Healthcare professionals and students awareness of Chagas disease: design and validation of ChaLKS (Chagas Level of Knowledge Scale)

Abstract

BackgroundThere are few studies evaluating awareness of Chagas disease among healthcare professionals attending migrants from Latin America or working in Chagas-endemic areas. The objective of this study was to design and validate instruments for assessing knowledge about Chagas disease among healthcare students and residents as well as students and professionals of social and other health science disciplines.\n\nPrincipal findingsTwo validated scales were obtained: the 10-item Chagas Level of Knowledge Scale for healthcare professionals (ChaLKS-Medical) and the 8-item ChaLKS-Social&Health for potential aid workers from those fields. Both scales were considered adequate in terms of readability, internal consistency, construct validity and discriminant validity.\n\nThe mean number of correct answers on the ChaLKS-Medical among respondents from non-healthcare versus healthcare sectors was 1.80 (standard deviation [SD] 2.55) versus 7.00 (SD 2.32) (p<0.001). The scores on the ChaLKS-Social&Health also discriminated between the knowledge levels in these two groups (1.76 [SD 2.47] versus 6.78 [SD 1.55], p<0.001). Knowledge among medical/pharmacy students and residents on the ChaLKS-Medical was acceptable (mean 5.8 [SD 2.1] and 7.4 [SD 2.2], respectively; p<0.001). Respondents knowledge on Chagas disease was greater in those who had previously received information on the disease; this was true in both respondents from the healthcare sector (mean correct answers, ChaLKS-Medical: 7.2 [SD 2.1] versus 4.3 [2.6], p<0.001) and in potential aid workers (mean correct answers, ChaLKS-Social&Health: 5.1 [SD 2.5] versus 1.1 [SD 1.9], p=0.001).\n\nConclusionsThe metric properties of both scales are adequate for their use in supporting aid operations in Chagas-endemic countries or in providing health and social care to migrant populations in non-endemic countries. The results of these scales also provide orientation regarding the knowledge gaps to be filled in future health professionals training programs.\n\nAuthor summaryChagas disease is endemic to much of Latin America, but it is still largely unrecognized in Europe, in part because of the lack of professional training in tropical medicine and global health among healthcare professionals. Few studies have evaluated awareness of Chagas disease among healthcare professionals and medical students, and to our knowledge none have done so in aid workers or volunteers working with Latin American populations. The aim of our study was to design and validate instruments for assessing knowledge about Chagas disease among healthcare students and professionals as well as potential aid workers. Two validated scales were obtained: the Chagas Level of Knowledge Scale for healthcare professionals (ChaLKS-Medical) and the ChaLKS-Social&Health for potential aid workers in social and other health fields. The two scales could be especially useful to reinforce training on Chagas disease among medical students and health and social aid workers working in Chagas-endemic regions or with migrants from those countries, regardless of whether their mission is related to Chagas or not. Moreover, this could reinforce the cross-cutting nature of programs in areas endemic to Chagas and other neglected tropical diseases.