Background: Chagas disease (CD) affects over 300,000 people in the United States, but fewer than 1% have been diagnosed and less than 0.3% have received etiological treatment. This is a significant public health concern because untreated CD can produce fatal complications. What factors prevent people with CD from accessing diagnosis and treatment in a nation with one of the world's most advanced healthcare systems?
Methodology/principal Findings: This analysis of barriers to diagnosis and treatment of CD in the US reflects the opinions of the authors more than a comprehensive discussion of all the available evidence. To enrich our description of barriers, we have conducted an exploratory literature review and cited the experience of the main US clinic providing treatment for CD. We list 34 barriers, which we group into four overlapping dimensions: systemic, comprising gaps in the public health system; structural, originating from political and economic inequalities; clinical, including toxicity of medications and diagnostic challenges; and psychosocial, encompassing fears and stigma.
Conclusions: We propose this multidimensional framework both to explain the persistently low numbers of people with CD who are tested and treated and as a potential basis for organizing a public health response, but we encourage others to improve on our approach or develop alternative frameworks. We further argue that expanding access to diagnosis and treatment of CD in the US means asserting the rights of vulnerable populations to obtain timely, quality healthcare.
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http://dx.doi.org/10.1371/journal.pntd.0007447 | DOI Listing |
Telemed J E Health
December 2024
Post Graduate Studies Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre-RS, Brazil.
: To explore the potential of gatekeeping for specialized consultations and patient care via remote interactions with family physicians. This cross-sectional study was conducted at a tertiary hospital between November 2020 and December 2021, when specialized consultations were canceled due to the COVID-19 pandemic. Patients who were evaluated for remote consultation with family physicians were included.
View Article and Find Full Text PDFAnn N Y Acad Sci
December 2024
Department of Medicine, School of Basic Medicine, Ningbo University, Ningbo, China.
Macroautophagy, a universal cellular process, sends cellular material to lysosomes for breakdown and is often activated by stressors like hypoxia or drug exposure. It is vital for protein balance, neurotransmitter release, synaptic function, and neuron survival. The role of macroautophagy in substance use disorders is dual.
View Article and Find Full Text PDFJ Med Internet Res
December 2024
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
Background: Mobile health (mHealth) interventions have gained popularity in augmenting psychiatric care for adults with psychosis. Interest has grown in leveraging mHealth to empower individuals living with severe mental illness and extend continuity of care beyond the hospital to the community. However, reported outcomes have been mixed, likely attributed in part to the intervention and adopted outcomes, which affected between-study comparisons.
View Article and Find Full Text PDFJAMA
December 2024
Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
Ann N Y Acad Sci
December 2024
National Institute of Health Data Science, Peking University, Beijing, China.
Behavior-change lifestyle interventions are fundamental in children and adolescent obesity management. This scoping review discusses optimal behavior-change lifestyle interventions in the treatment of overweight and obesity in children and adolescents. A literature search on diet, physical activity, and behavioral intervention for obesity treatment in children and adolescents aged 0-19 years was conducted in the Cochrane Library, MEDLINE (OVID), EMBASE, and ClinicalTrials.
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