Evidence map›Paper›PMID 39701994›Full record

ArticleBMC primary care2024

Barriers and facilitators for preventing mother-to-child transmission of Trypanosoma cruzi and hepatitis B in the Gran Chaco region: a qualitative analysis using the consolidated framework for implementation research (CFIR).

Yoshiko Takahashi, Susana Avila, Silvia Correa, Karina Cardone, Mariana Fernández, Favio Crudo, Miho Sato, Hirotsugu Aiga, Kenji Hirayama, Freddy Perez and 1 more

Abstract read
In one paragraph

Article in BMC primary care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Yoshiko TakahashiSchool of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan. yoshiko.t.0105@gmail.com.ORCID 0000-0001-6904-4843
Susana AvilaFundación Mundo Sano, Buenos Aires, Argentina.
Silvia CorreaUniversidad Nacional de Salta, Salta, Argentina.
Karina CardoneFundación Mundo Sano, Buenos Aires, Argentina.ORCID 0000-0002-0249-6789
Mariana FernándezFundación Mundo Sano, Buenos Aires, Argentina.
Favio CrudoFundación Mundo Sano, Buenos Aires, Argentina.ORCID 0000-0002-1924-9725
Miho SatoSchool of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.ORCID 0000-0002-5220-1715
Hirotsugu AigaSchool of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.ORCID 0000-0001-5910-3379
Kenji HirayamaSchool of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.ORCID 0000-0001-9467-1777
Freddy PerezCommunicable Diseases Prevention, Control and Elimination Department, Pan American Health Organization, Washington, DC, USA.ORCID 0000-0003-2001-0057
Maria Victoria PeriagoFundación Mundo Sano, Buenos Aires, Argentina.ORCID 0000-0002-1470-5146

Funding

Special Programme for Research and Training in Tropical Diseases (TDR), sponsored by UNICEF, UNDP, the World Bank, WHO P22-00736
6 · The paper itself

Abstract

backgroundMother-to-child transmission (MTCT) of Trypanosoma cruzi and hepatitis B virus (HBV) increases morbidity and disability in Latin America and the Caribbean. The tailormade comprehensive antenatal care based on the Framework for the elimination of MTCT of HIV, syphilis, hepatitis B virus (HBV), and Chagas disease (EMTCT Plus) has been implemented in the region since 2018 through a private-public partnership. This study aimed to estimate the effectiveness of the intervention in preparing MTCT of T. cruzi and hepatitis B. The study further attempted to identify the barriers to and facilitators for preventing MTCT of T. cruzi and HBV in the Gran Chaco region of Argentina and Paraguay.

methodsData on T. cruzi and HBV screening and treatment among pregnant women and infants were collected from antenatal care (ANC) registries between June 2018 and December 2022. A cascade-of-care analysis was applied to assess the intervention's effectiveness and identify bottlenecks. Additionally, key informant interviews were conducted for both implementors and service recipients to identify barriers to and facilitators for accessing screening and treatment using the Consolidated Framework for Implementation Research.

resultsA total of 1,658 pregnant women were recruited, achieving 100% antenatal care coverage and screening for T. cruzi and HBV. The prevalence of T. cruzi among pregnant women was 3.3% (95%CI: 2.4-4.1%), while in newborns it was 14.0% (95% CI: 6.0-25.0). Treatment coverage for newborns infected with T. cruzi was 100%, whereas post-delivery treatment coverage among mothers was 67.3%. This achievement was likely attributed to strong community engagement, contributing to 100% ANC coverage. However, barriers such as a fragile local health system, long-term follow-up requirements, high mobile populations, cultural beliefs, and social trauma were identified in target areas.

conclusionImplementing the EMTCT Plus Framework improved access to quality ANC in the study area. Nevertheless, continuous follow-up for T. cruzi screening and treatment for post-delivery remains challenging. To improve access to healthcare and ensure the sustainability of the intervention, an intercultural approach that empowers the community, alongside efforts to strengthen the local health system, is recommended.

Indexed as

Chagas DiseaseHepatitis BInfectious Disease Transmission, VerticalPrenatal CareAdultArgentinaFemaleHealth Services AccessibilityHumansInfantInfant, NewbornMass ScreeningPregnancyPregnancy Complications, InfectiousQualitative ResearchTrypanosoma cruziChagas diseaseEMTCT plusGran ChacoHepatitis BMother-to-child transmissionPregnant womenTrypanosoma cruzi

Identifiers

PMID39701994
PMCPMC11660772

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.