Barriers and facilitators for preventing mother-to-child transmission of Trypanosoma cruzi and hepatitis B in the Gran Chaco region: a qualitative analysis using the consolidated framework for implementation research (CFIR)
Abstract Background Mother-to-child transmission (MTCT) of Trypanosoma cruzi and hepatitis B virus (HBV) increases morbidity and disability in Latin America and the Caribbean. The tailormade comprehensive antenatal care based on the Framework for the elimination of MTCT of HIV, syphilis, hepatitis B...
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BMC
2024-12-01
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| Series: | BMC Primary Care |
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| Online Access: | https://doi.org/10.1186/s12875-024-02683-z |
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| author | Yoshiko Takahashi Susana Avila Silvia Correa Karina Cardone Mariana Fernández Favio Crudo Miho Sato Hirotsugu Aiga Kenji Hirayama Freddy Perez Maria Victoria Periago |
| author_facet | Yoshiko Takahashi Susana Avila Silvia Correa Karina Cardone Mariana Fernández Favio Crudo Miho Sato Hirotsugu Aiga Kenji Hirayama Freddy Perez Maria Victoria Periago |
| author_sort | Yoshiko Takahashi |
| collection | DOAJ |
| description | Abstract Background Mother-to-child transmission (MTCT) of Trypanosoma cruzi and hepatitis B virus (HBV) increases morbidity and disability in Latin America and the Caribbean. The tailormade comprehensive antenatal care based on the Framework for the elimination of MTCT of HIV, syphilis, hepatitis B virus (HBV), and Chagas disease (EMTCT Plus) has been implemented in the region since 2018 through a private-public partnership. This study aimed to estimate the effectiveness of the intervention in preparing MTCT of T. cruzi and hepatitis B. The study further attempted to identify the barriers to and facilitators for preventing MTCT of T. cruzi and HBV in the Gran Chaco region of Argentina and Paraguay. Methods Data on T. cruzi and HBV screening and treatment among pregnant women and infants were collected from antenatal care (ANC) registries between June 2018 and December 2022. A cascade-of-care analysis was applied to assess the intervention’s effectiveness and identify bottlenecks. Additionally, key informant interviews were conducted for both implementors and service recipients to identify barriers to and facilitators for accessing screening and treatment using the Consolidated Framework for Implementation Research. Results A total of 1,658 pregnant women were recruited, achieving 100% antenatal care coverage and screening for T. cruzi and HBV. The prevalence of T. cruzi among pregnant women was 3.3% (95%CI: 2.4-4.1%), while in newborns it was 14.0% (95% CI: 6.0–25.0). Treatment coverage for newborns infected with T. cruzi was 100%, whereas post-delivery treatment coverage among mothers was 67.3%. This achievement was likely attributed to strong community engagement, contributing to 100% ANC coverage. However, barriers such as a fragile local health system, long-term follow-up requirements, high mobile populations, cultural beliefs, and social trauma were identified in target areas. Conclusion Implementing the EMTCT Plus Framework improved access to quality ANC in the study area. Nevertheless, continuous follow-up for T. cruzi screening and treatment for post-delivery remains challenging. To improve access to healthcare and ensure the sustainability of the intervention, an intercultural approach that empowers the community, alongside efforts to strengthen the local health system, is recommended. |
| format | Article |
| id | doaj-art-e589b9400f9c43f3ba9888c093c527d1 |
| institution | Kabale University |
| issn | 2731-4553 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Primary Care |
| spelling | doaj-art-e589b9400f9c43f3ba9888c093c527d12024-12-22T12:39:00ZengBMCBMC Primary Care2731-45532024-12-0125111010.1186/s12875-024-02683-zBarriers and facilitators for preventing mother-to-child transmission of Trypanosoma cruzi and hepatitis B in the Gran Chaco region: a qualitative analysis using the consolidated framework for implementation research (CFIR)Yoshiko Takahashi0Susana Avila1Silvia Correa2Karina Cardone3Mariana Fernández4Favio Crudo5Miho Sato6Hirotsugu Aiga7Kenji Hirayama8Freddy Perez9Maria Victoria Periago10School of Tropical Medicine and Global Health, Nagasaki UniversityFundación Mundo SanoUniversidad Nacional de SaltaFundación Mundo SanoFundación Mundo SanoFundación Mundo SanoSchool of Tropical Medicine and Global Health, Nagasaki UniversitySchool of Tropical Medicine and Global Health, Nagasaki UniversitySchool of Tropical Medicine and Global Health, Nagasaki UniversityCommunicable Diseases