Chagas disease prophylaxis in a non-endemic country: a trans disciplinary Global Health approach.

This aim of this study was to define a protocol aimed at effective diagnosis and prevention of transmission of Chagas disease in the Bologna district. According to the WHO, Chagas disease is a neglected disease, ‘related to poverty and social disadvantage’. Non-vectorial transmission and increasing migra- tion from endemic areas have raised concerns regarding the spread of the disease in non-endemic countries. However, no public health approach is presently enforced in Italy. Risk factors related to migration and those related to the socio-economic and cultural characteristics of the areas of origin4, included in the spectrum of distal determinants of health, act on the disease and its perception in the host country. A careful analysis encompassing clinical, socio-cultural and economic aspects is required, and a trans disciplinary and multi methodological approach, rooted in the Global Health perspective, is therefore needed. Through a team composed by infectious disease specialists, public health doctors and medical anthropologies, after extensive literature review, we analyzed the social epidemiology of Chagas disease in our territory and developed a research protocol to be implemented shortly. Key issues to be addressed include: (1) health needs assessment of target migrant population (i.e. Latina Americans), through community participation and collection of both quantitative and qualitative data; (2) health services involvement, through health professional’s participation and specific training. EXPECTED RESULTS(1.) Creation of a local diagnostic and therapeutic program for Chagas disease, (2.) Increased diagnostic rate for Chagas disease, (3.) Increased accessibility of target migrant population to health services, (4.) Empowerment of the target migrant community. The described approach allowed combination of different views and expertises in the definition of an innovative public health approach grounded in the distal as well as proximal determinants of health.