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The WHO European Region has among the lowest rates of exclusive breastfeeding (EBF), with substantial variability across countries. In Italy, EBF rates remain below WHO targets, particularly in Southern regions. Several tools have been proposed to assess mothers' attitudes toward breastfeeding, although no gold standard has been established. This study aimed to explore mothers' attitudes toward breastfeeding using a questionnaire based on the Trans-Theoretical Model (TTM). An observational study was conducted in two Sicilian hospitals, where mothers were enrolled during postpartum hospitalization and interviewed using a structured questionnaire. The most frequently observed stage of change was action (39%, n&#x2009;=&#x2009;123/318), followed by contemplation (22%, n&#x2009;=&#x2009;70/318), pre-contemplation (21%, n&#x2009;=&#x2009;67/318), and determination (18%, n&#x2009;=&#x2009;58/318). A significant trend was observed across stages of change in relation to infant feeding patterns during hospitalization (p&#x2009;<&#x2009;0.0001), with higher stages showing a greater proportion of exclusive breastfeeding. The TTM-based approach may provide preliminary insights into mothers' attitudes toward breastfeeding, particularly in the pre-contemplation and contemplation stages of change. However, given the exploratory design, further studies are needed to refine the questionnaire and to assess its performance in longitudinal settings.

Patients with first-episode psychosis (FEP) frequently experience early metabolic alterations, including antipsychotic-induced weight gain (AIWG) and fasting glucose dysregulation. Birth weight (BW), a marker of the intrauterine environment and development, and its genetic proxy-the polygenic risk score for BW (PRSBW)-may influence these trajectories. This study investigated whether PRSBW and BW are associated with the progression of AIWG and fasting glucose levels over 24&#xa0;months in individuals with FEP. A total of 277 FEP patients with genetic, BW and longitudinal metabolic data were included. Linear mixed-effects models assessed associations of BW and the PRSBW with mean AIWG and glucose, as well as interactions with time. BW was analyzed both as a continuous variable and categorically (Lower/Higher vs. Intermediate BW). BW was significantly associated with mean AIWG across 24&#xa0;months (p=.009), with higher BW linked to greater AIWG. In contrast, neither BW nor the PRSBW were associated with mean fasting glucose levels. Significant time&#xd7;BW and time&#xd7;PRSBW interaction effects emerged for AIWG (p=2.2e-06 and p=4.6e-04, respectively), indicating steeper AIWG trajectories in individuals with higher BW or PRSBW. Our findings suggest that both BW and PRSBW influence the progression of AIWG in early stages of psychosis, reinforcing the role of early-life, both environmental and genetic, factors in shaping metabolic vulnerability. The consistent association between BW-related markers and AIWG highlights their potential value for early risk stratification and targeted prevention of adverse metabolic outcomes.

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The ethical conflicts involved in the medical indication of early serological diagnosis in Alzheimer's disease, for clinical contexts where a medical indication is required to perform the intervention, have been scarcely analyzed. The prescription of early serological diagnosis in Alzheimer's disease violates more principles than it supports. To carry out an analysis regarding the ethical conflicts associated with the indication of early serological diagnosis of Alzheimer's disease and to offer a clinical practice recommendation based on said analysis. Ethical analysis, in which the logical consequences of prescribing early serological diagnosis will be explained in terms of the ethical principles of autonomy, justice, beneficence and non-maleficence. The intervention presents marginal benefit in terms of autonomy and beneficence, while it violates the principles of beneficence, non-maleficence and justice. The intervention is not ethically recommended. This could change if its cost diminishes and if disease-modifying therapies with an adequate safety profile are developed.

To present the successful resolution of a type Ia endoleak in a patient previously treated with a fenestrated Anaconda endograft using a custom-made branched endograft. The limited working length and the retrograde orientation of the renal arteries due to caudal migration of the previous fenestrated endograft required a unique custom-made 5-branched graft configuration designed by COOK Medical (Bloomington, Indiana). This design featured 2 short (10-mm) retrograde branches for the renal arteries, along with an additional branch extending from the main body of the graft to accommodate the contralateral limb of the previous endograft. A .014&#x2033; wire was used as a stabilizing "pull-through wire" for the Fustar sheath, providing adequate stability for the challenging catheterization of the target vessels. Custom-made branched endovascular aneurysm repair after failed fenestrated Anaconda device is a feasible solution. Thorough planning and complex endovascular techniques may be necessary.Clinical ImpactThis technical report highlights the significant challenges associated with endovascular reintervention following failure of fenestrated endografts. Such reoperations often require customized grafts and advanced endovascular skills. Our experience demonstrates that with appropriate planning, branched endovascular repair (bEVAR) can be a feasible and effective solution for managing failed fenestrated endovascular aneurysm repair (fEVAR) apart from open conversion.

