Educating health workers is key in congenital syphilis elimination in Colombia
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.
Downloads
References
Newman L, Kamb M, Hawkes S, Gómez G, Say L, Seuc A, et al. Global estimates of syphilis in pregnancy and associated adverse outcomes: Analysis of multinational antenatal surveillance data. PLoS Med. 2013;10:e1001396. https://doi.org/10.1371/journal.pmed.1001396
Shafii T, Radolf JD, Sánchez PJ, Schulz KF, Murphy FK. Congenital syphilis. In: Holmes KK, Sparling PF, Stamm WE, Piot P, Wasserheit JN, Corey L, et al, editors. Sexually transmitted infections. New York: Mc Graw Hill; 2008. p. 1577-612.
Watson-Jones D, Changalucha J, Gumodoka B, Weiss H, Rusizoka M, Ndeki L, et al. Syphilis in pregnancy in Tanzania. I. Impact of maternal syphilis on outcome of pregnancy. J Infect Dis. 2002;186:940-7. https://doi.org/10.1086/342952
Terris-Prestholt F, Watson-Jones D, Mugeye K, Kumaranayake L, Ndeki L, Weiss H, et al. Is antenatal syphilis screening still cost effective in sub-Saharan Africa. Sex Transm Infect. 2003;79:375-81. https://doi.org/10.1136/sti.79.5.375
Kamb ML, Newman LM, Riley PL, Mark J, Hawkes SJ, Malik T, et al. A road map for the global elimination of congenital syphilis. Obstet Gynecol Int. 2010;2010:1-6.
https://doi.org/10.1155/2010/312798
Valderrama J. Eliminación de la sífilis congénita en America Latina y el Caribe. Marco de referencia para su implementación. Washington, D.C: OPS; 2005. p. 64.
Instituto Nacional de Salud. Sivigila, Sistema Nacional de Vigilancia en Salud Pública. Bogotá: INS; 2012. Fecha de consulta: 20 de noviembre de 2015. Disponible en: http://www.ins.gov.co/lineas-de-accion/Subdireccion-Vigilancia/sivigila/Paginas/sivigila.aspx
Mabey DC, Sollis KA, Kelly HA, Benzaken AS, Bitarakwate E, Changalucha J, et al. Point-of-care tests to strengthen health systems and save newborn lives: The case of syphilis. PLoS Med. 2012;9:e1001233. https://doi.org/10.1371/journal.pmed.1001233
Blencowe H, Cousens S, Kamb M, Berman S, Lawn JE. Lives Saved Tool supplement detection and treatment of syphilis in pregnancy to reduce syphilis related stillbirths and neonatal mortality. BMC Public Health. 2011;11(Suppl.3):S9. https://doi.org/10.1186/1471-2458-11-S3-S9
Chen XS, Peeling RW, Yin YP, Mabey D. Improving antenatal care to prevent adverse pregnancy outcomes caused by syphilis. Future Microbiol. 2011;6:1131-4. https://doi.org/10.2217/fmb.11.99
Tucker JD, Bu J, Brown LB, Yin YP, Chen XS, Cohen MS. Accelerating worldwide syphilis screening through rapid testing: A systematic review. Lancet Infect Dis. 2010;10:381-6. https://doi.org/10.1016/S1473-3099(10)70092-X
Watson-Jones D, Gumodoka B, Weiss H, Changalucha J, Todd J, Mugeye K, et al. Syphilis in pregnancy in Tanzania. II. The effectiveness of antenatal syphilis screening and single-dose benzathine penicillin treatment for the prevention of adverse pregnancy outcomes. J Infect Dis. 2002;186:948-57. https://doi.org/10.1086/342951
Gaitán H, Páez C, Rivera DP, Ángel E, Estrada S, Cifuentes MY, et al. Guía de práctica clínica (GPC) basada en la evidencia para la atención integral de la sífilis gestacional y congénita. Bogotá: Ministerio de Salud y Protección Social, Fondo de Población de las Naciones Unidas; 2014. p. 126.
World Health Organization. Global guidance on criteria and processes for validation: Elimination of mother-to-child transmission (EMTCT) of HIV and syphilis. Geneve: WHO; 2014. p. 32.
García PJ, Cotrina A, Gotuzzo E, González E, Buffardi AL. Research training needs in Peruvian national TB/HIV programs. BMC Med Educ. 2010;10:63. https://doi.org/10.1186/1472-6920-10-63
Borriello G, Schilit B, Lerer A, Chin J. Open Data Kit. Seattle: University of Washington; 2010. Fecha de consulta: 16 de septiembre de 2015. Disponible en: https://opendatakit.org/use/collect/
R-Core-Team.The R Project for Statistical Computing. Vienna: The R Foundation; 2014. Fecha de consulta: 16 de septiembre de 2015. Disponible en: http://www.R-project.org
Cruz AR, Castrillón MA, Minotta AY, Rubiano LC, Castaño MC, Salazar JC. Gestational and congenital syphilis epidemic in the Colombian Pacific Coast. Sex Transm Dis. 2013;40:813-8. https://doi.org/10.1097/OLQ.0000000000000020
Moreno CA, Martínez E, Cepeda M, Mora L, Pinzón C, Osorio D, et al. Guía de práctica clínica (GPC) basada en la evidencia científica para la atención de la infección por VIH/Sida en adolescentes (con 13 años o más de edad) y adultos. Bogotá, D.C.: Ministerio de Salud y Protección Social, Fondo de Poblaciones de Naciones Unidas; 2014. p. 95.
