Increasing Access to Treatment for Chagas Disease: The Case of Morelos, Mexico

Jennifer Manne-Goehler Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; Regional Center for Public Health Research, National Institute for Public Health, Tapachula, Mexico; State of Morelos Secretary of Health, Program on Chagas Disease, Cuernavaca, Mexico; Center for Global Health and Development, Boston University, Boston, Massachusetts; Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts

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Janine M. Ramsey Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; Regional Center for Public Health Research, National Institute for Public Health, Tapachula, Mexico; State of Morelos Secretary of Health, Program on Chagas Disease, Cuernavaca, Mexico; Center for Global Health and Development, Boston University, Boston, Massachusetts; Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts

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Marco Ocampo Salgado Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; Regional Center for Public Health Research, National Institute for Public Health, Tapachula, Mexico; State of Morelos Secretary of Health, Program on Chagas Disease, Cuernavaca, Mexico; Center for Global Health and Development, Boston University, Boston, Massachusetts; Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts

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Veronika J. Wirtz Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; Regional Center for Public Health Research, National Institute for Public Health, Tapachula, Mexico; State of Morelos Secretary of Health, Program on Chagas Disease, Cuernavaca, Mexico; Center for Global Health and Development, Boston University, Boston, Massachusetts; Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts

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Michael R. Reich Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; Regional Center for Public Health Research, National Institute for Public Health, Tapachula, Mexico; State of Morelos Secretary of Health, Program on Chagas Disease, Cuernavaca, Mexico; Center for Global Health and Development, Boston University, Boston, Massachusetts; Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts

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DOI:
https://doi.org/10.4269/ajtmh.14-0357
Volume/Issue:
Volume 91: Issue 6
Page(s):
1125–1127
Restricted access
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Chagas disease is a neglected vector-borne disease with an estimated prevalence of 1.1 million cases in Mexico. Recent research showed that access to treatment of Chagas disease is limited in Mexico, with < 0.5% of infected cases treated. This brief report used quantitative data from the Morelos Program on Chagas disease and qualitative analysis of key informant interviews to examine strategies to increase treatment access for infected patients in Morelos, Mexico. From 2007 to 2011, 263 (9.2%) of the registered cases of Chagas disease in Mexico occurred in Morelos. Among these, 152 (57.8%) were treated and 97.3% of those treated received benznidazole. The assessment finds that state officials decided to directly purchase benznidazole from the distributor to increase access and improve clinical quality of treatment of patients in their state. They also faced significant barriers, especially in regulation and health system organization, which limited efforts to make high quality treatment available.

Author Notes

* Address correspondence to Jennifer Manne-Goehler, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave., Boston, MA 02215. E-mail: jmanne@post.harvard.edu

Authors' addresses: Jennifer Manne-Goehler and Michael R. Reich, Harvard School of Public Health, Department of Global Health and Population, Boston, MA, E-mails: jmanne@post.harvard.edu and reich@hsph.harvard.edu. Janine M. Ramsey, Instituto Nacional de Salud Pública, Centro de Investigaciones sobre Enfermedades Infecciosas, Jefa de Departamento, Tapachula, Chiapas, Mexico, E-mail: jramsey@insp.mx. Marco Ocampo Salgado, Servicios de Salud del Estado de Morelos, Programa de Chagas Cuernavaca, Morelos, Mexico, E-mail: ocampo.ma@hotmail.com. Veronika J. Wirtz, Boston University, Center for Global Health and Development, Boston, MA, E-mail: vwirtz@bu.edu.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2014
Received:
09 Jun 2014
|
Accepted:
06 Aug 2014
|
Published Online:
03 Dec 2014
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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