir-la-transmision-vectorial-domiciliaria-de-la-enfermedad-de-chagas&Itemid=135&lang=en. Accessed 28 September 2018
Prüss-Ustün A, Wolf J, Corvalán C, Neville T, Bos R, Neira M (2016) Diseases due to unhealthy environments: an updated estimate of the global burden of disease attributable to environmental determinants of health. J Public Health 39(3):464–475. https://doi.org/10.1093/pubmed/fdw085
Ríos-Osorio LA, Crespo-González JJ, Zapata-Tamayo MA (2012) Etnometodología para la comprensión y el manejo de la Enfermedad de Chagas en las poblaciones indígenas Wiwa asentadas en la vertiente suroriental de la Sierra Nevada de Santa Marta. Saude soc 21(2):446–457. https://doi.org/10.1590/S0104-12902012000200017
Rojas de Arias A (2016) La certificación del corte de transmisión vectorial del Trypanosoma cruzi, agente causal de la enfermedad de Chagas. Mem Inst Investig Cienc Salud 14(3):3–6. https://doi.org/10.18004/Mem.iics/1812-9528/2016.014(03)03-006
Rojas de Arias A, Abad-Franch F, Acosta N, López E, González N, Zerba E et al (2012) Post-Control Surveillance of Triatoma infestans and Triatoma sordida with chemically-baited sticky traps. PLoS Negl Trop Dis 6(9):1822. https://doi.org/10.1371/journal.pntd.0001822
Rolón M, Vega MC, Román F, Gómez A, Rojas de Arias A (2011) First report of colonies of sylvatic Triatoma infestans (Hemiptera: Reduviidae) in the Paraguayan Chaco, using a trained dog. PLoS Negl Trop Dis 5(5):1026. https://doi.org/10.1371/journal.pntd.0001026
Rosecrans K, Cruz-Martin G, King A, Dumonteil E (2014) Opportunities for improved Chagas disease vector control based on knowledge, attitudes and practices of communities in the Yucatan Peninsula, Mexico. PLoS Negl Trop Dis 8(3):2763. https://doi.org/10.1371/journal.pntd.0002763
Sanmartino M, Crocco L (2000) Conocimientos sobre la enfermedad de Chagas y factores de riesgo en comunidades epidemiológicamente diferentes de Argentina. Rev Panam Salud Pública 7:173–178
Sanmartino M, Saavedra A, i Prat J, Parada Barba M, Albajar-Viñas P (2015) Que no tengan miedo de nosotros: el Chagas según los propios protagonistas. (Portuguese). Interface-Comunicação, Saúde, Educação 19(55):1063–1075. https://doi.org/10.1590/1807-57622014.1170
Susnik B (1982) El Rol de los indígenas en la formación y en la vivencia del Paraguay. Instituto Paraguayo de Estudios Nacionales. I.P.E.N., Asunción
Vazquez-Prokopec GM, Spillmann C, Zaidenberg M, Kitron U, Gürtler RE (2009) Cost-effectiveness of vector control strategies against Triatoma infestans in rural northwestern Argentina. PLoS Negl Trop Dis 3:363. https://doi.org/10.1371/journal.pntd.0000363
Verdú J, Ruiz MT (2003) Control del Chagas en comunidades guaraníes: conocimiento y hábitos higiénicos dentro del Proyecto de Mejoramiento de Viviendas en Bolivia. Gac Sanit 17(2):166–168. https://doi.org/10.1016/S0213-9111(03)71717-8
Zabala JP (2012) La enfermedad en su laberinto: avances, desafíos y paradojas de cien años del Chagas en Argentina. Salud Colectiva (online) 8(1), 9–21. http://www.scielo.org.ar/scielo.php?script=sci_arttext&pid=S1851-82652012000300002&lng=es&tlng=es. Accessed 28 September 2018
World Health Organization (2015) Chagas disease in Latin America: an epidemiological update based on 2010 estimates = Maladie de Chagas en Amérique latine: le point épidémiologique basé sur les estimations de 2010. Weekly Epidemiological Record = Relevé épidémiologique hebdomadaire, 90 (06), 33–44. http://www.who.int/iris/handle/10665/242316. Accessed 28 September 2018
Acknowledgments
The authors thank the four indigenous communities of the Chaco.
The International Development Research Center (IDRC) financed the study, project no. A70596. The article was initially drafted and reviewed in the workshop of the Communicable Diseases Research Program of the Communicable Diseases and Health Analysis Department of PAHO/WHO, which supports and disseminates the eco-health approach. All authors belong to the National Program of Incentives to Researchers (PRONII in Spanish) from the CONACYT Paraguay. The authors thank to Dr. Carla Cecere by the indigenous communities map published.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
CM Arrom Suhurt declares that she has no conflict of interest.
CH Arrom Suhurt declares that she has no conflict of interest.
MA Arrom Suhurt declares that she has no conflict of interest.
M Rolón declares that she has no conflict of interest.
MC Vega Gómez declares that she has no conflict of interest.
A Rojas de Arias declares that she has no conflict of interest.
Ethical Statement
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent
Informed consent was previously obtained from all individual participants included in the study.
Ethical approval
The Fundación Moisés Bertoni Ethical Committee approved the protocol of this study in July 2009.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Arrom-Suhurt, C.M., Arrom-Suhurt, C.H., Arrom-Suhurt, M.A. et al. Socioeconomic profile and perceptions of Chagas disease in indigenous communities of the Paraguayan Chaco. J Public Health (Berl.) 27, 723–732 (2019). https://doi.org/10.1007/s10389-018-1001-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10389-018-1001-x