Advancing Lab Equity in Latin America

Sept. 20, 2024

Latin America is significantly affected by vector-borne diseases, which can cause a range of symptoms that may escalate to life-threatening conditions.
Latin America is significantly affected by vector-borne diseases, which can cause a range of symptoms that may escalate to life-threatening conditions.
Source: Wikimedia Commons
Latin America faces high rates of vector-borne diseases, including dengue, Zika virus disease, chikungunya, Chagas disease and Oropouche virus disease. According to the World Health Organization (WHO), the Latin American region faces such high risk because large numbers of vector mosquitoes are contributing to the spread of viruses into areas where people might not have preexisting immunity or recognize the clinical presentations of the associated diseases. Ongoing disease outbreaks highlight the need to strengthen epidemiological and entomological surveillance and to reinforce preventive measures in all populations. However, in many countries and areas within Latin America access to quality-assured laboratory diagnostics remains limited, leading to delays or inaccuracies in diagnosis and treatment with severe public health consequences. Access to reliable laboratory diagnostics and medicine is essential for effective disease detection, surveillance, control and management, creating an urgent need to address gaps in lab equity in this region and improve overall public health outcomes. 

The Recent Rise of Vector-Borne Diseases 

Latin America is significantly affected by vector-borne diseases, which can cause a range of symptoms that may escalate to life-threatening conditions. Dengue fever, known for its flu-like symptoms, can progress to severe dengue, a potentially fatal complication. To date in 2024, over 11 million cases and 5,000 dengue-related deaths have been reported in the Pan American Health Organization (PAHO) region. This represents an increase of 230% compared to the same period in 2023. 

In Latin America, Chagas disease shows an annual incidence of 30,000 new cases on average, resulting in 12,000 deaths per year, with approximately 9,000 newborns becoming infected during gestation. It is estimated that around 70 million people in Latin America live in areas of exposure and are at risk of contracting this disease. 

In 2024, reports of a febrile disease called Oropouche virus disease increased in Latin America, including areas with no previously recognized history of the disease. Common symptoms include fever and severe headache, with some people developing more serious symptoms. Between Jan. 1 and July 20, 2024, a total of 8,078 confirmed Oropouche cases, including 2 deaths, were reported across Bolivia, Brazil, Colombia, Cuba and Peru.  

Barriers to Lab Equity 

The collective burden of these vector-borne diseases in Latin American countries is high, yet regional equity deficits, including language gaps, distribution delays, socioeconomic disparities and epidemiological factors, continue to limit reliable access to laboratory medicine that will mitigate the spread of disease. Identifying and addressing these gaps is the first step toward eliminating barriers to equitable health care in this region (and around the world).  

Language Gaps

Non-Spanish speaking populations and individuals often face language barriers when accessing laboratory and treatment services in Latin American countries. This issue is particularly pronounced among indigenous populations in Latin America, many of whom speak languages other than Spanish, including Quechua, Aymara and Mayan. While 560 indigenous languages are spoken throughout Latin America, the lack of health workers proficient in indigenous languages compromises the quality of services provided to these communities. Similarly, when traveling to non-Spanish speaking nations, language barriers impact the diagnosis and treatment of diseases for Spanish-speaking travelers. Linguistic gaps impact health care delivery, resulting in poorer health outcomes.  

Distribution Delays

Triatoma dimidiata, an important vector of Trypanosoma cruzi, the protozoa that causes Chagas disease.
Triatoma dimidiata, an important vector of Trypanosoma cruzi, the protozoa that causes Chagas disease.
Source: Wikimedia Commons
Many diseases endemic in Latin America, such as chikungunya, are not as prevalent in other geographic locations. Consequently, when travelers from Latin American countries present symptoms in non-endemic regions, accurate and timely diagnostics are often unavailable. For example, in the U.S., testing for Chagas disease, Zika virus disease and dengue often require sending samples to reference or public health laboratories for analysis, resulting in delayed receipt of results. This lack of diagnostic capability negatively impacts treatment rates and may contribute to the spread of diseases.

