ABSTRACT
Resumen Objetivos: identificar a partir de relatos individuales y familiares los componentes del estigma social asociado a un diagnóstico de Chagas positivo. Métodos: el estudio recopila los testimonios de tres familias a través de entrevistas a profundidad que fueron grabadas, cuyo contenido fue estructurado y luego compartido entre los investigadores a través de un proceso de triangulación. Resultados: se identificaron las diferentes formas de estigma social, experimentado, percibido, anticipado, así como el autoestigma, el estigma por asociación y comportamientos de discriminación; lo que conlleva el aislamiento social, refuerza los miedos tradicionalmente relacionados a esta enfermedad, y provoca tensiones intrafamiliares. El estigma social y el silencio que lo acompaña son serias barreras de acceso a la consulta médica y al tratamiento antiparasitario. Conclusiones: Es importante tomar en cuenta aspectos de tipo psico-socio-cultural en las estrategias de atención integral de Chagas, principalmente en los programas de información, educación, comunicación (IEC) y durante la consulta médica. Para romper el estigma y el silencio que lo acompaña, es indispensable integrar las personas afectadas por Chagas y otros actores de la sociedad civil en el diseño de esas estrategias.
Abstract Objectives: to identify the components of social stigma associated with a positive diagnosis of Chagas disease based on individual and family accounts. Methods: The study compiles the testimonies of 3 families through in-depth interviews that were recorded, the content of which was structured and then shared among the researchers through a process of triangulation. Results: different forms of social stigma, experienced, perceived, anticipated, as well as self-stigma, stigma by association and discriminatory behaviours were identified, leading to social isolation, reinforcing traditional fears associated with the disease, and causing intra-familial tensions. Social stigma and the silence that accompanies it are serious barriers to access to medical consultation and deworming treatment. Conclusions: It is important to take into account psycho-socio-cultural aspects in strategies for comprehensive care of Chagas disease, especially in information, education and communication (IEC) programmes and during the medical consultation. Also, to break the stigma and the silence surrounding it, it's essential to integrate people affected by Chagas and other civil society actors into the conception of these programs.
ABSTRACT
The definition of a biomarker provided by the World Health Organization is any substance, structure, or process that can be measured in the body, or its products and influence, or predict the incidence or outcome of disease. Currently, the lack of prognosis and progression markers for chronic Chagas disease has posed limitations for testing new drugs to treat this neglected disease. Several molecules and techniques to detect biomarkers in Trypanosoma cruzi-infected patients have been proposed to assess whether specific treatment with benznidazole or nifurtimox is effective. Isolated proteins or protein groups from different T. cruzi stages and parasite-derived glycoproteins and synthetic neoglycoconjugates have been demonstrated to be useful for this purpose, as have nucleic acid amplification techniques. The amplification of T. cruzi DNA using the real-time polymerase chain reaction method is the leading test for assessing responses to treatment in a short period of time. Biochemical biomarkers have been tested early after specific treatment. Cytokines and surface markers represent promising molecules for the characterisation of host cellular responses, but need to be further assessed.