Apt et al., J Community Med Health Educ 2013, 4:1
DOI: 10.4172/2161-0711.1000260
Research Article Open Access
Volume 4 • Issue 1 • 1000260
J Community Med Health Educ
ISSN: 2161-0711 JCMHE, an open access journal
Chagas Disease: A Global Neglected Disease that Require Continuous
Medical Education
Werner Apt
1
, Sebastián Galafé
1
, Inés Zulantay
1
*, Sebastián Yuhasz
1
, Paulina Urbina
1
, Karina Yévenes
1
and Jorge Rodríguez
2
1
Laboratory of Basic-Clinical Parasitology, Program of Cellular and Molecular Biology, Biomedical Science Institute, Faculty of Medicine, University of Chile, Chile
2
School of Public Health, Faculty of Medicine, University of Chile, Chile
*Corresponding author: Inés Zulantay, Professor of Parasitology, Laboratory of
Basic-Clinical Parasitology, Program of Cellular and Molecular Biology, Biomedical
Science Institute, Faculty of Medicine, University of Chile, PO Box 1440, Santiago
3, Chile, Tel: 56-2-29786753; Fax: 56-2-29786122; E-mail: izulanta@med.uchile.cl
Received October 30, 2013; Accepted November 26, 2013; Published November
28, 2013
Citation: Apt W, Galafé S, Zulantay I, Yuhasz S, Urbina P, et al. (2013) Chagas
Disease: A Global Neglected Disease that Require Continuous Medical Education.
J Community Med Health Educ 4: 260. doi:10.4172/2161-0711.1000260
Copyright: © 2013 Apt W, et al. This is an open-access article distributed under
the terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original author and
source are credited.
Keywords: Chagas disease; Medical education; Self-learning
Introduction
Chagas disease, caused by the protozoa Trypanosoma cruzi, is
endemic in Latin America and is considered as “the most neglected of
the neglected diseases [1]. It currently afects around 10 million people
in Latin America, and 10 to 30 per cent of cases have developed or will
develop cardiac, digestive or nervous system disorders [2]. Te T. cruzi
parasite can travel with population movements from endemic to non-
endemic countries such as North America (United States and Canada),
the western Pacifc region (particularly Japan and Australia) and, more
recently, Europe (mainly Belgium, Spain, France, Italy, the United
Kingdom and Switzerland, and to a lesser Germany, Austria, Croatia,
Denmark, the Netherlands, Luxemburg, Norway, Portugal, Romania
and Sweden), therefore posing a challenge for the public health [3-
5]. Te congenital transmission, blood transfusion and solid organ
transplant are main non vectorial transmission mechanism in those
countries; many of them have not yet established ofcial guidelines to
avoid these routes [3].
For the adequate medical attention of infected by diferent routes and
coursing acute, indeterminate or chronic Chagas disease, proceeding of
areas endemic or non-endemic, is necessary to have professional health
teams training in the application of ofcial guidelines as part of the
development of a comprehensive strategy for control and elimination
of Chagas disease [5-7]. One interesting questionnaire was applied in
members of American College of Obstetricians and Gynecologist, USA
in 421 respondents. 68.2% described their knowledge about Chagas
disease as “very limited” [8]. In this study, we evaluated in an endemic
chagasic area of Chile the level of knowledge of Chagas disease in health
Methods
Before Educational Intervention Inquiry design (BEII)
Parasitology teachers of the Faculty of Medicine of the University of
Chile, and members of the Chilean Society of Parasitology (SOCHIPA),
whose main investigation was Chagas disease, elaborated an inquiry of
45 multiple choice questions with one corrected answer of four possible
options on etiology, pathology, epidemiology, diagnosis, clinical aspects,
treatment and control of Chagas disease. Te questions were performed
with diferent difculties and stratifcations according the professional
competences. Te questionnaire was submitted to four experts, two on
Chagas disease, one on public health and one on medical education.
At the same time, the inquiry was submitted to ten pre and post-grade
thesis students of the Faculty of Medicine of the University of Chile
whose investigations subjects was Chagas disease. Te opinion of the
experts and thesis students, allow improve and stratify the questions.
Te minimal percentage to approve the test was 60% of correct answers
from 41 questions for medical professionals. 16,17,18 and 25 questions
Abstract
Objective: In endemic zones of Chagas disease the knowledge of the professional health teams is very important
for the success of control of the zoonosis. For this reason, we want to evaluate the knowledge of the parasite diseases
Methods:
educational intervention inquiry) was applied. The questions related with epidemiological, basic, diagnostic, clinical,
chemotherapeutic and preventive aspects, had different grades of complexity and stratifcation according to the
professional competences. The approval criterion was 60% of corrected answers. The educational intervention was
focused on self-learning by printed and digital interactive material. 30 days was the study period, after the time an AEII
(after educational intervention inquiry) was applied.
Results: The approval of the BEII fuctuated between 11.6% to 28.89%, and the AEII fuctuated between 68.75%
and 89.66% (p=0.0001). By profession, the percentage of approval of the BEII and AEII was 13.98% and 66.20%
(paramedics); 14.29% to 85.71% (medical technicians); 19.35% and 83.87% (medical doctors); 27.27% and 90%
(midwives); 41.18% and 100% (nurses), respectively (p=0,0001). The global percentage of approval before and after
the educational intervention was 19.28% and 77.70%, respectively (chi
2
=107.27).
Conclusions:
on Chagas disease. An adequate educational intervention will allow the acquisition of new knowledge and revert a
negative initial diagnosis. The teaching in this global parasitosis must be continuous. Teaching-learning of Chagas
disease is not only important in countries where the disease is endemic, but also in no endemic countries where the
disease exists through immigration.
in health teams before and after an educational intervention.
We selected 166 professionals who were related which Chagas disease to whom the BEII (before
The members of the health teams in endemic areas of Chile, don’t have the necessary knowledge
teams pre and post educational intervention.
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ISSN: 2161-0711
Community Medicine & Health Education