Original Research
A qualitative exploration of knowledge of Chagas disease among adolescents in rural Ecuador
AUTHORS
Sharon Casapulla3 EdD, MPH, Assistant Professor 
Benjamin R Bates4 PhD, Professor
Mario J Grijalva5 PhD, Professor *
AFFILIATIONS
1 Infectious and Tropical Disease Institute, Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA
2 Department of Biosciences and Department of Anthropology, Durham University, UK
3 Office of Rural and Undeserved Programs, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA; and Department of Primary Care, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA
4 Infectious and Tropical Disease Institute, Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA; and School of Communication Studies, Scripps College of Communication, Ohio University, Athens, Ohio, USA
5 Infectious and Tropical Disease Institute, Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA; and Centro de Investigación para la Salud en America Latina (CISeAL), Escuela de Ciencias Biológicas, Facultad de Ciencias Exactas y Naturales, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
ACCEPTED: 5 September 2022
Patricia Mora-Criollo: Knowledge of Chagas disease among adolescents in rural Ecuador
early abstract:
Introduction: Chagas disease (CD) is a neglected tropical disease that affects 6 to 7 million people worldwide. In South America, CD is a major health problem in several regions, causing more than 12,000 deaths per year. CD is caused by a parasite called Trypanosoma cruzi, which is mostly transmitted through the contaminated feces of a triatomine bug called the 'kissing bug'. CD is endemic in Loja Province, located in the southern region of Ecuador where triatomines were found in 68% of the communities located in the area. Previous promotion of healthy practices in Loja Province had included educational programs directed toward youth to affirm cultural and social norms that support health and prevent CD transmission. The present study was designed to evaluate current knowledge related to CD among youth in the three communities of Loja Province with previous intervention programs.
Methods: A descriptive, qualitative approach was applied using individual semi-structured interviews with 14 young people (8 young women, 6 young men) from three rural communities in Loja Province. Interviews assessed knowledge about CD transmission; knowledge about the parasite-vector-disease; and the role of youth in preventing Chagas disease in their communities.
Results: Following a thematic analysis of the data, our results showed there is cursory knowledge of the triatomine insect that can carry the causative parasite for CD. Participants were able to generally talk about the vector, habitat, and prevention practices for triatomine infestation. Nevertheless, limited understanding of transmission dynamics for the parasite-vector-disease itself was found. One of our major findings was that prevention practices were not correctly applied or followed, increasing the risk of exposure in the community. Youth also articulated that CD is stigmatized in their communities, which may be a barrier for prevention efforts.
Discussion: gaps in knowledge about the parasite-vector-disease were identified among youth. Overall, youth responses indicated positive regard for prevention practices and a desire to be involved in prevention programs. Developing educational programs focusing on CD transmission may be needed to improve control and prevention of this parasitic disease. The implications of this findings are discussed for developing effective control programs in the region.