Fleming Eleanor, Oremo Jared, O'Connor Katherine, Odhiambo Aloyce, Ye Tun, Oswago Simon, Zeh Clement, Quick Robert, Kamb Mary L
Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Office of the Director, Office of Health Equity, 1600 Clifton Road Mailstop E07, Atlanta, GA 30333, USA ; Division of Applied Sciences, Epidemic Intelligence Service, Centers for Disease Control and Prevention, Scientific Education and Professional Development Program Office, Atlanta, GA 30333, USA.
Safe Water and AIDS Project, Kisumu 40100, Kenya.
J Sex Transm Dis. 2013;2013:674584. doi: 10.1155/2013/674584. Epub 2013 Nov 5.
We evaluated the integration of rapid syphilis tests (RSTs) and penicillin treatment kits into routine antenatal clinic (ANC) services in two rural districts in Nyanza Province, Kenya. In February 2011, nurses from 25 clinics were trained in using RSTs and documenting test results and treatment. During March 2011-February 2012, free RSTs and treatment kits were provided to clinics for use during ANC visits. We analyzed ANC registry data from eight clinics during the 12-month periods before and during RST program implementation and compared syphilis testing, diagnosis, and treatment during the two periods. Syphilis testing at first ANC visit increased from 18% (279 of 1,586 attendees) before the intervention to 70% (1,123 of 1,614 attendees) during the intervention (P < 0.001); 35 women (3%) tested positive during the intervention period compared with 1 (<1%) before (P < 0.001). Syphilis treatment was not recorded according to training recommendations; seven clinics identified 28 RST-positive women and recorded 34 treatment kits as used. Individual-level data from three high-volume clinics supported that the intervention did not negatively affect HIV test uptake. Integrating RSTs into rural ANC services increased syphilis testing and detection. Record keeping on treatment of syphilis in RST-positive women remains challenging.
我们评估了在肯尼亚尼扬扎省两个农村地区将快速梅毒检测（RSTs）和青霉素治疗试剂盒纳入常规产前诊所（ANC）服务的情况。2011年2月，来自25家诊所的护士接受了使用RSTs以及记录检测结果和治疗情况的培训。在2011年3月至2012年2月期间，向各诊所提供了免费的RSTs和治疗试剂盒，供其在ANC就诊时使用。我们分析了RST项目实施前和实施期间12个月内来自8家诊所的ANC登记数据，并比较了这两个时期的梅毒检测、诊断和治疗情况。首次ANC就诊时的梅毒检测率从干预前的18%（1586名就诊者中的279名）增至干预期间的70%（1614名就诊者中的1123名）（P<0.001）；干预期间有35名女性（3%）检测呈阳性，而干预前为1名（<1%）（P<0.001）。梅毒治疗未按照培训建议进行记录；7家诊所识别出28名RST检测呈阳性的女性，并记录使用了34个治疗试剂盒。来自3家就诊量大的诊所的个体层面数据表明，该干预措施未对HIV检测接受率产生负面影响。将RSTs纳入农村ANC服务可提高梅毒检测和发现率。对RST检测呈阳性的女性进行梅毒治疗的记录保存仍然具有挑战性。
