# name
A strategy for scaling up access to comprehensive care in adults
                with Chagas disease in endemic countries: The Bolivian Chagas
                Platform

# metadata.dc.description.abstract[].value
BACKGROUND: Bolivia has the highest prevalence of Chagas disease
                (CD) in the world (6.1%), with more than 607,186 people with
                Trypanosoma cruzi infection, most of them adults. In Bolivia CD
                has been declared a national priority. In 2009, the Chagas
                National Program (ChNP) had neither a protocol nor a clear
                directive for diagnosis and treatment of adults. Although
                programs had been implemented for congenital transmission and
                for acute cases, adults remained uncovered. Moreover, health
                professionals were not aware of treatment recommendations aimed
                at this population, and research on CD was limited; it was
                difficult to increase awareness of the disease, understand the
                challenges it presented, and adapt strategies to cope with it.
                Simultaneously, migratory flows that led Bolivian patients with
                CD to Spain and other European countries forced medical staff to
                look for solutions to an emerging problem. INTERVENTION: In this
                context, thanks to a Spanish international cooperation
                collaboration, the Bolivian platform for the comprehensive care
                of adults with CD was created in 2009. Based on the
                establishment of a vertical care system under the umbrella of
                ChNP general guidelines, six centres specialized in CD
                management were established in different epidemiological
                contexts. A common database, standardized clinical forms, a and
                a protocolized attention to adults patients, together with
                training activities for health professionals were essential for
                the model success. With the collaboration and knowledge transfer
                activities between endemic and non-endemic countries, the
                platform aims to provide care, train health professionals, and
                create the basis for a future expansion to the National Health
                System of a proven model of care for adults with CD. RESULTS:
                From 2010 to 2015, a total of 26,227 patients were attended by
                the Platform, 69% (18,316) were diagnosed with T. cruzi, 8,567
                initiated anti-parasitic treatment, more than 1,616 health
                professionals were trained, and more than ten research projects
                developed. The project helped to increase the number of adults
                with CD diagnosed and treated, produce evidence-based clinical
                practice guidelines, and bring about changes in policy that will
                increase access to comprehensive care among adults with CD. The
                ChNP is now studying the Platform's health care model to adapt
                and implement it nationwide. CONCLUSIONS: This strategy provides
                a solution to unmet demands in the care of patients with CD,
                improving access to diagnosis and treatment. Further scaling up
                of diagnosis and treatment will be based on the expansion of the
                model of care to the NHS structures. Its sustainability will be
                ensured as it will build on existing local resources in Bolivia.
                Still human trained resources are scarce and the high staff
                turnover in Bolivia is a limitation of the model. Nevertheless,
                in a preliminary two-years-experience of scaling up this model,
                this limitations have been locally solved together with the
                health local authorities.

# metadata.dc.relation.isformatof[].value
Reproducció del document publicat a:
                http://dx.doi.org/10.1371/journal.pntd.0005770

# metadata.dc.relation.ispartof[].value
PLoS Neglected Tropical Diseases, 2017, vol. 11, num. 8, p.
                e0005770

# metadata.dc.source[].value
Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
A strategy for scaling up access to comprehensive care in adults
                with Chagas disease in endemic countries: The Bolivian Chagas
                Platform