# Knowledge about Chagas disease among Primary Health Care professionals in a municipality located in northeastern Brazil

## TL;DR

Primary health care professionals in northeastern Brazil have limited and uneven knowledge about Chagas disease, highlighting the need for better training to improve diagnosis and control.

## Contribution

This study provides new insights into the gaps in Chagas disease knowledge among health professionals in a high-risk Brazilian region.

## Key findings

- Most professionals recognized fever and edema as acute symptoms but had poor knowledge of transmission routes and treatment.
- Over 90% had never received information about Chagas disease, and many incorrectly believed it is incurable.
- Knowledge varied by occupational category, suggesting uneven training and awareness among health workers.

## Abstract

Knowledge about Chagas disease (CD) among health professionals is essential to control this public health problem. The objective was to evaluate the knowledge about CD among these professionals. A descriptive cross-sectional study was conducted between April and September 2023, in the city of Irecê, Bahia State, Brazil. Data were collected using a standardized questionnaire and analyzed descriptively. Of the 257 participants, 226 (87.9%) claimed to know the etiological agent, although only 173 (76.5%) recognized it as a protozoan. Regarding the modes of transmission, all workers recognized the vector-borne route, but only 102 (39.7%) identified the vertical route. The majority of workers identified the heart as the affected organ (n = 255; 99.2%). The most identified signs/symptoms in the acute phase were fever (n = 196; 76.6%) and edema (n = 218; 85.2%); in chronic cases, it was recognized that they can be asymptomatic, but the majority recognized that electrocardiographic changes and congestive heart failure may be present. Regarding etiological treatment, 175 (72.0%) acknowledged its existence, but 122 (65.9%) could not state the recommended medication; and for 189 (73.5%), CD is incurable. Regarding the vector insect, 210 (82.0%) reported knowing it. Concerning the service to which located triatomine bugs should be sent, 165 (65.7%) identified the Zoonoses Control Center, and that the precaution to be taken when handling triatomine bugs was to protect their hands; for 234 (91.8%) of the participants, the procedure in case of a triatomine bite in humans was to perform serological tests, and 243 (94.6%) had never had access to information about CD. The health workers’ knowledge about CD was incipient and differed among occupational categories. For accurate surveillance of CD, training should be offered to health professionals, covering everything from signs/symptoms to the investigation of household and entomological contacts.

Chagas disease (CD) is a neglected disease that affects millions of people in several countries around the world. In Brazil, it represents a public health problem, but not all cases are diagnosed. The lack of knowledge about the disease among primary health care (PHC) professionals represents a significant barrier to timely diagnosis and effective treatment, which can result in the worsening of the clinical condition of affected individuals and the spread of the disease. The knowledge of primary care health professionals was evaluated in a northeastern Brazilian municipality classified as a risk area for vector-borne transmission of T. cruzi. In the studied municipality, the knowledge among PHC professionals about CD was limited and unequal among occupational categories, which may compromise the effectiveness of surveillance actions, from initial clinical suspicion to the adoption of prevention and control measures. This reality may reflect the situation in other endemic areas of the disease. Our results indicate an urgent need for continuing education for workers regarding CD public programs and policies, in order to improve surveillance in regions at risk for the disease, as well as to provide adequate care to its carriers.