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Title: Modelling the epidemiology and healthcare burden of Chagas disease in Colombia
Author: Cucunuba Perez, Zulma
ISNI:       0000 0004 7963 7118
Awarding Body: Imperial College London
Current Institution: Imperial College London
Date of Award: 2017
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Chagas disease remains as a major cause of heart disease burden in Latin American countries. Although in the last three decades most endemic countries have implemented various control strategies, the impact of such interventions has not been rigorously quantified, and questions remain as how to address old and new challenges as countries progress towards the 2020 goals proposed by the World Health Organization (WHO). These goals are aimed to achieve interruption of domiciliary transmission in all endemic countries and to have all infected/ill patients under care. However, estimates on the current status of domiciliary transmission and on the burden of disease in those countries remains poorly understood and even ambiguous. Since the majority of Trypanosoma cruzi infections remain in asymptomatic state for decades before showing the heart/digestive complications, most infected people continue unaware of their condition. Therefore, access to early diagnosis and treatment are yet very precarious and the surveillance health systems are not really capturing the changing epidemiology of the disease. Given the nature of the multi-pronged interventions required to Chagas disease control, obtaining disease estimates is crucial to understand how the health system is responding to such demand and how to better plan interventions. Taking Colombia as a case study, in this PhD thesis I am presenting a methodological and analytical approach to understand five key issues relevant for planning interventions for Chagas disease in endemic countries: historical exposure to Force-of-Infection, disease progression, disease burden, costs and access to early diagnosis and treatment. The methods, results and limitations of this approach and its components are presented and discussed.
Supervisor: Basáñez, Maria-Gloria ; Conteh, Lesong ; Nouvellet, Pierre Sponsor: Departamento Administrativo de Ciencia, Tecnología e Innovación de Colombia (COLCIENCIAS)
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral