Beber Andréa Mônica Brandão, Sabidó Meritxell, Vieira Janete Maria Rebelo, Bazzo Maria Luiza, Benzaken Adele Schwartz
Instituto de Pesquisas Leônidas & Maria Deane, Fundação Oswaldo Cruz, Manaus, AM, Brazil.
Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, AM, Brazil.
Rev Soc Bras Med Trop. 2015;48 Suppl 1:87-97. doi: 10.1590/0037-8682-0106-2014.
In 2011, the Brazilian Ministry of Health rolled out a program for the external quality assessment of rapid human immunodeficiency virus (HIV) tests using the dried tube specimen (DTS) method (EQA-RT/DTS-HIV). Our objective was to evaluate the implementation of this program at 71 voluntary counseling and testing centers (VCTCs) in the Brazilian Legal Amazonian area one year after its introduction.
Quantitative and qualitative study that analyzed secondary data and interviews with healthcare workers (HCWs) (n=39) and VCTC coordinators (n=32) were performed. The assessment used 18 key indicators to evaluate the three dimensions of the program's logical framework: structure, process, and result. Each indicator was scored from 1-4, and the aggregate results corresponding to the dimensions were expressed as proportions. The results were compared to the perceptions of the HCWs and coordinators regarding the EQA-RT/DTS-HIV program.
The aggregate scores for the three dimensions of structure, process, and result were 91.7%, 78.6%, and 95%, respectively. The lowest score in each dimension corresponded to a different indicator: access to Quali-TR online system 39% (structure), registration in Quali-TR online system 38.7% (process), and VCTC completed the full process in the program's first round 63.4% (result). Approximately 36% of the HCWs and 52% of the coordinators reported enhanced trust in the program for its rapid HIV testing performance.
All three program dimensions exhibited satisfactory results (>75%). Nevertheless, the study findings highlight the need to improve certain program components. Additionally, long-term follow-ups is needed to provide a more thorough picture of the process for external quality assessment.
2011年，巴西卫生部推出了一项使用干管标本（DTS）方法对快速人类免疫缺陷病毒（HIV）检测进行外部质量评估的计划（EQA-RT/DTS-HIV）。我们的目标是在该计划引入一年后，评估其在巴西合法亚马逊地区71个自愿咨询和检测中心（VCTC）的实施情况。
进行了定量和定性研究，分析了二手数据，并对医护人员（n = 39）和VCTC协调员（n = 32）进行了访谈。评估使用18个关键指标来评估该计划逻辑框架的三个维度：结构、过程和结果。每个指标的评分从1到4，各维度的综合结果以比例表示。将结果与医护人员和协调员对EQA-RT/DTS-HIV计划的看法进行了比较。
结构、过程和结果三个维度的综合得分分别为91.7%、78.6%和95%。每个维度的最低得分对应不同的指标：Quali-TR在线系统的访问率为39%（结构），Quali-TR在线系统的注册率为38.7%（过程），VCTC在该计划第一轮中完成全过程的比例为63.4%（结果）。约36%的医护人员和52%的协调员表示，因其快速HIV检测表现而对该计划的信任增强。
该计划的所有三个维度都取得了令人满意的结果（>75%）。然而，研究结果突出了改进某些计划组成部分的必要性。此外，需要进行长期随访，以更全面地了解外部质量评估过程。
