Summer Nguyen

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Chagas disease, caused by the protozoan parasite, Trypanosoma cruzi, is the most important vector-borne disease in Latin America. It is estimated that 16 to 18 million people are infected with Chagas disease and some 50,000 people die each year. In endemic countries, people living in rural areas are at greatest risk for acquiring infection. Ecuador is one of these countries, and it is estimated that between 2.4-3.8 million people in Ecuador are exposed to Chagas disease, primarily in the Eastern endemic coastal region. The indigenous people of the Amazon region in Ecuador have historically been protected from Chagas disease due to a geographic border provided by the Andes Mountain Range. However, recent developments in oil mining in the Amazon Basin have created a need for migratory workers resulting in a population shift from the Chagas endemic coastal region into the Amazon Basin. This migratory shift can have an ecological as well as epidemiological impact on the indigenous population by the introduction of a disease that is largely unknown, opening new possibilities for expanding the domestic cycle of Chagas disease. This research study is an assessment of the reliability of the recognition and diagnosis of Chagas Disease by indigenous promotores of the Amazon Basin in Ecuador. Survey questionnaires were conducted in face-to-faceinterviews with indigenous promotores who lived and worked in the communities along the Napo River of the Orelleans province in Northeastern Ecuador Amazonia. The questionnaire is compose of simple yes/no, multiple choice, and open-ended questions designed to assess the knowledge of acute and chronic stages of Chagas disease, signs and symptoms, and knowledge of Chagas transmission vectors. The survey included 18 of the 22 communities present, covering 81.8% of the entire available communities. Of these communities, 15 were included in the survey, and 3 were excluded. A total of 19 interview-surveys were conducted. 42% (8 out of 19) of the promotores surveyed reported seeing the symptoms of the early stage of Chagas disease. However only 5 promotores (30%, 5 out of 19) can correctly identify acute Chagas Disease and none knew that Chagas Disease had chronic sequelae. Currently there is no cure for Chagas disease and public health efforts have aimed to prevent the transmission by education and implementing bed nets to prevent infections. The success of these implementations relies on the recognition of Chagas disease among the indigenous promotores who are in a position to be the first to recognize the signs of acute Chagas disease. The results of our survey demonstrated that less than half of the indigenous promotores in Amazonia Ecuador along the Napo River had knowledge of Chagas disease. Chagas is reported to be present in the region, however there is little evidence that it can be reliably reported by the local indigenous promotores.