title: Short report: Increasing access to treatment for Chagas disease: the case of Morelos, Mexico.
abstract: Chagas disease is a neglected vector-borne disease with an estimated prevalence of 1.1 million cases in Mexico. Recent research showed that access to treatment of Chagas disease is limited in Mexico, with < 0.5% of infected cases treated. This brief report used quantitative data from the Morelos Program on Chagas disease and qualitative analysis of key informant interviews to examine strategies to increase treatment access for infected patients in Morelos, Mexico. From 2007 to 2011, 263 (9.2%) of the registered cases of Chagas disease in Mexico occurred in Morelos. Among these, 152 (57.8%) were treated and 97.3% of those treated received benznidazole. The assessment finds that state officials decided to directly purchase benznidazole from the distributor to increase access and improve clinical quality of treatment of patients in their state. They also faced significant barriers, especially in regulation and health system organization, which limited efforts to make high quality treatment available.
authors.affiliation: Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; Regional Center for Public Health Research, National Institute for Public Health, Tapachula, Mexico; State of Morelos Secretary of Health, Program on Chagas Disease, Cuernavaca, Mexico; Center for Global Health and Development, Boston University, Boston, Massachusetts; Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts jmanne@post.harvard.edu.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Manne-Goehler
authors.affiliation: Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; Regional Center for Public Health Research, National Institute for Public Health, Tapachula, Mexico; State of Morelos Secretary of Health, Program on Chagas Disease, Cuernavaca, Mexico; Center for Global Health and Development, Boston University, Boston, Massachusetts; Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts.
authors.forename: Janine M
authors.initials: JM
authors.lastname: Ramsey
authors.affiliation: Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; Regional Center for Public Health Research, National Institute for Public Health, Tapachula, Mexico; State of Morelos Secretary of Health, Program on Chagas Disease, Cuernavaca, Mexico; Center for Global Health and Development, Boston University, Boston, Massachusetts; Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts.
authors.forename: Marco Ocampo
authors.initials: MO
authors.lastname: Salgado
authors.affiliation: Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; Regional Center for Public Health Research, National Institute for Public Health, Tapachula, Mexico; State of Morelos Secretary of Health, Program on Chagas Disease, Cuernavaca, Mexico; Center for Global Health and Development, Boston University, Boston, Massachusetts; Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts.
authors.forename: Veronika J
authors.initials: VJ
authors.lastname: Wirtz
authors.affiliation: Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; Regional Center for Public Health Research, National Institute for Public Health, Tapachula, Mexico; State of Morelos Secretary of Health, Program on Chagas Disease, Cuernavaca, Mexico; Center for Global Health and Development, Boston University, Boston, Massachusetts; Department of Global Health and Population, Harvard School of Public Health, Boston, Massachusetts.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Reich
mesh_terms: D014355:Chagas Disease / Q000188:drug therapy* / Q000453:epidemiology; D006297:Health Services Accessibility; D006801:Humans; D008800:Mexico / Q000453:epidemiology; D009593:Nitroimidazoles / Q000627:therapeutic use; D014344:Trypanocidal Agents / Q000627:therapeutic use
chemical_list: D009593:Nitroimidazoles; D014344:Trypanocidal Agents; C009999:benzonidazole