Chagas Disease Screening: Awareness, Practices and Perceived Barriers Among Health Care Providers in Connecticut

BackgroundAn estimated 288,000 people in the United States are infected with Chagas disease. Despite published recommendations for healthcare providers, the neglected nature of this disease persists, in part due to gaps in knowledge and low levels of Chagas disease awareness among healthcare providers. A survey was emailed to healthcare providers to assess knowledge of Chagas disease, screening practices, and provider-perceived barriers to screening. MethodsThe survey link was emailed to healthcare providers and department heads. Providers answered a series of questions categorized either as knowledge (K), practice (P), or perceived barriers (B), which were then scored by category. The analysis included Spearmans rho test to measure the strength of the correlation coefficient between K and P scores and between K and B scores, Kruskal-Wallis tests to see if average K, P, and B scores were equal across specialty groups, and Pairwise Wilcoxon Rank Sum Tests to assess for a significant difference between average scores of cardiology, infectious disease, and the "other specialties" category. Results92 providers consented to complete the survey, 88 of whom fit the inclusion criteria of either affiliation with Yale University or YNHH. Infectious disease scored highest on average in knowledge and practices and reported lower provider-perceived barriers (0.66{+/-}0.183, 0.35{+/-}0.247, 0.42{+/-}0.365). No specialty received higher than 0.66{+/-}0.183 on average for knowledge or screening practices. Average perceived barriers to screening were highest in the "other" specialty category (0.76{+/-}0.303). There was a significant positive association between knowledge scores and screening practice scores and a significant negative association between knowledge scores and perceived barriers to screening. ConclusionsThis study revealed a knowledge deficit among healthcare providers in various specialties, which was associated with less frequent adherence to recommended screening practices for Chagas disease, as well as higher provider-perceived barriers to screening. This information can inform provider education initiatives so that patients at risk for Chagas disease may be better served in Connecticut and throughout the United States.