The multidimensional comprehension of Chagas disease. Contributions, approaches, challenges and opportunities from and beyond the Information, Education and Communication field

Chagas is a complex, multidimensional phenomenon in which political, economic, environmental, biomedical, epidemiological, psychological, and sociocultural factors intersect. Nonetheless, the hegemonic conceptualisation has long envisioned Chagas as primarily a biomedical question, while ignoring or downplaying the other dimensions, and this limited view has reinforced the disease’s long neglect. Integrating the multiple dimensions of the problem into a coherent approach adapted to field realities and needs represents an immense challenge, but the payoff is more effective and sustainable experiences, with higher social awareness, increased case detection and follow-up, improved adherence to care, and integrated participation of various actors from multiple action levels. Information, Education, and Communication (IEC) initiatives have great potential for impact in the implementation of multidimensional programs of prevention and control successfully customised to the diverse and complex contexts where Chagas disease persists.

Key words:
Chagas disease; multidimensional comprehension; information; education; communication; public health

Authorship

Mariana Sanmartino ⁺+ Corresponding author: mariana.sanmartino@conicet.gov.ar / mariana.sanmartino@gmail.com

Consejo Nacional de Investigaciones Científicas y Técnicas, Instituto de Física de Líquidos y Sistemas Biológicos, Grupo de Didáctica de las Ciencias, La Plata, Buenos Aires, ArgentinaConsejo Nacional de Investigaciones Científicas y TécnicasArgentinaLa Plata, Buenos Aires, ArgentinaConsejo Nacional de Investigaciones Científicas y Técnicas, Instituto de Física de Líquidos y Sistemas Biológicos, Grupo de Didáctica de las Ciencias, La Plata, Buenos Aires, Argentina

https://orcid.org/0000-0002-3950-4826

Colin J Forsyth

Drugs for Neglected Diseases initiative - Latin America, Rio de Janeiro, RJ, BrasilDrugs for Neglected Diseases initiativeBrasilRio de Janeiro, RJ, BrasilDrugs for Neglected Diseases initiative - Latin America, Rio de Janeiro, RJ, Brasil

Andrea Avaria

Universidad Autónoma de Chile, Facultad de Ciencias Sociales y Humanidades, Santiago, Región Metropolitana, ChileUniversidad Autónoma de ChileChileSantiago, Región Metropolitana, ChileUniversidad Autónoma de Chile, Facultad de Ciencias Sociales y Humanidades, Santiago, Región Metropolitana, Chile

Mar Velarde-Rodriguez

Swiss Tropical and Public Health Institute, Department of Epidemiology and Public Health, Basel, SwitzerlandSwiss Tropical and Public Health InstituteSwitzerlandBasel, SwitzerlandSwiss Tropical and Public Health Institute, Department of Epidemiology and Public Health, Basel, Switzerland

University of Basel, Basel, SwitzerlandUniversity of BaselSwitzerlandBasel, SwitzerlandUniversity of Basel, Basel, Switzerland

Jordi Gómez i Prat

Hospital Universitari Vall d’Hebron, Servei de Medicina Preventiva, Unitat de Salut Internacional Drassanes-Vall d’Hebron, Equip de Salut Pública i Comunitària, Barcelona, CatalunyaHospital Universitari Vall d’HebronSpainBarcelona, SpainHospital Universitari Vall d’Hebron, Servei de Medicina Preventiva, Unitat de Salut Internacional Drassanes-Vall d’Hebron, Equip de Salut Pública i Comunitària, Barcelona, Catalunya

Pedro Albajar-Viñas

World Health Organization, Department of Control of Neglected Tropical Diseases, Geneva, SwitzerlandWorld Health OrganizationSwitzerlandGeneva, SwitzerlandWorld Health Organization, Department of Control of Neglected Tropical Diseases, Geneva, Switzerland

+ Corresponding author: mariana.sanmartino@conicet.gov.ar / mariana.sanmartino@gmail.com

MS participated in all work instances and coordinated the article writing process; CJF, AA, JGiP and MV-R participated in the writing of the article and general revision of the text. Additionally, CJF performed the English proofreading / translation task; PA-V carried out the general review and contributed fundamental aspects in the final stages of the work. All the authors participated in the instances of organisation of the text and discussion of the content.

