AUTHOR=Juan Jimenez Cristina , Arsuaga Vicente Marta , Santamaría Seijas María , Lago Nuñez Mar , Díaz Menéndez Marta , de Miguel Buckley Rosa , de la Calle-Prieto Fernando , Ayuso_Alvarez Ana M. , Gold Marina 

TITLE=“A guardian angel that just appeared”: the impact of a community health worker in supporting treatment adherence and follow-up for Chagas disease patients

JOURNAL=Frontiers in Tropical Diseases

VOLUME=Volume 6 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/tropical-diseases/articles/10.3389/fitd.2025.1632961

DOI=10.3389/fitd.2025.1632961

ISSN=2673-7515

ABSTRACT=BackgroundLatin American migrants living with Chagas disease (CD) face significant healthcare challenges, including limited awareness of the disease among primary care providers and patients, undocumented status, and inflexible working conditions that hinder timely diagnosis and treatment. This study evaluates the impact of community health worker (CHW) interventions on CD patients in a hospital in Madrid and identifies key barriers within the public healthcare system.MethodsThis phenomenological study (October 2021–February 2025) involved 13 patients supported by a CHW, six unsupported patients, nine health workers, and one CHA.ResultsMost patients were Bolivian women over 41 years old working in the service and domestic roles. Health workers and the CHW had over 10 years of experience with CD. Most were diagnosed in Spain, with at least 10 individuals reporting cardiac symptoms. However, none had Chagas cardiomyopathy. They usually present with the indeterminate form, which corresponds to the chronic phase of CD. Patients had limited CD knowledge, but they generally adhered well to treatment when indicated. Key findings included misdiagnosis and lack of awareness among primary healthcare workers, leading to referrals to tropical medicine units. Barriers were administrative, geographical, work-related, financial, and cultural. The CHW improved adherence and follow-up through culturally tailored interventions. Recommendations included enhancing primary care knowledge, improving referral pathways, better integrating the CHW, and establishing a patient association in Madrid for education and support.ConclusionsCD remains a major health issue among Latin American migrants or descendants of mothers from endemic areas, who face many obstacles in diagnosis and treatment. CHWs are key to improving treatment adherence, but their integration into the healthcare system is still ongoing. Addressing socioeconomic and cultural barriers requires collaboration, ongoing education, and stronger support networks for primary health workers and patients.