Evidence map›Paper›PMID 40529848›Full record

ArticleLancet regional health. Americas2025

Bridging the gap in Chagas disease management: a mixed-methods study using an implementation science approach within the Brazilian primary health care system-'Implementa-Chagas/SaMi-Trop project'.

Carlos Henrique Valente Moreira, Laura Azevedo, Ariela Mota Ferreira, Ana Carolina Gonçalves Oliveira, Andréia Brito de Souza, Desirée Sant'Ana Haikal, Cláudia Di Lorenzo Oliveira, Clareci Silva Cardoso, Matthew Spinelli, Ana Luiza Bierrenbach and 12 more

Abstract read
In one paragraph

Article in Lancet regional health. Americas, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. 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

22 authors.

Carlos Henrique Valente MoreiraDivision of HIV, Infectious Diseases, & Global Medicine- Zuckerberg San Francisco General Hospital, University of California, San Francisco, CA, USA.
Laura AzevedoLaboratório de Parasitologia Médica (LIM-46), Institute of Tropical Medicine - Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
Ariela Mota FerreiraPrograma de Pós Graduação em Ciências da Saúde - Universidade Estadual de Montes Claros (UNIMONTES), Montes Claros, MG, Brazil.
Ana Carolina Gonçalves OliveiraPrograma de Pós Graduação em Ciências da Saúde - Universidade Federal de São João del-Rei (UFSJ), Divinópolis, MG, Brazil.
Andréia Brito de SouzaPrograma de Pós Graduação em Ciências da Saúde - Universidade Estadual de Montes Claros (UNIMONTES), Montes Claros, MG, Brazil.
Desirée Sant'Ana HaikalPrograma de Pós Graduação em Ciências da Saúde - Universidade Estadual de Montes Claros (UNIMONTES), Montes Claros, MG, Brazil.
Cláudia Di Lorenzo OliveiraPrograma de Pós Graduação em Ciências da Saúde - Universidade Federal de São João del-Rei (UFSJ), Divinópolis, MG, Brazil.
Clareci Silva CardosoPrograma de Pós Graduação em Ciências da Saúde - Universidade Federal de São João del-Rei (UFSJ), Divinópolis, MG, Brazil.
Matthew SpinelliDivision of HIV, Infectious Diseases, & Global Medicine- Zuckerberg San Francisco General Hospital, University of California, San Francisco, CA, USA.
Ana Luiza BierrenbachInstituto de Ensino e Pesquisa - Hospital Sírio Libanês, São Paulo, SP, Brazil.
Nayara Dornela QuintinoSuperintendência Regional de Saúde de Divinópolis, Secretaria de Estado de Saúde de Minas Gerais, Brazil.
Nayara Ragi BaldoniUniversidade de Itaúna (UIT), Itaúna, MG, Brazil.
Renata Fiuza DamascenoSuperintendência Regional de Saúde de Montes Claros, Secretaria de Estado de Saúde de Minas Gerais, Brazil.
Malu Ribeiro DrumondPrograma de Pós Graduação em Ciências da Saúde - Universidade Estadual de Montes Claros (UNIMONTES), Montes Claros, MG, Brazil.
Thallyta Maria VieiraPrograma de Pós Graduação em Ciências da Saúde - Universidade Estadual de Montes Claros (UNIMONTES), Montes Claros, MG, Brazil.
Dardiane Santos CruzPrograma de Pós Graduação em Ciências da Saúde - Universidade Estadual de Montes Claros (UNIMONTES), Montes Claros, MG, Brazil.
Sâmara Fernandes LeitePrograma de Pós Graduação em Ciências da Saúde - Universidade Estadual de Montes Claros (UNIMONTES), Montes Claros, MG, Brazil.
Ana Clara de Jesus SantosPrograma de Pós Graduação em Ciências da Saúde - Universidade Estadual de Montes Claros (UNIMONTES), Montes Claros, MG, Brazil.
Léa Campos de Oliveira SilvaLaboratório de Parasitologia Médica (LIM-46), Institute of Tropical Medicine - Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
Renata BuccheriVitalant Research Institute, San Francisco, CA, USA.
Antônio Luiz Pinho RibeiroDepartment of Internal Medicine, Faculdade de Medicina, and Telehealth Center and Cardiology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
Ester Cerdeira SabinoUniversidade de São Paulo (USP), Instituto de Medicina Tropical da Faculdade de Medicina da USP, São Paulo, SP, Brazil.

Funding

Sao Paulo-Minas Gerais Tropical Medicine Research Center for Chagas Disease Biomarker DiscoveryU19AI098461 · NIAID · FUNDACAO FACULDADE DE MEDICINA · PI PEREIRA, ALEXANDRE DA COSTA · 2017 to 2021
$2.1M
Developing a U.S. National Cohort to Improve Virologic Suppression among Stimulant-using Men Living with HIV.UG3DA058304 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CARRICO, ADAM WAYNE, GANDHI, MONICA · 2023 to 2024
$2.0M
"Sao Paulo-Minas Gerais Center for Chagas Disease Treatment (SaMiTrop)"U01AI168383 · NIAID · FUNDACAO FACULDADE DE MEDICINA · PI Ester Cerdeira Sabino · 2022 to 2026
$1.9M
Randomized Directly Observed Therapy Study to Interpret Clinical Trials of Doxy-PEPR01AI186641 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI SPINELLI, MATTHEW A. · 2024 to 2025
$1.6M
NIAID NIH HHS R01 AI186641NIAID NIH HHS U01 AI168383NIAID NIH HHS U19 AI098461NIDA NIH HHS UG3 DA058304
6 · The paper itself

Abstract

Background: Chagas Disease (ChD), a prevalent Neglected Tropical Disease in Latin America, affects millions and poses significant challenges in Brazil's primary healthcare system. Despite the availability of diagnostic tools and effective drugs, screening and treatment rates remain alarmingly low. This study aims to identify barriers and facilitators in ChD management, focusing on integrating services into routine healthcare operations. Methods: An exploratory sequential mixed-methods approach was used, combining focus groups with primary care physicians, in-depth interviews, and quantitative surveys with healthcare professionals. The Theoretical Domains Framework (TDF) and the Capability Opportunity Motivation-Behaviour (COM-B) model guided the analysis of decision-making processes in ChD management. Intervention strategies were developed using the Behaviour Change Wheel (BCW) framework, emphasizing educational programmes, hands-on training, and infrastructural improvements. Findings: The study identified key barriers, including limited awareness of ChD among healthcare professionals, reliance on symptomatic diagnosis, environmental constraints, and inadequate public and professional engagement with ChD. We proposed tailored interventions to enhance primary healthcare personnel competencies through education, training, and infrastructure adjustments. Interpretation: The study advocates for a paradigm shift in ChD management towards early intervention and comprehensive care. It highlights the importance of a team-based strategy aligned with the WHO's Neglected Tropical Diseases roadmap, particularly in remote areas. This approach addresses healthcare workers' challenges, fostering a more proactive and informed ChD management strategy. Funding: The NIH supported the study under the Sami-Trop cohort study (Grant n. U01AI168383).

Indexed as

BrazilChagas diseaseImplementation scienceNeglected tropical diseasesPrimary healthcare

Identifiers

PMID40529848
PMCPMC12173612

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

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.