Implementation of Fast Tests for Syphilis and HIV in Prenatal Care in Fortaleza - Ceará

OBJECTIVE:

to describe the implementation of the Fast Test (FT) of syphilis and HIV in prenatal care in primary healthcare units in Fortaleza, Ceará.

METHOD:

a descriptive study with a quantitative approach. There were training supervisions carried out in 24 units between May and August 2014, and the inclusion criterion was to have at least one trained professional.

RESULTS:

the physical space, the availability, validity and the performance of FT in prenatal were analyzed. The data were presented in simple frequency tables. It was identified adequate space in 79.2% of the units, availability of FT in 62.5%, performing the tests in 37.5%, and of these, 55.6% doing these procedures in routine prenatal care.

CONCLUSION:

the primary units have difficulties in implementing FT in syphilis and HIV in the prenatal routine. This activity is seen as an effective strategy to reduce vertical transmission of these infections.

Aspects related to physical space to perform the Fast Test in primary health care units, Fortaleza, Ceará, Brazil, 2014 

Variables	n	%
Complete ESF (n=24)
Yes	11	44.8
No	13	55.2
Trained professionals (n = 24)
Nurses	20	83.3
Doctors	04	16.7
Private offices (n=24)
Yes	19	79.2
No	05	20.8
Refrigerator exclusive for FT (n = 24)
Yes	18	75.0
No	06	25.0

Aspects related to implementation of the Fast Test (TR) in Primary Health Care Units (UAPS), Fortaleza, Ceará, Brazil, 2014 

Variables	n	%
Had FT in the unit (n=24)
Yes	15	62.5
No	09	37.5
FT in the valdity date (n = 15)
Yes	05	33.4
No	10	66.6
Perform Ft in the unit (n=24)
Yes	09	37.5
No	15	62.5
Perform FT in the routine of PN care (n = 09)
Yes	05	55.6
No	04	44.4

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By:  Lopes AC1, Araújo MA1, Vasconcelo LD2, Uchoa FS3, Rocha HP4, Santos JR5.

• 1Programa de Pós-Graduação em Saúde Coletiva, Universidade de Fortaleza, Fortaleza, CE, Brasil.
• 2Área Técnica de Saúde da Mulher e Gênero, Rede Cegonha, Secretaria Municipal de Saúde, Fortaleza, CE, Brasil.
• 3Área Técnica de DST/Aids e Hepatites Virais, Secretaria Municipal de Saúde, Fortaleza, CE, Brasil.
• 4Hospital Universitário Walter Cantídio, Universidade Federal do Ceará, Fortaleza, CE, Brasil.
• 5Residência Integrada em Saúde, Escola de Saúde Pública do Ceará, Fortaleza, CE, Brasil.
• Rev Bras Enferm. 2016 Feb;69(1):62-66. 

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Subsequent Pregnancies in Women with Previous Gestational Syphilis

This study included data on syphilis-positive pregnant women seen for delivery or miscarriage, between 1997 and 2004, in Sao Lucas Hospital, Porto Alegre, RS. Their subsequent obstetric outcomes were studied, until December 2011, to see if the disease recurred. From 450 pregnant women with positive syphilis serology, seen from 1997 to 2004, 166 had at least one more obstetric attendance until December 2011, with 266 new obstetric outcomes. 

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Perinatal mortality rate was 119/1000 in initial and 41/1000 in subsequent pregnancies (p < 0.01). CS recurrence was frequent in subsequent pregnancies of women who tested positive for syphilis in a preceding pregnancy. No or inadequate prenatal care was the main risk factor for CS, both in initial and in subsequent pregnancies. These data suggest that non-infected neonates could have been defined as CS cases because of insufficient information about the mother's history.

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