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P3.79 Barriers for syphilis screening in bolivia
  1. Tinajeros Freddy1,
  2. R Revollo2,
  3. L Rey Ares3,
  4. V Elias4,
  5. L Reveiz4
  1. 1STI and HIV Independent Consultant
  2. 2Ministry of Health Bolivia
  3. 3Research of Institute for Clinical and Sanitary Effectivity, Bolivia
  4. 4Pan-American Health Organisation

Abstract

Introduction Syphilis is a global problem, with an estimated incidence of 12 million people infected each year and is a public health problem in Bolivia. This can result in fetal death, perinatal death, or severe neonatal infections. However, simple and cost-effective options for screening and treatment during pregnancy can reduce these complications.

Methods For the present study, mixed methods (qualitative and quantitative) were used, however the quantitative results are presented in the summary. The data were collected through a review of the prenatal control clinical records, from which data such as syphilis test results, results records, and treatment in the perinatal history were extracted. The data extracted from the medical records of the 8 health centres of the Los Andes Network were input into an Excel database and analysis was performed using Epi Info 7.

Results Of 294 clinical records reviewed, we observed that on average, 55.4% of patients had syphilis results attached to their clinical histories. The lowest percentage in any centre was 13.3% and the highest was 62.1%. The percentages for each centre were: Alto Lima III 61.7%, Alto Lima IV 45.8%, Ambulatory Reference Centre (ARC) 61.1%, German Busch 62.1%, Huayna Potosí 67.3%, Puerto Mejillones 40.0%, Santa Rosa de Lima 13.3% and Villa Ingenio 51.1%. Significant differences (p<0.05) were observed among the establishments of the first level of complexity without laboratory (46.8%, 95% CI: 37.9–55.3) and the second level centres with laboratory (63.5%, 95% CI 49.7–74.5). This suggests that the syphilis test is more likely to be performed in the second level than in the first level and that the results are recorded in the clinical records, mainly on the perinatal card.

Conclusion Failure to record results in the medical records could result in a pregnant woman being screened for syphilis without results and with the consequent risk that if she gives birth in a different health centre, she may not receive adequate treatment or necessary follow-up to the newborn. The sensitisation and monitoring to be implemented by the health personnel in each centre and a deeper discussion on the subject of syphilis can become catalysts for the health system. The sharing of the results of the study could allow the implementation of corrective measures to improve the monitoring of syphilis screening.

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