Physician Awareness of Chagas Disease, USA

To the Editor: The year 2009 was the 100th anniversary of Carlos Cha-gas's discovery of the disease caused by the parasite Trypanosoma cruzi, now known as Chagas disease. Spread by infected bugs called triatomines, the disease is endemic throughout much of Mexico and Central and South Ameri-ca. An estimated 8–11 million persons in Latin America have the disease (1). T. cruzi infection causes more public health problems with long-term consequences in Latin America than any other parasitic disease (2). Although earlier estimates suggested that 100,000 infected persons may live in the United States (3), recent data suggest that ≈300,000 persons are infected (4). Most of these persons are unaware that they are infected. Anti-parasitic drugs to treat Chagas disease have not been approved by the US Food and Drug Administration and are only available in the United States through the Centers for Disease Control and Prevention (CDC) for use under investigational protocols for compassionate treatment. Screening of the US blood supply for Chagas disease began in early 2007; more than 500 donors with T. cruzi infection were identifi ed within the fi rst 18 months (5). However, to date, only ≈11% of T. cruzi–positive donors (or their physicians) have contacted CDC for treatment consultations (CDC, un-pub. data). One possible explanation is the limited awareness of Chagas disease in the United States among health professionals, the general public, and even among Mexican-born Americans To assess healthcare provider awareness of Chagas disease, a study was conducted by MedscapeCME (www.medscape.com) with technical support from CDC. MedscapeCME, a leading provider of online clinical and medical information and continuing medical education (CME) for physicians and other healthcare professionals , carried out a knowledge, attitudes, and practices (KAP) assessment of physician members of its website. Researchers anticipated that the results of the study would inform larger formal studies among healthcare providers in geographic areas where population demographics and blood donor screening results suggest that persons are at risk for Chagas disease. The KAP study was based on fi ve 10-question surveys, which were posted on the MedscapeCME website. Each survey was tailored for a specifi c specialty: primary care, infectious disease, cardiology, obstetrics/gyne-cology, and transplantation medicine; they were designed to measure basic knowledge of Chagas disease epidemiology and consideration of Chagas disease risk among these physicians. MedscapeCME members were given the option of participating in the surveys when they logged onto each specialty site. MedscapeCME membership …