Título:	Point-of-care screening for syphilis and HIV in the borderlands : challenges in implementation in the Brazilian Amazon
Autor(es):	Ruffinen, Carole Zen Sabidó, Meritxell Díaz Bermúdez, Ximena Pamela Lacerda, Marcus Mabey, David Peeling, Rosanna W. Benzaken, Adele Schwartz
Assunto:	Sífilis Amazônia HIV (Vírus)
Data de publicação:	Nov-2015
Editora:	BMC Health Services Research
Referência:	RUFFINEN, Carole Zen et al. Point-of-care screening for syphilis and HIV in the borderlands: challenges in implementation in the Brazilian Amazon. BMC Health Services Research, v. 15, p. 1-10, 2015. Disponível em: <http://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-015-1155-y>. Acesso em: 28 mar. 2017.
Abstract:	Background: Point-of-care (POC) screening for HIV and syphilis using rapid testing was implemented in indigenous communities in the triple-border area of the Brazilian Amazon. We describe the context of the early introduction of POC screening, explore hindering and enabling factors for POC implementation, and recommend strategies for feasible, viable, and sustainable syphilis and HIV screening interventions. Methods: This was a qualitative study based on grounded theory methodology. Data were collected using indepth interviews, semi-structured questionnaires, and field observations and were analysed using the framework approach. Qualitative information was complemented by quantitative data for descriptive purposes. Results: An overall high score for vulnerability to acquiring HIV and syphilis was observed among the indigenous communities. Health professionals reported satisfactory rapid testing acceptance, although concerns were raised about the pain of the fingerprick. Counselling-related challenges included ensuring the accuracy of translations, collaborating with translators and communicating positive test results. Over 3 months, 86.7 % of the syphilispositive individuals began treatment, and all of them notified their partners. Accessibility, measured as travel time via the local transportation network, was a barrier to health care access. A lack of gasoline for boats and other transportation was also a hindering factor at all levels of implementation. Conclusions: The recommendations address the preparation phase at the coordination level as well as at the training level. Tools such as strengths, weaknesses, opportunities, and threats (SWOT) analyses; checklists; contextadapted protocols; and fact sheets are very simple methods to facilitate implementation. The findings of this study are important because they may inform the implementation of new health technologies in low-resource national disease control programmes in remote communities.
Unidade Acadêmica:	Faculdade de Ciências da Saúde (FS) Departamento de Saúde Coletiva (FS DSC)
Licença:	BMC Health Services Research - © 2015 Ruffinen et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Fonte: http://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-015-1155-y. Acesso em: 28 mar. 2017.
DOI:	https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-015-1155-y
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