Representations of Chagas disease among Bolivian immigrants in the city of São Paulo

Abstract

Background: Transnational immigrants are particularly impactedbyneglecteddiseases,which take a heavy biological, social, and emotional toll in these marginalizedcommunities. Chagas disease has transformed from an exclusively rural to anincreasingly urban phenomenon encompassing non-endemic areas in Latin America.Methods: Through semi-structured interviews, we investigated representations ofChagas disease in Bolivian immigrants in São Paulo, Brazil. Between August andSeptember 2015, 27 adult migrants were interviewed, 11 of them with Chagasdisease. We explored problems of access to health services and essentialknowledge about the disease, as well as related conceptions and health practices.Results: Participants constructed social representations of Chagas through interactionswith family and social networks, drawing on earlier experiences in Bolivia. Diagnosis oftenprovoked fear, and participants faced barriers to care based on language differences anduncertainties about the disease and treatment options. Healthcare personnel played animportant role in alleviating concerns and facilitating access to information.Discussion: The complex intersection of migration and neglected diseases createschallenges for local and national health programs, requiring innovative responsesincorporating the perspectives and needs of the often vulnerable affected communities.