Analysis of the therapeutic gap for Trypanosoma cruzi infection in Colombia (2012 - 2022).

BACKGROUND

In 2017, an estimated 1.2% of the population at risk for Chagas disease (CD) in Colombia was screened, and only 0.4% were treated. The recent implementation of CD-related Care roadmap has improved access to diagnosis and treatment. However, a therapeutic gap (TG) persists.

OBJECTIVES

In this work, we aim to analyse the TG for Trypanosoma cruzi/CD infection in Colombia over the last years.

METHODS

This is a descriptive study estimating the TG for T. cruzi/CD infection between 2012 and 2022. TG is defined as the number of people with a confirmed infection who have the indication of treatment but do not receive it. Two scenarios were considered in the TG analysis: (A) antiparasitic treatment is indicated in 70% of people with confirmed infection; (B) antiparasitic treatment indication in 85%. Data sources were official National and Departmental databases.

FINDINGS: In scenario A, the TG was 77.5% in 2012, and by 2022, decreased to 48.1%. Two phases in the TG dynamics were observed: between 2012 and 2014, there was an increase of 4.5%; from 2014 onwards, there was a reduction of 40.7%. The most important reduction of TG was observed in 2018 and 2019. Linear projections from 2014-2022 indicate a potential reduction to 13.7% by 2030. Nevertheless, there are differences in terms of the reduction observed in different departments.

MAIN

CONCLUSION

TG calculation allows monitoring of treatment coverage, and its analysis facilitates target interventions to improve it, by reducing TG. Implementing interventions aimed at reducing the TG allows countries like Colombia to take a step forward in CD control.