Hi everyone. My name is Chan and I'm a current M2 student at the Nova Southeastern University College of Osteopathic Medicine. Today I'm going to be presenting our team's ongoing research on Chagas disease. As listed by the World Health Organization as a neglected tropical disease, Chagas disease is a vector-borne disease caused by the parasite trypanosoma cruzi. By the CDC, it is estimated that Florida alone may have over 18,000 estimated individuals living with Chagas disease, and this is mainly due to immigration such as travel from Chagas disease endemic areas. The state is also home to various epidemiological factors such as the vector, as you can see here in figure one, the parasite seen in figure two, as well as certain reservoir species such as raccoons and opossums, increasing the potential transmission risk of Chagas disease in the area, making it a possible public health concern. Overall, there have not been any focused survey studies conducted in Florida or South Florida among healthcare professionals or specialties of interest where patients may present with these classical clinical findings of Chagas disease. So for this pilot study, we aim to develop the awareness of Chagas disease among these healthcare professionals and specialties. To understand more about this parasite, we focus on Southern Florida as we hypothesize it would be a good place to conduct more research on Chagas disease due to the presence of the high-risk immigrant population from Chagas disease endemic countries, as was the potential for other epidemiological factors of Chagas disease. So for our methods, we created a 25-question knowledge, attitudes, and practices survey, which we sent to over 2,000 healthcare professionals across various specialties, and we focused on specialties such as family medicine, internal medicine, infectious disease, and cardiology among the few, which we believe are where patients have the more potential likelihood of presenting with these classical symptoms of Chagas disease. And as seen in figure three, these are the counties that we focused on, and we utilized, as you can see in figure four, the publicly available practitioner profile database from the Florida Department of Health to retrieve these emails of these healthcare professionals by county and specialty. We used the REDCap database to ensure the safety and non-amidity of our survey respondents. So overall, we've actually gotten 66 responses across our demographics, and this is mainly from 64 physicians, but we've also gotten a respond from one resident as well as one nurse practitioner. And as you can see in the table under demographics, we've gotten responses from quite a few of specialties, and this is about 24 subspecialties across family medicine, infectious disease, pediatrics, cardiology, and internal medicine, showing that there is a broad interest in this pathogen across these various specialties. Looking at some other demographics, we also have gotten respondents majority from urban settings as well as private areas, but we have also very interestingly gotten respondents from suburban as well as rural areas, as well as those that practice in academic centers or community hospitals or clinics, showing that there is a broad or could be broad differences in Chagas disease knowledge and attitudes across these various healthcare professions. Overall, looking at knowledge, a majority of our respondents are actually completely unable to identify the modes and transmission of Chagas disease, and the one that we've seen is the most commonly missed is actually the oral transmission of Chagas disease, and this is the oral ingestion of the parasite, such as the parasite or the feces of the kissing bug vector, which can be on food products or other surfaces. Overall, six questions asked about the causative agent identification of the vector, as well as the endemic world regions of Chagas disease, as well as the common Chagas disease symptoms. Interestingly, as you can see in this figure below knowledge, a majority do show that reduvid bugs are the common vector, but many still believe that sand flies, mosquitoes, or even ticks are vectors of Chagas disease, showing a knowledge gap of this disease. Looking at attitudes, many of our respondents actually believe that Chagas disease is underdiagnosed in our area, or that more training of Chagas disease is needed in the state, and that's about 90% believe that more training is needed in Chagas disease in our state, and that's a very important finding, as it shows that more awareness and training can be beneficial in our area, and interestingly, even 50% believe that the process required to confirm a diagnosis, or even that assessing screening and treatment is actually a barrier for their patient population, indicating that certain health disparities do exist on Chagas disease in our area. A very interesting finding is in our practices. We show that actually specialists within family medicine, pediatrics, cardiology, as well as infectious disease have even confirmed the diagnosis of Chagas disease in their practice, and indicating that the disease is actually present in our area, and this shows, you know, the limited awareness, but also that many respondents don't feel very confident in their Chagas disease practices, indicating future steps for this education, and our pilot study, we do believe, we hope we are increasing awareness, but also management of Chagas disease. We want to try to inform future steps for research, for cross-sector collaborations, education, community outreach, and training across healthcare professionals and students on this neglected tropical disease. I think our study does affirm the category of Chagas disease as a neglected tropical disease in, or across the world, but in our region, and we hope that we can, you know, partner with the Florida Department of Health to increase more outreach to students, or even doctors who go to these Chagas disease in the big areas, or who are more likely to treat patients with Chagas disease. This project can also be conducted in various regions of Florida, even across different states where Chagas disease may be present in their patient population. Lastly, we could also connect this to osteopathic principles. Of course, more study is needed, but hopefully processes as lymphatic drainage, myofascial release, mesentric lift, thoracic inlet release, could help eradicate the pathogen, or limit its potential spread. And overall, thank you for listening to our project. We hope that we increase awareness. If you are part of South Florida, or practicing in South Florida as a physician, please join our studies in the link below, or use the references here as well for you to look at. Thank you so much.

Chagas disease

Trypanosoma cruzi

healthcare awareness

South Florida

medical training