02612nas a2200301   4500000000100000008004100001653000900042653001100051653001600062653001400078653002300092653002000115653003000135100001800165700001500183700001900198700002400217700001300241700001300254700001500267700002200282245010900304856009800413300001300511490000700524520176500531022001402296       2017                            d10aNTDs10aChagas10aElimination10aGuatemala10aNeonatal Screening10aPRECEDE-PROCEED10aHealth promotion strategy1 aPennington PM1 aJuárez JG1 aArrivillaga MR1 aDe Urioste-Stone SM1 aDoktor K1 aBryan JP1 aEscobar CY1 aCordón-Rosales C00aTowards Chagas disease elimination: Neonatal screening for congenital transmission in rural communities.  uhttp://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0005783&type=printable  ae00057830 v113 a<p>Chagas disease is a neglected tropical disease that continues to affect populations living in extreme poverty in Latin America. After successful vector control programs, congenital transmission remains as a challenge to disease elimination. We used the PRECEDE-PROCEED planning model to develop strategies for neonatal screening of congenital Chagas disease in rural communities of Guatemala. These communities have persistent high triatomine infestations and low access to healthcare. We used mixed methods with multiple stakeholders to identify and address maternal-infant health behaviors through semi-structured interviews, participatory group meetings, archival reviews and a cross-sectional survey in high risk communities. From December 2015 to April 2016, we jointly developed a strategy to illustratively advertise newborn screening at the Health Center. The strategy included socioculturally appropriate promotional and educational material, in collaboration with midwives, nurses and nongovernmental organizations. By March 2016, eight of 228 (3.9%) pregnant women had been diagnosed with T. cruzi at the Health Center. Up to this date, no neonatal screening had been performed. By August 2016, seven of eight newborns born to Chagas seropositive women had been parasitologically screened at the Health Center, according to international standards. Thus, we implemented a successful community-based neonatal screening strategy to promote congenital Chagas disease healthcare in a rural setting. The success of the health promotion strategies developed will depend on local access to maternal-infant services, integration with detection of other congenital diseases and reliance on community participation in problem and solution definition.</p>
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