Fenton LJ, Light IJ. Congenital syphilis after maternal treatment with erythromycin. Obstet Gynecol. 1976;47:492-4.
Hashisaki P, Wertzberger GG, Conrad GL, Nichols CR. Erythromycin failure in the treatment of syphilis in a pregnant woman. Sex Transm Dis. 1983;10:36-8.
South MA, Short DH, Knox JM. Failures of erythromycin estolate therapy in utero syphilis. JAMA. 1964;190:70-1. https://doi.org/10.1001/jama.1964.03070140076020
Galvao TF, Silva MT, Serruya SJ, Newman LM, Klausner JD, Pereira MG, et al. Safety of benzathine penicillin for preventing congenital syphilis: A systematic review. PLoS One. 2013;8:e56463. https://doi.org/10.1371/journal.pone.0056463
Peeling RW. Applying new technologies for diagnosing sexually transmitted infections in resource-poor settings. Sex Transm Infect. 2011;87(Suppl.2):ii28-30. https://doi.org/10.1136/sti.2010.047647
Ministerio de Salud. Plan Decenal de Salud Pública, PDSP, 2012-2021. Bogotá, D.C.: Ministerio de Salud y Protección Social; 2013. p. 237.
Kamb M, Schwartz-Benzaken A, Karem K, Matheu J, Pérez F. Orientación para el diagnóstico de la sífilis en América Latina y el Caribe: cómo mejorar la adopción, interpretación y calidad del diagnóstico en diferentes entornos clínicos. En: Salud DdETyAd, editor. Washington: OPS/OMS; 2015. p. 32.
Frenk J, Chen L, Bhutta ZA, Cohen J, Crisp N, Evans T, et al. Health professionals for a new century: Transforming education to strengthen health systems in an interdependent world. Lancet. 2010;376:1923-58. https://doi.org/10.1016/S0140-6736(10)61854-5
World Health Organization. The world health report: 2006: Working together for health. Geneva: WHO; 2006.
Some similar items:
- Cristian Vallejo, Yolanda Cifuentes, Characterization and six-month follow-up on a cohort of newborns with congenital syphilis , Biomedica: Vol. 36 No. 1 (2016)
- Germán Briceño, Jaime Céspedes, Martha Leal, Sarha Vargas, Prevalence of cardiovascular risk factors in schoolchildren from a rural and urban area in Colombia , Biomedica: Vol. 38 No. 4 (2018)
- Gladys Pinilla, Lesly Campos, Andrea Durán, Jeannette Navarrete, Liliana Muñoz, Detection of Treponema pallidum subspecies pallidum for the diagnosis of congenital syphilis by nested polymerase chain reaction , Biomedica: Vol. 38 No. 1 (2018)
- Luz Elena Velásquez, Catalina Gómez, Erika Valencia, Laura Salazar, Eudoro Casas, Paragonimosis in the peri-urban zone of Medellín, Antioquia , Biomedica: Vol. 28 No. 3 (2008)
- Pedro José Villamizar, Sandra Milena Moreno, Freddy Moreno, Management of electronic social networks by students of medicine: The case of publication of photographs with patients and professional medical conduct , Biomedica: Vol. 36 No. 1 (2016)
- Henry Ostos, Gilberto Astaiza, Francisco Garcia, Miller Bautista, Favio Rojas, Low incidence of congenital neural tube defects at the Neiva University Hospital: possible effect of folic acid supplementation , Biomedica: Vol. 20 No. 1 (2000)
- Luis Carlos Domínguez, Neil Valentín Vega, Erick Leonardo Espitia, Álvaro Enrique Sanabria, Claudia Corso, Adriana Margarita Serna, Camilo Osorio, Impact of the flipped classroom strategy in the learning environment in surgery: A comparison with the lectures , Biomedica: Vol. 35 No. 4 (2015)
- Yolanda Cifuentes, Martha Isabel Murcia, Jorge Piar, Patricia Pardo, Cerebral microcalcifications in a newborn with congenital tuberculosis , Biomedica: Vol. 36 No. 1 (2016)
- Diana Marín, Eduardo Romero, Virtual microscopy systems: Analysis and perspectives , Biomedica: Vol. 31 No. 1 (2011)
- Sandra Milena Arias, Lina Marcela Salazar, Eudoro Casas, Alexandra Henao, Luz Elena Velásquez, Paragonimus sp. in crabs and awareness of the educational community to aquatic ecosystems in La Miel and La Clara, Caldas, Antioquia , Biomedica: Vol. 31 No. 2 (2011)
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