Pain is a common non-motor symptom in Parkinson's disease (PD) and is often associated to fluctuations. The OpiCapone Effect on motor fluctuations and pAiN (OCEAN) study evaluated the effect of opicapone on fluctuation-related pain when added to levodopa therapy in PD patients. Patients with PD with end-of-dose motor fluctuations and associated pain were randomized to opicapone 50&#x2009;mg or placebo for 24&#x2009;weeks. The primary end point was reduction from baseline to week 24 in the King's Parkinson's Disease Pain Scale (KPPS) domain 3. Reductions in KPPS and Movement Disorder Society-sponsored Non-Motor Rating Scale (MDS-NMS) total scores and safety/tolerability were also evaluated. A total of 122 patients were included (opicapone, n&#x2009;=&#x2009;59; placebo, n&#x2009;=&#x2009;63). Mean (standard deviation) change from baseline in KPPS domain 3 was -8.8 (6.9) points in the opicapone group versus -9.3 (6.2) points in the placebo group (P&#x2009;=&#x2009;0.7940). Opicapone resulted in numerically greater reductions versus placebo in KPPS and MDS-NMS total scores and was generally well tolerated. Opicapone did not reach statistical superiority over placebo, highlighting the complexities of studying pain in PD. &#xa9; 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Granular cell tumors of the neurohypophysis are rare, benign neoplasms originating from pituicytes that often pose diagnostic challenges due to their resemblance to other sellar lesions. We report the case of a 26-year-old man with a 2-year history of headache, polyuria, and hypopituitarism. Magnetic resonance imaging revealed a 21&#x2009;&#xd7;&#x2009;23&#xd7;30&#x2009;mm suprasellar mass compressing the optic chiasm and hypothalamus. Hormonal evaluation showed hypogonadotropic hypogonadism, central hypothyroidism, and arginine vasopressin deficiency. The patient underwent partial tumor resection. Histopathology confirmed a grade I granular cell tumor, positive for thyroid transcription factor 1, S100, and vimentin. Granular cell tumors are slow-growing lesions with nonspecific clinical and radiologic features. Diagnosis relies on histologic and immunohistochemical findings. Complete resection is often limited by tumor vascularity and proximity to vital structures. Granular cell tumors should be considered in the differential diagnosis of suprasellar tumors. Early recognition and multidisciplinary management may improve patient outcomes.

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BackgroundAlzheimer's disease is the leading cause of dementia and constitutes a major public health problem. Recent research suggests that certain chronic infections, particularly periodontal infections, may play a role in the development or progression of this disease. Among the bacteria involved in periodontal disease, Porphyromonas gingivalis has attracted particular attention from researchers.ObjectiveIn this way, the aim of this thesis, conducted in the form of a scoping review, was to analyze existing scientific data on the relationship between Porphyromonas gingivalis infection and Alzheimer's disease.MethodsTo achieve this, a literature search was conducted in several scientific databases leading to the selection of fourteen studies that met the inclusion criteria.ResultsSome of the selected studies have shown the presence of Porphyromonas gingivalis or its virulence factors in the brain tissues of patients with Alzheimer's disease. Experimental studies also indicate that this bacterium can promote certain mechanisms involved in neurodegeneration, namely inflammation and accumulation of amyloid-&#x3b2;.ConclusionsSelected studies point to the existence of an association between exposure to periodontal bacteria and an increased risk of developing Alzheimer's disease.

