Title

Chronic Chagas' disease in northeast Brazil: An anthropological study

Date of Completion

January 1997

Keywords

Anthropology, Cultural|Anthropology, Physical|Health Sciences, Public Health

Degree

Ph.D.

Abstract

The purpose of this research was to explore people's experience of chronic Chagas' disease, in order both to draw the attention of medical workers and public policy makers to the sufferers of this disease, as well as to discover essential aspects of the overall process of adjusting to it.^ Recent estimates show that Chagas' disease affects around 90 million people throughout Latin America. A parasitic infection by Trypanosoma cruzi, the circumstances of natural transmission via Reduviid insects (kissing bugs) make this a disease most frequently seen among the rural poor. This distribution is shifting as a result of contaminated blood in blood banks throughout North and South America, and as urban in-migrants unwittingly transport vectors in their belongings.^ Chagas' disease typically appears as an acute infection shortly after transmission followed by a lengthy asymptomatic latent period of 10-20 years or more, with the final chronic debilitating onset of congestive cardiac insufficiency, characteristic arrhythmias, and/or digestive complications.^ The results of 43 structured interviews were content analyzed to discover domains of knowledge and experience characterizing the subjects' experience of this illness. Five principal areas of impact were identified: physical status, employment, financial/economic circumstances, social interaction, and existential matters.^ The consequences of Chagas' disease are best understood in terms of the threat they pose to particular cultural values identified in the study: (1) maintaining meaningful roles, (2) an ordered life, (3) resisting a stigmatizing label, and (4) avoiding perceived morbidity and mortality. Successfully adjusting to this chronic condition requires resolving these threats; subjects' tentative mechanisms to do so are discussed. The need to resolve the threat to cultural values may apply to the process of adjusting to any chronic illness.^ Finally, recommendations are made for patient/physician interactions in order to facilitate the adjustment process. Several recommendations for public policy changes will minimize the distress of this disease. ^