Department of Cardiology, Cardiovascular Foundation of Colombia, Floridablanca
Rachel Marcus
LASOCHA, Washington, DC; Medstar Union Memorial Hospital, Baltimore, MD
Gabriel Novick
Swiss Medical Group, Buenos Aires; Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA
Sergio Sosa-Estani
Drugs for Neglected Diseases initiative-Latin America, Rio de Janeiro
Kate Ralston
World Heart Federation, Geneva
Ezequiel Jose Zaidel
Sanatorio Güemes, Buenos Aires; Pharmacology Department, School of Medicine, University of Buenos Aires, Buenos Aires
Colin Forsyth
Drugs for Neglected Diseases initiative-Latin America, Rio de Janeiro
Antonio Luiz P. Ribeiro
Internal Medicine Department, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte; Hospital das Clínicas, UFMG, Belo Horizonte
Iván Mendoza
Central University of Venezuela, Caracas
Mariano Luis Falconi
Cardiology Division, Italian Hospital of Buenos Aires, Buenos Aires; University Institute of the Italian Hospital of Buenos Aires, Buenos Aires
Jorge Mitelman
Faculty of Medicine, University of Buenos Aires, Buenos Aires; School of Medicine, Barcélo University, Buenos Aires
Carlos A. Morillo
Department of Cardiac Sciences, Cumming School of Medicine Division of Cardiology, Libin Cardiovascular Institute, University of Calgary, Calgary; Southeastern Alberta Region, Alberta Health Services, Foothills Medical Centre, Calgary
Ana Cristina Pereiro
Mundo Sano Foundation, Buenos Aires
María Jesús Pinazo
ISGlobal, Hospital Clínic, University of Barcelona, Barcelona
Roberto Salvatella
PAHO/WHO, Montevideo
Felipe Martinez
National University of Cordoba, Cordoba; DAMIC Institute/Rusculleda Foundation, Cordoba
Pablo Perel
World Heart Federation, Geneva, CH; Centre for Global Chronic Conditions, London School of Hygiene and Tropical Medicine, London
Álvaro Sosa Liprandi
Sanatorio Güemes, Buenos Aires; Medical School of Cardiology, University of Buenos Aires, Buenos Aires
Daniel José Piñeiro
Faculty of Medicine, University of Buenos Aires, Buenos Aires
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.
