Article type
Abstract
Background: Chagas disease is an infectious disease caused by the protozoan parasite Trypanossoma cruzi. It is estimated that 8 million people are chronically infected worldwide, especially in Latin America. However, its prevalence has increased outside endemic areas, such as USA and Europe, due to migration. Thirty to forty per cent of chronically infected patients develop Chagas cardiomyopathy or gastrointestinal disease, with clinical manifestations including heart failure and megaesophagus.
Objectives: To present the recommendations of the Brazilian guideline for diagnosis and treatment of Chagas disease.
Methods: The guideline development process followed the Guidelines International Network (G-I-N) and Institute of Medicine (IOM) standards and the G-I-N – McMaster Guideline Development Checklist. The guideline aimed to provide recommendations for diagnosis and treatment of Chagas disease, as requested by the Brazilian Ministry of Health. No high-quality guideline was available for adaptation or adoption. The scoping meeting was held in August 2016, with 15 panel members, including infection disease specialists, cardiologists, gastroenterologists, primary care physicians, biochemical, policy makers, health economists and patient representatives. No financial conflict of interest was reported by panel members. Seventeen clinical questions were defined for both acute and chronic phases, including special populations, such as pregnant women and immunosuppressed patients. An independent group of methodologists is responsible for evidence search and synthesis, including decision tree models for diagnostic tests.
Results: Evidence synthesis is currently in progress and the second guideline panel meeting will occur on March 2017. Results will be available for the Summit.
Conclusions: No high-quality evidence-based guideline for Chagas disease is available. This will be the first guideline for Chagas disease using the G-I-N and IOM standards. Although it has been developed for the Brazilian context, this guideline may be adopted by or adapted to other countries.
Objectives: To present the recommendations of the Brazilian guideline for diagnosis and treatment of Chagas disease.
Methods: The guideline development process followed the Guidelines International Network (G-I-N) and Institute of Medicine (IOM) standards and the G-I-N – McMaster Guideline Development Checklist. The guideline aimed to provide recommendations for diagnosis and treatment of Chagas disease, as requested by the Brazilian Ministry of Health. No high-quality guideline was available for adaptation or adoption. The scoping meeting was held in August 2016, with 15 panel members, including infection disease specialists, cardiologists, gastroenterologists, primary care physicians, biochemical, policy makers, health economists and patient representatives. No financial conflict of interest was reported by panel members. Seventeen clinical questions were defined for both acute and chronic phases, including special populations, such as pregnant women and immunosuppressed patients. An independent group of methodologists is responsible for evidence search and synthesis, including decision tree models for diagnostic tests.
Results: Evidence synthesis is currently in progress and the second guideline panel meeting will occur on March 2017. Results will be available for the Summit.
Conclusions: No high-quality evidence-based guideline for Chagas disease is available. This will be the first guideline for Chagas disease using the G-I-N and IOM standards. Although it has been developed for the Brazilian context, this guideline may be adopted by or adapted to other countries.