Socioeconomic Disparities

Laboratories rely on the ability to accurately identify and diagnose diseases and medical conditions (i.e., diagnostic capability), yet many countries in Latin America experience pronounced socioeconomic disparities, which are reflected in their health care systems. Persisting gaps in preventive measures result from limited resources. Laboratories struggle to perform essential tests due to outdated or insufficient resources and trained staff. This can lead to delays in diagnosis and treatment. Not only do socioeconomic disparities impede timely and accurate diagnosis of infectious diseases, but they also hinder effective surveillance outcomes.  

Impacts to Diagnostics and Surveillance

Vector surveillance and control depend on accurate diagnostic data provided by well-equipped labs, and any limitations to accurate data collection, analysis or reporting on the prevalence, transmission and outcomes of vector-borne infections will prevent health authorities from proactively responding to and preventing outbreaks, leaving communities vulnerable.  

Monitoring and surveillance are challenging due to language barriers, geographic dispersion and socioeconomic disparities. Poor surveillance leads to long-term health impacts, including the sustained presence of preventable diseases, which affect the quality of life and economic stability of affected communities. How can these limitations be addressed to improve diagnostic capabilities and overall public health outcomes across Latin America? 

Opportunities 

Fostering lab equity in Latin America requires collaborative and engaged approaches. For example, as travel plays a crucial role in the spread of infectious diseases, educating travelers and local populations about disease prevention and the importance of health screenings can mitigate this spread. Implementing comprehensive strategies, such as vaccination campaigns, prevention strategies (e.g., bed netting to prevent mosquitoes and other vectors from accessing new hosts), improved country reporting systems and travel advisories, can help control the transmission of diseases. Collaboration between governments and health organizations is vital to these efforts. 

Building laboratory capacity can significantly improve lab equity by enhancing the skills and knowledge of laboratory technicians and health care professionals. Through programs and partnerships ASM promotes access to resources and technology and provides training to laboratory personnel to detect and respond to infectious diseases. Additionally, ASM develops and delivers professional development content for members and professionals to increase their knowledge and laboratory skills and practices.

Medical laboratory professionals testing infectious disease specimens in the laboratory.
Medical laboratory professionals testing infectious disease specimens in the laboratory.
Source: Navy Medicine/Flickr


ASM’s Laboratory Equity Working Group, comprised of ASM volunteers and staff, aims to promote awareness of lab inequity, gather data on barriers to lab equity, share resources for addressing lab equity and create a community of microbiologists dedicated to furthering lab equity. These initiatives contribute to improvements in diagnostic accuracy and patient outcomes. 

Technological advancements in point-of-care testing also offer promising solutions. Rapid diagnostic tools (RDTs) can bring testing capabilities directly to communities, reducing delays and improving accessibility. The efficient and accurate diagnosis of diseases, such as dengue, is important for clinical care, surveillance and outbreak control. For example, the low-resource formats of rapid dengue serotyping tests have the potential to support effective dengue disease surveillance and enhance the diagnostic testing capacity in resource-limited countries with endemic dengue. Additionally, advanced molecular detection (AMD) technologies can help researchers and providers understand, monitor and control disease outbreaks. Developing RDTs and AMD technologies can have similarly positive impacts in Latin America and other regions with endemic vector-borne diseases. 

Addressing lab equity is critical for improving health outcomes in Latin America. Significant barriers—including language gaps, resource limitations and inadequate surveillance—hinder effective disease management. Through travel and community education initiatives, building laboratory capacity and leveraging technological innovations, Latin American countries can ensure equitable access to quality laboratory services and diagnostics for all populations. 


Are you interested in learning more about lab equity? What is it? Why is it important? How can you take active steps to promote equity in your laboratory today? Contact the ASM Lab Equity Working Group today!

 

Author: Shannon Vassell

Shannon Vassell
Shannon Vassell is the Senior Program Officer for IDEAA at ASM.