Departamento de Ciências da Vida, Universidade do Estado da Bahia, Salvador, Bahia, Brazil
Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Bahia, Brazil.
BMJ Open. 2023 Jun 20;13(6):e068016. doi: 10.1136/bmjopen-2022-068016.
The key tools for mitigating the impact of COVID-19 and reducing its transmission include testing, quarantine and isolation, as well as telemonitoring. Primary healthcare (PHC) can be essential in increasing access to these tools. Therefore, the primary objective of this study is to implement and expand an intervention consisting of COVID-19 testing, isolation, quarantine and telemonitoring (TQT) strategies and other prevention measures at PHC services in highly socioeconomically vulnerable neighbourhoods of Brazil.
This study will implement and expand COVID-19 testing in PHC services in two large Brazilian capital cities: Salvador and Rio de Janeiro. Qualitative formative research was conducted to understand the testing context in the communities and at PCH services. The TQT strategy was structured in three subcomponents: (1) training and technical support for tailoring the work processes of health professional teams, (2) recruitment and demand creation strategies and (3) TQT. To evaluate this intervention, we will conduct an epidemiological study with two stages: (1) a cross-sectional sociobehavioural survey among individuals from these two communities covered by PHC services, presenting symptoms associated with COVID-19 or being a close contact of a patient with COVID-19, and (2) a cohort of those who tested positive, collecting clinical data.
The WHO Ethics Research Committee (ERC) (#CERC.0128A and #CERC.0128B) and each city's local ERC approved the study protocol (Salvador, ISC/UFBA: #53844121.4.1001.5030; and Rio de Janeiro, INI/Fiocruz: #53844121.4.3001.5240, ENSP/Fiocruz: #53844121.4.3001.5240 and SMS/RJ #53844121.4.3002.5279). Findings will be published in scientific journals and presented at meetings. In addition, informative flyers and online campaigns will be developed to communicate study findings to participants, members of communities and key stakeholders.
减轻 COVID-19 影响和降低其传播的关键工具包括检测、检疫和隔离，以及远程监护。初级保健（PHC）可以在增加这些工具的可及性方面发挥重要作用。因此，本研究的主要目标是在巴西高度社会经济脆弱社区的 PHC 服务中实施和扩大包括 COVID-19 检测、隔离、检疫和远程监护（TQT）策略以及其他预防措施的干预措施。
本研究将在巴西两个主要城市萨尔瓦多和里约热内卢的 PHC 服务中实施和扩大 COVID-19 检测。进行了定性形成性研究，以了解社区和 PCH 服务中的检测情况。TQT 策略分为三个子组件：（1）培训和技术支持，以调整卫生专业团队的工作流程，（2）招聘和需求创造策略，以及（3）TQT。为了评估这项干预措施，我们将进行一项具有两个阶段的流行病学研究：（1）对来自这两个社区并接受 PHC 服务覆盖的个体进行横断面社会行为调查，这些个体出现与 COVID-19 相关的症状或与 COVID-19 患者有密切接触，以及（2）对检测呈阳性的个体进行队列研究，收集临床数据。
世界卫生组织伦理研究委员会（ERC）（#CERC.0128A 和 #CERC.0128B）和每个城市的地方 ERC 批准了研究方案（萨尔瓦多，ISC/UFBA：#53844121.4.1001.5030；和里约热内卢，INI/Fiocruz：#53844121.4.3001.5240，ENSP/Fiocruz：#53844121.4.3001.5240 和 SMS/RJ #53844121.4.3002.5279）。研究结果将发表在科学期刊上，并在会议上展示。此外，还将制定信息传单和在线宣传活动，将研究结果传达给参与者、社区成员和利益攸关方。