Infertility is a globally prevalent disease affecting approximately 1 in 6 people at some stage in their lives. Despite its profound personal significance, access to fertility care remains uneven, shaped by legal, financial, cultural and infrastructural barriers. While declining fertility rates have prompted some policymakers to frame medically assisted reproduction within demographic strategies, we argue that fertility care must be fundamentally understood as a matter of individual rights, reproductive autonomy and self&#x2011;fulfilment. International human rights instruments increasingly recognize equitable access to fertility treatment as a core component of reproductive health, yet country-level disparities in eligibility, public funding and available treatment options persist. These inequalities disproportionately affect marginalized groups, leading many to delay or abandon treatment or to seek cross&#x2011;border care. The fertility journey is further burdened by emotional strain, stigma, workplace challenges and financial and psychological uncertainty. Individuals who remain involuntarily childless after treatment may require long&#x2011;term psychosocial support, underscoring the need for patient&#x2011;centred, rights&#x2011;based policies that extend beyond medical intervention. Ensuring fair access to fertility care, improving outcome reporting and integrating psychological and social support are essential to addressing infertility as both a private struggle and a broader public health issue.

The recovery of ancient DNA (aDNA) from skeletal remains continues to be a critical challenge in forensic genetics and paleogenomics due to its high fragmentation, low quantity, and susceptibility to exogenous contamination. This study assessed the combined effect of four surface cleaning pretreatments (PT) and two automated extraction methods, AutoMate Express (AM) and EZ2 Connect Fx (EZ), on aDNA recovery from a pre-Hispanic individual dated to the Postclassic period (950-1521 CE). The pretreatments included chlorine (C), chlorine with ultraviolet irradiation (CUV), chlorine with bone fragment demineralization (CDB), chlorine with bone powder demineralization (CDP), and a non-treated control (NT). DNA quantity and quality were assessed using spectrophotometry, fluorometry, and quantitative PCR (qPCR), while genetic profiling was evaluated using autosomal short tandem repeat (A-STR) analysis and next-generation sequencing (NGS) of STR and SNP markers. The EZ method consistently generated higher DNA concentrations and greater amounts of amplifiable human DNA than the AM method across all pretreatments. However, differences in input mass limit direct comparisons (200&#x202f;mg for EZ vs. 80&#x202f;mg for AM); after normalization, EZ maintained a general performance advantage. STR analysis revealed more informative partial profiles with EZ, particularly under CDB and CUV pretreatments, while NGS results also favored EZ, showing improved locus recovery and higher read depth. Extraction methodology was the primary determinant of DNA recovery, with PT providing additional profiling. This study provides an optimized workflow for degraded human DNA, with direct relevance to forensic genetics and paleogenomics.

A large body of evidence indicates that cholinergic neurons in the brainstem tegmental nuclei play a pivotal role in controlling neurons of the reticular nucleus pontis oralis (PnO), an area considered executive for rapid eye movement (REM) sleep onset and maintenance. More recent data indicate that the PnO is also under GABAergic control -which gates REM sleep- thereby highlighting the importance of interactions between cholinergic and GABAergic processes as a key mechanism in REM sleep regulation. Here we employed a rat mesopontine slice preparation to investigate the modulation of GABAergic inputs to PnO neurons by cholinergic agents. Carbachol, a mixed muscarinic-nicotinic cholinergic agonist, provoked either depression or facilitation of single monosynaptic GABAergic IPSCs evoked by extracellular stimulation of the region of mesopontine tegmental nuclei. Both effects were presynaptic in origin and are likely attributable to the activation of distinct presynaptic cholinergic receptors as depression was replicated by muscarine (presynaptic inhibition) and facilitation by nicotine (presynaptic facilitation). Furthermore, IPSCs evoked by stimulation patterns mimicking physiological activity (short trains at 15 Hz) were also affected by cholinergic agonists. Muscarine caused presynaptic inhibition accompanied by frequency facilitation and nicotine promoted the opposite effect. Notably, both agonists converge toward reducing net inhibitory charge transfer during physiologically relevant patterns of presynaptic activity. This suggests a potential additional mechanism by which cholinergic modulation may relieve GABAergic inhibition of PnO neurons under physiological conditions, possibly contributing as a local component of the reciprocal inhibitory interactions between sleep-regulating networks in REM sleep brainstem executive areas.

