Table 1.

Strategy for Non-Endemic Countries

1. Estimation of the approximate population at risk, taken from

● Official sources, if country of origin or “Latin American” is available  ● Unofficial sources (contact Latin American groups and associations, social media, country-specific diplomatic representatives like Embassies and Consulates, research studies, immigration data)

2. Estimation of case burden

● From local/national case reports/series/laboratory data and informal communication within networks

3. Establish a collaborative network with

● Health professionals across primary and secondary care involved in patients’ diagnostic, referral pathways or treatment of condition or complications (eg, cardiology, gastroenterology specialists) ● Involvement of primary care and antenatal care professionals (main point of contacts of the population at risk) ● Researchers ● Patients and public, to offer peer-support and establish connections with local communities

4. Identify potential collaborations within the Latin American communities

● Contact with influent, community-based groups who can help to increase awareness, identify opportunities to roll out patient-centered, community-based screening campaigns and disseminate information and materials (eg, music, community, sports events, virtual/on-line gatherings) ● Explore preferred means of communication of the local Latin American communities as they may differ from those of the country (radio, local newspapers, text/rapid messaging groups, etc)

5. Define priorities

● DIAGNOSTIC PATHWAY Can primary and secondary care health care providers easily request T. cruzi serology? – if not, review and optimise the pathway/set up a pathway if it does not exist: the test should be easy to request from primary care and antenatal clinics, “with a click”, without having to fill complicated referral forms or call the laboratory. ● REFERRAL AND MANAGEMENT PATHWAY oSet up a centralised referral clinic for evaluation and management of patients oWrite up guidance for referral/management, identify secondary care specialists for referrals ● SCREENING oAre blood donors screened? – contact blood and tissue banks oAre women in child-bearing age/pregnant women screened? – contact antenatal clinics oAre immunosuppressed patients screened? – contact transplant, HIV, oncology specialists

6.Educate, train, communicate, increase awareness, advocate

● Organise awareness/information campaigns – target primary, antenatal care and patients and public  ● Produce data at a local and national level, use data to influence policymakers