Diagnosis of the Chagas disease and Chagas heart disease in Olopa. Chiquimula Department

The general objective of this project is to decrease the incidence of Chagas disease in small villages of Olopa.

Secondary objectives are

(1) diagnosis through screening with th quick test and serologic confirmation afterwards.

(2) To begin the follow-up with the establish protocol in the Primary Health Care to those patients identified by the clinical evaluation and the EKG.

(3) To begin the treatment.

The population included in the study is the relative to small villages and hamlets chosen by The DRISS Epidemiolgy team from Chiquimula in relation to epidemiological indexes. It is already known by previous studies that there is a high number of positive cases in the samall villages of the municipality.

The activities to carry out are:

1. screening in the small villages and hamlets wkhich have a high index of infestation and/or colonistion with de bug. Those positive cases will have confirmastion by a serological tes afterwards.
2. Clinical evalutation and EKG in Primary Health Centre. If there are alterations in the EKG an
3. echocardiogram is carried out and if theres is suspicion of CC, the patient is sent to Department Hospital or Guatemala city UNICAR Centre to finish the study and begin the treatment.
4. One important point to take into account in the treatment of the Chagas disease is the very low adherence to it in spite of the efforts of  the health personnel. The majority of the population is Chortí ethnicity and them tend to reject treatments. In order to improve the adherence is needed a very close supervision  to deal with the secondary effects and to add a nutrition supplement. For that reason we have proposed to have specific personnel to be dedicated to care, form a global point of view, the Chagas patients.

We hope to have the following results:

1. diagnosis of Chagas disease in populations with risk factors not having been previously studied.
2. To improve the circuits to care the patients with an initial evaluation, and EKG in those confirmed.
3. Administrations of the treatment anti bug, with surveillance and annual follow-up.
4. Echocardiogram in those with CCC.