In the current context of increasing production of biomedical studies, health professionals face significant challenges in remaining updated with the latest knowledge. Given this reality, literature reviews have emerged as vital tools to synthesize and organize existing knowledge in a coherent and accessible manner. Traditionally, narrative reviews have provided an initial approach to specific topics; however, these studies exhibit significant methodological limitations as they do not systematically describe the processes of identification, selection, and analysis of information. In contrast, systematic reviews adhere to explicit and rigorous methods that enable specific clinical questions to be answered with greater validity and reproducibility, thereby establishing a higher standard of evidence synthesis. The evidence synthesis ecosystem has experienced remarkable expansion in recent years, diversifying into multiple types of systematic reviews, each designed to address various research questions. The key to selecting the most suitable review lies in clearly defining the research question and the specific objective being pursued. The current trend indicates a shift from opinion studies -such as narrative reviews, which are primarily helpful for teaching clinicians and early career researchers- to systematically structured designs that address specific clinical questions and serve primarily for informed decision-making and the identification of research gaps. This article aims to provide key guidelines for selecting the most appropriate type of review according to the research question posed, as well as to describe the essential methodological aspects that should be considered during its development and reporting.

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Given that mobile health (mHealth) technology offers a feasible solution for early hearing loss (HL) screening, the purpose of this study was to determine the diagnostic accuracy and acceptability of an mHealth intervention for HL screening in people over 65 years old across four primary health care (PHC) centers. It was hypothesized that the mHealth app would have higher diagnostic accuracy compared with other index tests. Using a multicenter diagnostic accuracy comparative study design, 203 adults over 65 years old (Mdn = 72 years) were assessed using pure-tone audiometry as the reference-standard test, with mild (> 25 dB) and moderate (&#x2265; 40 dB) HL as cutoffs. Index tests included the following: mHealth hearing screening app, preventive medical examination assessment, diagnostic hearing assessments, and self-reported HL measures. Sensitivity, specificity, and area under the curve (AUC) values were estimated. Acceptability was determined using a validated Likert-type questionnaire. The results of the mHealth HL screening showed the highest sensitivity for mild (90.06%) and moderate (98.44%) HL. The AUC for the mHealth intervention was significantly higher (p < .001) for mild HL compared with all index tests, and it was significantly higher (p < .001) for moderate HL compared with the preventive medical examination assessment. Acceptability of the mHealth intervention was rated as highly acceptable by older adults and professionals. mHealth screening is a sensitive, user-friendly, and acceptable tool for HL screening in older adults. Integration within preventive medical examination programs is feasible and could enhance early HL detection and management within PHC contexts. https://doi.org/10.23641/asha.32536584.

Over the past decade, Chile has experienced a sustained decline in birth rates, along with a progressive increase in maternal age at the time of first pregnancy. This phenomenon reflects demographic and sociocultural dynamics with significant implications for health planning and public policy. An ecological study was conducted using aggregated data from the National Institute of Statistics (INE) for the period 2010-2022. Trends in overall birth rates and age-specific fertility rates were described, as well as changes in the relative contribution of each maternal age group to the total number of births. The number of births in Chile declined by 24.5% between 2010 and 2022. Fertility among women aged 15 to 24 showed a marked decrease, while the proportion of births among women aged 30 and over increased steadily. A progressive shift in the reproductive timeline toward older maternal age groups was observed. Chile is undergoing an advanced stage of demographic transition, characterized by delayed motherhood. This shift is associated with higher levels of female education, unequal labor conditions, and structural barriers to balancing work and caregiving. Public policies must adapt to this new scenario through a life-course approach that promotes equity and shared responsibility, strengthening both the prevention of adolescent pregnancy and support for later motherhood.

