1Fundacao Alfredo da Matta, Manaus, Brasil2Secretaria de Saúde de São Paulo, São Paulo, Brasil3Fundação Alfredo da Matta, Manaus, Brasil4London School of Hygiene & Tropical Medicine, London, UK
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BackgroundSyphilis continues to be a public health problem in Brazil, particularly among populations with limited access to health services. Indigenous populations, who live in remote locations in the interior of the Amazon forest, are of even greater concern. Traditional laboratory tests for the diagnosis of syphilis are scarce in these regions. The objective of this presentation is to describe the implementation of rapid tests (RT) in the Amazon region.MethodsWe trained health professionals of 9 Special Indigenous Health Districts (DSEI) to screen the sexually active population (over 10 years of age) for syphilis and HIV using RT with Quality Assurance (QA).ResultsIn total, 509 health professionals were trained and 160 units participated in the screening efforts. From a sexually active population of 83 311 indigenous people 38 799 (47%) were tested, of whom 594 (1.5%) tested positive for syphilis. 44/3650 pregnant women (1.3%) tested positive for syphilis, and 3 for HIV (0.1%). There is extensive variation between the rate of syphilis and HIV positivity between DSEIs (Abstract S2.2 table 1). The external QA performance was important in assuring correct results as initial scores were 77.1% for the HIV test and 61.5% for the syphilis test.ConclusionsThis project has demonstrated to policy makers in Brazil the existence of syphilis and HIV among indigenous people and the feasibility of addressing it. As a result of this work, it is now government policy to use RT to screen for HIV and syphilis with QA in remote regions of Brazil. This project provided a model for the introduction of point of care tests supported by a QA programme in remote regions.