Physician knowledge and prevalence of Chagas disease in Appalachian Ohio Hispanic Immigrants

Studies have indicated that U.S. physicians may not consider Chagas disease when diagnosing immigrant patients from Chagas-endemic areas. The purpose of this quantitative cross-sectional study was to estimate the prevalence of Chagas disease and chronic Chagas cardiomyopathy and evaluate physician knowledge of Chagas disease in 6 Appalachian Ohio counties. Prevalence was estimated using existing data, and physician knowledge was assessed by self-administated survey. The estimated prevalence rates of Chagas disease and chronic Chagas cardiomyopathy were 1.3% and 0.1%, respectively. Surveys were sent to 262 Appalachian Ohio physicians, and 105 completed surveys were used in the analysis. Appalachian Ohio physicians were less likely to identify the clinical manifestations of Chagas (11%), the progression of chronic disease (44%), and to consider Chagas disease in diagnosis (27%) than a published national sample. Knowledge was not significantly associated with physician age, time since residency, gender, specialty, ethnicity, or foreign origin. The prevalence indicated that there are likely individuals with chronic Chagas disease living in Appalachian Ohio. A lack of physician awareness of Chagas disease may create a barrier to care by decreasing the likelihood of proper diagnosis and treatment. The results of this study support the need for interventions to ensure proper diagnosis and treatment of Chagas disease in Hispanic immigrants in rural Appalachian Ohio.