Sporotrichosis is a globally distributed subcutaneous mycosis caused by fungi of the Sporothrix complex, and is associated with worse outcomes in immunocompromised individuals, including those with diabetes mellitus. The impact of diabetes mellitus on the clinical presentation and outcomes of sporotrichosis remains poorly characterized. We conducted a systematic review of individual participant data to assess this association. Eight databases (Cochrane Library, Embase, LILACS, MEDLINE/PubMed, Scopus, Global Index Medicus/WHO, SciELO, and Web of Science) were searched without restrictions on publication date, country, language, sex, or age. The retrieved case data were divided into two groups: (1) localized disease and (2) systemic disease. We identified 122 cases of sporotrichosis in patients with diabetes mellitus from 64 articles and from 28 unpublished cases from Brazil and Mexico. Most patients were male (62.3%), with a mean age of 56.6 years, and 73% were from hyperendemic countries. Among cutaneous presentations, lymphocutaneous and fixed cutaneous forms were most frequent (41%), while osteoarticular multifocal disease was the leading extracutaneous manifestation (22.1%). Alcohol use disorder was independently associated with systemic disease (adjusted OR 4.76, 95% CI 1.45-18.05; P&#xa0;=&#xa0;.014). Compared with localized disease, systemic disease more commonly presented with joint symptoms (40.6% vs. 13.5%; P&#xa0;<&#xa0;.001), lesions with lower limb involvement (80% vs. 20%; P&#xa0;<&#xa0;.001), head involvement (81.3% vs. 18.8%; P&#xa0;<&#xa0;.001), and trunk involvement (84.6% vs. 15.4%; P&#xa0;<&#xa0;.001). Itraconazole monotherapy was the main treatment (45.9%), followed by amphotericin B-based regimens (33.6%). There were better outcomes for patients with localized disease than for those with systemic disease (cure rate 86.6% vs. 56.4%; P&#xa0;<&#xa0;.001). Systemic disease carried a 20% mortality rate in this population. These findings underscore the challenges posed by sporotrichosis in patients with diabetes mellitus and highlight the need for further research on risk factors for systemic disease and optimal treatment strategies for this population. Diabetes mellitus is associated with more severe sporotrichosis disease and outcomes. A review of 122 diabetic cases found systemic disease carried 20% mortality. Diabetes and alcohol use increased systemic risk 5-fold. Early diagnosis and tailored treatment are critical for diabetic population.

Acute intracranial stenting during endovascular thrombectomy (EVT) for ischemic stroke requires intraprocedural antiplatelet therapy (APT) to maintain patency. However, the hemorrhagic risk of combining APT with intravenous thrombolysis (IVT) remains uncertain. We evaluated the safety of IVT combined with conservative versus aggressive intraprocedural APT in patients requiring stenting during EVT. This multicenter RESISTANT registry subanalysis (2016-2023) included 823 adults. APT was categorized as conservative (aspirin +/- oral P2Y12) or aggressive (including GPIIb/IIIa inhibitors or cangrelor). The primary outcome was a composite of symptomatic intracranial hemorrhage (sICH) and parenchymal hematoma (PH1/PH2). Multivariable logistic regression assessed associations and interactions between IVT and APT. A total of 823 patients were included: 44 (5.3%) received IVT&#x2009;+&#x2009;conservative APT, 130 (15.8%) No IVT&#x2009;+&#x2009;conservative APT, 145 (17.6%) IVT&#x2009;+&#x2009;aggressive APT, and 504 (61.2%) No IVT&#x2009;+&#x2009;aggressive APT. Frequencies of sICH-PH1-PH2 were 9.3% with IVT&#x2009;+&#x2009;conservative APT, 10.7% with IVT&#x2009;+&#x2009;aggressive APT, 3.2% with No IVT&#x2009;+&#x2009;conservative APT, and 9.9% with No IVT&#x2009;+&#x2009;aggressive APT. In multivariable analysis without interaction terms, neither IVT (aOR 1.18, 95% CI 0.58-2.27; p&#x2009;=&#x2009;0.64) nor aggressive APT (aOR 2.10, 95% CI 0.92-5.69; p&#x2009;=&#x2009;0.10) was independently associated with increased risk of sICH-PH1-PH2. However, in the interaction model, IVT within the conservative-APT stratum (aOR 5.84, 95% CI 1.07-43.92; p&#x2009;=&#x2009;0.05) and aggressive APT within the no-IVT stratum (aOR 4.81, 95% CI 1.41-30.22; p&#x2009;=&#x2009;0.03) were each associated with higher odds of sICH-PH1-PH2, while the IVT-by-APT interaction term was <&#x2009;1 (aOR 0.15, 95% CI 0.02-0.94; p&#x2009;=&#x2009;0.05), indicating attenuation of the joint effect on the multiplicative odds scale. Among patients requiring intracranial stenting during EVT, we found no evidence that IVT and aggressive intraprocedural APT act synergistically to increase hemorrhagic risk. Rather, the negative IVT-by-APT interaction suggested attenuation of the joint effect on the multiplicative odds scale, although patients receiving both therapies remained at increased hemorrhagic risk relative to the reference group.

Chagas disease is a neglected tropical disease caused by the parasite Trypanosoma cruzi. It causes a significant health burden in the Americas, especially in Bolivia and Paraguay, where the disease is most endemic in the transnational Chaco region. Issues with data quality and availability prevent a true understanding of the current burden of disease, with missed opportunities for surveillance, resource allocation, and evaluation of interventions. This study aimed to explore routine Chagas disease data systems in Bolivia and Paraguay, focusing on data flow, barriers to data quality and reporting, and data sharing across health system levels, and to identify opportunities to strengthen surveillance and decision-making. A qualitative study was conducted between July-September 2024 in Bolivia and Paraguay. In-depth interviews were carried out with 43 key informants, with roles as healthcare workers, data managers, and technical advisors involved in Chagas Programs across different health system levels. A thematic analysis was conducted to develop a set of themes and recommendations related to data management practices. Four key themes emerged throughout interviews, with findings on data management practices, barriers to high quality routine data, data use, and cross-border data sharing. Key recommendations from participants to improve the overall Chagas disease data management systems in each country included strengthening digital infrastructure, promoting interoperability across systems, and fostering regional collaboration for cross-border data exchange. The study highlights critical gaps in routine data management for Chagas disease and underscores the importance of national-level solutions to support surveillance and control efforts. These findings offer concrete, actionable guidance for national health authorities and international stakeholders working to improve data systems for this neglected disease in endemic regions. This work was supported by the Fulbright U.S. Student Program; the Wellcome Trust [220211/Z/20/Z]; and ISGlobal (CEX2023-0001290-S, MCIN/AEI/10.13039/501100011033), with additional support from the Generalitat de Catalunya (CERCA Program). La enfermedad de Chagas es una enfermedad tropical desatendida causada por el par&#xe1;sito Trypanosoma cruzi. Representa una importante carga sanitaria en las Am&#xe9;ricas, especialmente en Bolivia y Paraguay, donde la enfermedad es m&#xe1;s end&#xe9;mica en la regi&#xf3;n transnacional del Chaco. Los problemas relacionados con la calidad y disponibilidad de los datos impiden una comprensi&#xf3;n real de la carga actual de la enfermedad, lo que limita las oportunidades para la vigilancia, la asignaci&#xf3;n de recursos y la evaluaci&#xf3;n de intervenciones. Se realiz&#xf3; un estudio cualitativo entre julio y septiembre de 2024 para comprender el flujo actual de los datos rutinarios de la enfermedad de Chagas desde el nivel local hasta el nivel nacional en Bolivia y Paraguay, e identificar las principales barreras para una gesti&#xf3;n de datos de calidad en cada pa&#xed;s. En total, se entrevist&#xf3; a 43 participantes en ambos pa&#xed;ses, incluyendo personal sanitario, gestores de datos y asesores t&#xe9;cnicos de los programas de Chagas. Los datos de las entrevistas se analizaron mediante un an&#xe1;lisis tem&#xe1;tico para desarrollar un conjunto de temas y recomendaciones. Se identificaron cuatro temas clave a partir de las entrevistas, relacionados con las pr&#xe1;cticas de gesti&#xf3;n de datos, las barreras para obtener datos rutinarios de alta calidad, el uso de los datos y el intercambio transfronterizo de informaci&#xf3;n. Las principales recomendaciones de los participantes para mejorar los sistemas de gesti&#xf3;n de datos de la enfermedad de Chagas incluyeron