SCIMAGO INSTITUTIONS RANKINGS

University of Basel, Basel, SwitzerlandUniversity of BaselSwitzerlandBasel, SwitzerlandUniversity of Basel, Basel, Switzerland

Figures

Figures (4)

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Fig. 1:
environment and society in an ecohealth perspective of Chagas disease.⁽¹⁴⁾ (Graphic adaptation: Iván Pasanau)

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Fig 2:
tricycle strategy of the World Health Organization Programme on Control of Chagas disease.¹⁷17. WHO - World Health Organization. Sustaining the drive to overcome Chagas disease in non-endemic countries. Report of the Third WHO Meeting of the Non-Endemic Countries Initiative on the Control of Chagas disease. Florence; 2013; 4-6 June. (Graphic adaptation: Iván Pasanau)

Thumbnail

Fig. 3:
the “kaleidoscopic puzzle”of Chagas.¹⁹19. Marti GA, Amieva Nefa SC, Balsalobre A, Carrillo C, Medone P, Mordeglia C, et al. Hablamos de Chagas. Aportes para (re)pensar la problemática con una mirada integral. Buenos Aires: CONICET; 2015. (Graphic adaptation: Iván Pasanau)

Thumbnail

Fig. 4:
interlocking gears to address the multidimensionality of Chagas (Illustration: Iván Pasanau). Each gear represents a key component to consider in a multidimensional strategy for Chagas. Key aspects of each gear are described below. IEC APPROACHES (Information, Communication and Education tools, strategies, methodologies, social media, technology), TERRITORIES (rural, urban, local, regional, national, global, borders), INTERSECTORAL ACTIONS/INSTITUTIONS (health systems -national, local, international; public administration; educational settings; universities and technical schools; media; and legislative and operative public and private institutions involved in labour, housing, migration, and the environment, NGO, macro structures), INTERSECTIONALITY (gender, sexual orientation, race / ethnicity, nationality, social class, vital cycle, physical abilities), INTERVENTION LEVELS (awareness, prevention, care, follow-up, primary and secondary systems, individual, family and community levels), POLITICAL & SOCIAL ACTORS (associations of people with Chagas, other social organisations, decision makers, educators and communicators, specialists, artists, health workers, activists).

Fig. 1: environment and society in an ecohealth perspective of Chagas disease.⁽¹⁴⁾ (Graphic adaptation: Iván Pasanau)

Fig 2: tricycle strategy of the World Health Organization Programme on Control of Chagas disease.¹⁷17. WHO - World Health Organization. Sustaining the drive to overcome Chagas disease in non-endemic countries. Report of the Third WHO Meeting of the Non-Endemic Countries Initiative on the Control of Chagas disease. Florence; 2013; 4-6 June. (Graphic adaptation: Iván Pasanau)

Fig. 3: the “kaleidoscopic puzzle”of Chagas.¹⁹19. Marti GA, Amieva Nefa SC, Balsalobre A, Carrillo C, Medone P, Mordeglia C, et al. Hablamos de Chagas. Aportes para (re)pensar la problemática con una mirada integral. Buenos Aires: CONICET; 2015. (Graphic adaptation: Iván Pasanau)

Fig. 4: interlocking gears to address the multidimensionality of Chagas (Illustration: Iván Pasanau). Each gear represents a key component to consider in a multidimensional strategy for Chagas. Key aspects of each gear are described below. IEC APPROACHES (Information, Communication and Education tools, strategies, methodologies, social media, technology), TERRITORIES (rural, urban, local, regional, national, global, borders), INTERSECTORAL ACTIONS/INSTITUTIONS (health systems -national, local, international; public administration; educational settings; universities and technical schools; media; and legislative and operative public and private institutions involved in labour, housing, migration, and the environment, NGO, macro structures), INTERSECTIONALITY (gender, sexual orientation, race / ethnicity, nationality, social class, vital cycle, physical abilities), INTERVENTION LEVELS (awareness, prevention, care, follow-up, primary and secondary systems, individual, family and community levels), POLITICAL & SOCIAL ACTORS (associations of people with Chagas, other social organisations, decision makers, educators and communicators, specialists, artists, health workers, activists).

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10.1590/0074-02760210460chgsa

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