4. Diagnosis and Treatment. A Second, Faster Test
At Tenza’s regional hospital, there is a lab and a human team coordinated by Andrea Ávila. She tells us about the changes they have been able to implement in order to achieve early detection of the disease. They no longer wait for a second visit from the patient, knowing that time is valuable, so that patients do not stray from their care path and they can offer them timely diagnosis and care. The confirming test is now performed without the patient having to come in again for more test, which can represent a barrier for those who live in remote places or have no resources to come back several times.
The process has been simplified with two ELISA tests, which has reduced the time it takes to determine the presence of the disease, brief the patients and begin the corresponding treatment in cases where the test result is positive. Now it is a question of less than one month. Before the new model was implemented, this process could take one year.
Time from diagnosis to the initiation of treatment have also been reduced thanks to the decentralization of pharmaceutical stock in the most high-incidence areas. With these developments, the it does not take more than 3 days since the request until the delivery of the treatment at the primary healthcare centers, which are supplied by the pharmacies of local hospitals such as the Tenza regional hospital.
On the opposite, in other areas of lower incidence, the drugs demand and delivery process is centralized, simply because, as explained by Dr. Mauricio Vera from the Ministry of Health, who is in charge of the Chagas program, “this ensures that there is no stock shortage in the areas where more cases appear, such as Boyacá”.
A Comprehensive Health Care Route for Chagas (RIAS) has been implemented for several years now in the departments with the highest incidence of the disease in Colombia. Thanks to this pilot project, developed in collaboration with DNDi, the number of persons diagnosed and treated has increased until 13-fold and 5-fold respectively. This shows that it is possible and crucial to diagnose and provide early treatment at the first tier of healthcare.
Report compiled during field visits by Javier Sancho and Ulrich-Dietmar Madeja. Images from Jorge Martinez.
To arrive on time to interrupt Chagas disease: