RESUMO
INTRODUCTION: Colombia promotes the diagnosis and treatment of gestational syphilis in a single visit using rapid diagnostic tests to prevent mother-to-child transmission. Additionally, integrated health programs pursue the coordinated prevention of mother-to-child transmission of syphilis/HIV. OBJECTIVE: To identify knowledge gaps among health workers in the prevention of mother-to-child transmission of syphilis/HIV and to provide recommendations to support these programs. MATERIALS AND METHODS: We conducted a descriptive study based on 306 surveys of health workers in 39 health institutions in the city of Cali. Surveys inquired about planning, management and implementation of services for pregnant women, clinical knowledge of HIV/syphilis rapid diagnostic tests, and prior training. RESULTS: Knowledge deficits in the management of gestational syphilis were detected among the surveyed health workers, including physicians. Rapid tests for syphilis are currently used in clinical laboratories in Cali, however, procedural deficiencies were observed in their use, including quality control assurance. During the two years prior to the survey, training of health workers in the prevention of mother-to-child transmission of syphilis/HIV had been limited. Health workers are interested in identifying and treating gestational syphilis in a single event, in using rapid diagnostic tests and in receiving training. CONCLUSIONS: Intensive training targeting health workers, policy/decision makers and academic groups is needed to ensure adequate implementation of new strategies for the prevention of mother-to-child transmission of syphilis/HIV.
Assuntos
Pessoal de Saúde/educação , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Serviços de Saúde Materna , Complicações Infecciosas na Gravidez/tratamento farmacológico , Cuidado Pré-Natal/métodos , Sífilis Congênita/prevenção & controle , Sífilis/tratamento farmacológico , Colômbia/epidemiologia , Estudos Transversais , Gerenciamento Clínico , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/prevenção & controle , Pesquisas sobre Atenção à Saúde , Humanos , Serviços de Saúde Materna/organização & administração , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Melhoria de Qualidade , Sífilis/diagnóstico , Sorodiagnóstico da Sífilis , Sífilis Congênita/epidemiologiaRESUMO
Resumen Introducción. Para la prevención de la transmisión materno-infantil de la sífilis en Colombia, se promueve el diagnóstico y el tratamiento en una sola consulta mediante el uso de pruebas de diagnóstico rápido, así como programas de eliminación conjunta de la transmisión materno-infantil de la sífilis y el HIV. Objetivo. Detectar los vacíos de capacitación del personal de salud en torno a la prevención de la transmisión materno-infantil de la sífilis y el HIV, y hacer recomendaciones para mejorar los programas. Materiales y métodos. Se hizo un estudio descriptivo mediante 306 encuestas hechas al personal de salud de 39 instituciones de Cali. Se indagó sobre la planeación, la gestión y la ejecución de los servicios ofrecidos a las mujeres gestantes, los conocimientos clínicos sobre la sífilis, el HIV y las pruebas rápidas, así como sobre las capacitaciones recibidas. Resultados. Se encontraron deficiencias en el conocimiento del manejo de la sífilis gestacional entre el personal de salud, incluidos los médicos. Las pruebas de diagnóstico rápido para sífilis se utilizan en los laboratorios de la ciudad, pero se detectaron fallas en su uso adecuado, especialmente en el control de calidad. La capacitación en temas de prevención de la transmisión materno-infantil de la sífilis y el HIV había sido escasa en los dos años anteriores. El personal de salud expresó su interés por diagnosticar y tratar la sífilis gestacional en una sola consulta, usar las pruebas de diagnóstico rápido y asistir a actividades de capacitación. Conclusiones. Se requiere la capacitación intensiva del personal de salud, de quienes toman las decisiones y de los grupos académicos, para lograr una adecuada implementación de las nuevas estrategias de prevención de la transmisión materno-infantil de la sífilisy el HIV.
Abstract Introduction: Colombia promotes the diagnosis and treatment of gestational syphilis in a single visit using rapid diagnostic tests to prevent mother-to-child transmission. Additionally, integrated health programs pursue the coordinated prevention of mother-to-child transmission of syphilis/HIV. Objective: To identify knowledge gaps among health workers in the prevention of mother-to-child transmission of syphilis/HIV and to provide recommendations to support these programs. Materials and methods: We conducted a descriptive study based on 306 surveys of health workers in 39 health institutions in the city of Cali. Surveys inquired about planning, management and implementation of services for pregnant women, clinical knowledge of HIV/syphilis rapid diagnostic tests, and prior training. Results: Knowledge deficits in the management of gestational syphilis were detected among the surveyed health workers, including physicians. Rapid tests for syphilis are currently used in clinical laboratories in Cali, however, procedural deficiencies were observed in their use, including quality control assurance. During the two years prior to the survey, training of health workers in the prevention of mother-to-child transmission of syphilis/HIV had been limited. Health workers are interested in identifying and treating gestational syphilis in a single event, in using rapid diagnostic tests and in receiving training. Conclusions: Intensive training targeting health workers, policy/decision makers and academic groups is needed to ensure adequate implementation of new strategies for the prevention of mother-to-child transmission of syphilis/HIV.