Strong Hearts Program: the results of a novel primary-care based diagnostic and referral program for Chagas disease in East Boston, MA, USA
Presenter Biography
Javier Huerta is a student in the MPH Epidemiology program at the OHSU-PSU School of Public Health. He is a research assistant working with Dr. Jennifer Manne-Goehler focused on neglected disease research at Harvard Medical School in Boston, MA. This study expands on his practice experience for the MPH program.
Institution
OHSU
Program/Major
Epidemiology
Degree
MPH
Presentation Type
Poster
Start Date
4-4-2024 1:00 PM
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Keywords
Chagas disease, Trypanosoma cruzi, Epidemiology, Screening
Abstract
Purpose: Chagas disease (CD), a neglected parasitic infection, affects ~300,000 people in the US. Untreated, CD leads to irreversible cardiac morbidity and death in 20-30% of cases, yet
Methods: After provider and community sessions, 14,354 patients were screened at EBNHC from March 2017 - May 2023, following a prespecified protocol. Confirmed Chagas patients were referred to Boston Medical Center for further evaluation. Using chi-squared tests, we analyze diagnostic uptake and prevalence stratified by demographics. Additionally, we abstracted care continuum barriers from Chagas patients' records.
Results: Per quarter, a median of 572 patients were screened (IQR: 393 – 712). 3.4% of screening tests were positive. After confirmation, the overall prevalence of Chagas in the population was 0.7% (95% CI: 0.6% – 0.9%) with no sex difference. A statistically significant age gradient was observed, with the lowest prevalence observed in(0.0%) and the highest in 40-49 year-olds (0.8%; p=
Conclusion: Given the significant prevalence of Chagas disease in high-risk US communities, increased access to screening, confirmatory testing, and diagnostics is needed. Chagas care by motivated primary care providers is feasible when support for confirmatory testing and care navigation are in place.
Strong Hearts Program: the results of a novel primary-care based diagnostic and referral program for Chagas disease in East Boston, MA, USA
Purpose: Chagas disease (CD), a neglected parasitic infection, affects ~300,000 people in the US. Untreated, CD leads to irreversible cardiac morbidity and death in 20-30% of cases, yet
Methods: After provider and community sessions, 14,354 patients were screened at EBNHC from March 2017 - May 2023, following a prespecified protocol. Confirmed Chagas patients were referred to Boston Medical Center for further evaluation. Using chi-squared tests, we analyze diagnostic uptake and prevalence stratified by demographics. Additionally, we abstracted care continuum barriers from Chagas patients' records.
Results: Per quarter, a median of 572 patients were screened (IQR: 393 – 712). 3.4% of screening tests were positive. After confirmation, the overall prevalence of Chagas in the population was 0.7% (95% CI: 0.6% – 0.9%) with no sex difference. A statistically significant age gradient was observed, with the lowest prevalence observed in(0.0%) and the highest in 40-49 year-olds (0.8%; p=
Conclusion: Given the significant prevalence of Chagas disease in high-risk US communities, increased access to screening, confirmatory testing, and diagnostics is needed. Chagas care by motivated primary care providers is feasible when support for confirmatory testing and care navigation are in place.