Modelling the epidemiology and healthcare burden of chagas disease in colombia
File(s)
Author(s)
Cucunuba Perez, Zulma
Type
Thesis or dissertation
Abstract
Chagas disease remains as a major cause of heart disease burden in Latin American countries. Although in the last three decades most endemic countries have implemented various control strategies, the impact of such interventions has not been rigorously quantified, and questions remain as how to address old and new challenges as countries progress towards the 2020 goals proposed by the World Health Organization (WHO). These goals are aimed to achieve interruption of domiciliary transmission in all endemic countries and to have all infected/ill patients under care. However, estimates on the current status of domiciliary transmission and on the burden of disease in those countries remains poorly understood and even ambiguous. Since the majority of Trypanosoma cruzi infections remain in asymptomatic state for decades before showing the heart/digestive complications, most infected people continue unaware of their condition. Therefore, access to early diagnosis and treatment are yet very precarious and the surveillance health systems are not really capturing the changing epidemiology of the disease. Given the nature of the multi-pronged interventions required to Chagas disease control, obtaining disease estimates is crucial to understand how the health system is responding to such demand and how to better plan interventions. Taking Colombia as a case study, in this PhD thesis I am presenting a methodological and analytical approach to understand five key issues relevant for planning interventions for Chagas disease in endemic countries: historical exposure to Force-of-Infection, disease progression, disease burden, costs and access to early diagnosis and treatment. The methods, results and limitations of this approach and its components are presented and discussed.
Version
Open Access
Date Issued
2017-05
Date Awarded
2017-11
Advisor
Basáñez, Maria -Gloria
Conteh, Lesong
Nouvellet, Pierre
Sponsor
Colombia's Administrative Department of Science, Technology and Innovation (Spanish: Departamento Administrativo de Ciencia, Tecnología e Innovación de Colombia, COLCIENCIAS)
Grant Number
grant no. 380-2011, code 5014-537-30398
Scholarship for PhD studies abroad (call 569)
Publisher Department
School of Public Health
Publisher Institution
Imperial College London
Qualification Level
Doctoral
Qualification Name
Doctor of Philosophy (PhD)