Prevention, Control and Elimination Department, Pan American Health OrganizationFundación Mundo SanoAbstract Background Mother-to-child transmission (MTCT) of Trypanosoma cruzi and hepatitis B virus (HBV) increases morbidity and disability in Latin America and the Caribbean. The tailormade comprehensive antenatal care based on the Framework for the elimination of MTCT of HIV, syphilis, hepatitis B virus (HBV), and Chagas disease (EMTCT Plus) has been implemented in the region since 2018 through a private-public partnership. This study aimed to estimate the effectiveness of the intervention in preparing MTCT of T. cruzi and hepatitis B. The study further attempted to identify the barriers to and facilitators for preventing MTCT of T. cruzi and HBV in the Gran Chaco region of Argentina and Paraguay. Methods Data on T. cruzi and HBV screening and treatment among pregnant women and infants were collected from antenatal care (ANC) registries between June 2018 and December 2022. A cascade-of-care analysis was applied to assess the intervention’s effectiveness and identify bottlenecks. Additionally, key informant interviews were conducted for both implementors and service recipients to identify barriers to and facilitators for accessing screening and treatment using the Consolidated Framework for Implementation Research. Results A total of 1,658 pregnant women were recruited, achieving 100% antenatal care coverage and screening for T. cruzi and HBV. The prevalence of T. cruzi among pregnant women was 3.3% (95%CI: 2.4-4.1%), while in newborns it was 14.0% (95% CI: 6.0–25.0). Treatment coverage for newborns infected with T. cruzi was 100%, whereas post-delivery treatment coverage among mothers was 67.3%. This achievement was likely attributed to strong community engagement, contributing to 100% ANC coverage. However, barriers such as a fragile local health system, long-term follow-up requirements, high mobile populations, cultural beliefs, and social trauma were identified in target areas. Conclusion Implementing the EMTCT Plus Framework improved access to quality ANC in the study area. Nevertheless, continuous follow-up for T. cruzi screening and treatment for post-delivery remains challenging. To improve access to healthcare and ensure the sustainability of the intervention, an intercultural approach that empowers the community, alongside efforts to strengthen the local health system, is recommended.https://doi.org/10.1186/s12875-024-02683-zTrypanosoma cruziChagas diseaseHepatitis BMother-to-child transmissionGran ChacoPregnant women |
| spellingShingle | Yoshiko Takahashi Susana Avila Silvia Correa Karina Cardone Mariana Fernández Favio Crudo Miho Sato Hirotsugu Aiga Kenji Hirayama Freddy Perez Maria Victoria Periago Barriers and facilitators for preventing mother-to-child transmission of Trypanosoma cruzi and hepatitis B in the Gran Chaco region: a qualitative analysis using the consolidated framework for implementation research (CFIR) BMC Primary Care Trypanosoma cruzi Chagas disease Hepatitis B Mother-to-child transmission Gran Chaco Pregnant women |
| title | Barriers and facilitators for preventing mother-to-child transmission of Trypanosoma cruzi and hepatitis B in the Gran Chaco region: a qualitative analysis using the consolidated framework for implementation research (CFIR) |
| title_full | Barriers and facilitators for preventing mother-to-child transmission of Trypanosoma cruzi and hepatitis B in the Gran Chaco region: a qualitative analysis using the consolidated framework for implementation research (CFIR) |
| title_fullStr | Barriers and facilitators for preventing mother-to-child transmission of Trypanosoma cruzi and hepatitis B in the Gran Chaco region: a qualitative analysis using the consolidated framework for implementation research (CFIR) |
| title_full_unstemmed | Barriers and facilitators for preventing mother-to-child transmission of Trypanosoma cruzi and hepatitis B in the Gran Chaco region: a qualitative analysis using the consolidated framework for implementation research (CFIR) |
| title_short | Barriers and facilitators for preventing mother-to-child transmission of Trypanosoma cruzi and hepatitis B in the Gran Chaco region: a qualitative analysis using the consolidated framework for implementation research (CFIR) |
| title_sort | barriers and facilitators for preventing mother to child transmission of trypanosoma cruzi and hepatitis b in the gran chaco region a qualitative analysis using the consolidated framework for implementation research cfir |
| topic | Trypanosoma cruzi Chagas disease Hepatitis B Mother-to-child transmission Gran Chaco Pregnant women |
| url | https://doi.org/10.1186/s12875-024-02683-z |
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