el fortalecimiento de la infraestructura digital, la promoci&#xf3;n de la interoperabilidad entre sistemas y el fomento de la colaboraci&#xf3;n regional para el intercambio de datos entre pa&#xed;ses. El estudio pone de manifiesto brechas cr&#xed;ticas en la gesti&#xf3;n de datos rutinarios sobre la enfermedad de Chagas y destaca la importancia de soluciones a nivel nacional para apoyar los esfuerzos de vigilancia y control. Estos hallazgos ofrecen orientaciones concretas y aplicables para las autoridades sanitarias nacionales y los actores internacionales que trabajan para mejorar los sistemas de datos de esta enfermedad desatendida en regiones end&#xe9;micas. Este trabajo fue financiado por el programa Fulbright U.S. Student; el Wellcome Trust [220211/Z/20/Z]; e ISGlobal (CEX2023-0001290-S, MCIN/AEI/10.13039/501100011033), con apoyo adicional de la Generalitat de Catalunya (Programa CERCA). Con el prop&#xf3;sito de acceso abierto, el autor ha aplicado una licencia p&#xfa;blica CC BY a cualquier versi&#xf3;n del manuscrito aceptado derivada de esta presentaci&#xf3;n. A doen&#xe7;a de Chagas &#xe9; uma doen&#xe7;a tropical negligenciada causada pelo parasita Trypanosoma cruzi. Representa uma importante carga de doen&#xe7;a nas Am&#xe9;ricas, especialmente na Bol&#xed;via e no Paraguai, onde a doen&#xe7;a &#xe9; mais end&#xea;mica na regi&#xe3;o transnacional do Chaco. Problemas relacionados &#xe0; qualidade e disponibilidade dos dados dificultam uma estimativa precisa da carga atual da doen&#xe7;a, limitando oportunidades para vigil&#xe2;ncia, aloca&#xe7;&#xe3;o de recursos e avalia&#xe7;&#xe3;o de interven&#xe7;&#xf5;es. Foi realizado um estudo qualitativo entre julho e setembro de 2024 para compreender o fluxo atual dos dados rotineiros da doen&#xe7;a de Chagas desde o n&#xed;vel local at&#xe9; o n&#xed;vel nacional na Bol&#xed;via e no Paraguai, e identificar as principais barreiras para uma gest&#xe3;o de dados de qualidade em cada pa&#xed;s. Foram entrevistados, 43 participantes nos dois pa&#xed;ses, incluindo profissionais de sa&#xfa;de, gestores de dados e assessores t&#xe9;cnicos dos programas de Chagas. Os dados das entrevistas foram analisados por meio de an&#xe1;lise tem&#xe1;tica para desenvolver um conjunto de temas e recomenda&#xe7;&#xf5;es. Quatro temas principais emergiram das entrevistas, relacionados &#xe0;s pr&#xe1;ticas de gest&#xe3;o de dados, barreiras &#xe0; obten&#xe7;&#xe3;o de dados rotineiros de alta qualidade, uso dos dados e compartilhamento transfronteiri&#xe7;o de informa&#xe7;&#xf5;es. As principais recomenda&#xe7;&#xf5;es dos participantes para melhorar os sistemas de gest&#xe3;o de dados da doen&#xe7;a de Chagas inclu&#xed;ram o fortalecimento da infraestrutura digital, a promo&#xe7;&#xe3;o da interoperabilidade entre sistemas e o incentivo &#xe0; colabora&#xe7;&#xe3;o regional para o interc&#xe2;mbio de dados entre pa&#xed;ses. O estudo destaca lacunas cr&#xed;ticas na gest&#xe3;o de dados rotineiros sobre a doen&#xe7;a de Chagas e ressalta a import&#xe2;ncia de solu&#xe7;&#xf5;es em n&#xed;vel nacional para apoiar esfor&#xe7;os de vigil&#xe2;ncia e controle. Esses achados oferecem orienta&#xe7;&#xf5;es concretas e aplic&#xe1;veis para autoridades de sa&#xfa;de nacionais e atores internacionais que trabalham para melhorar os sistemas de dados dessa doen&#xe7;a negligenciada em regi&#xf5;es end&#xea;micas. Este trabalho foi financiado pelo programa Fulbright U.S. Student; pelo Wellcome Trust [220211/Z/20/Z]; e pelo ISGlobal (CEX2023-0001290-S, MCIN/AEI/10.13039/501100011033), com apoio adicional da Generalitat de Catalunya (Programa CERCA). Para fins de acesso aberto, o autor aplicou uma licen&#xe7;a p&#xfa;blica CC BY a qualquer vers&#xe3;o do manuscrito aceito resultante desta submiss&#xe3;o.