Vreden Stephen, Heemskerk Marieke, Hiwat Hélène, Cairo Hedley
Foundation for the Advancement of Scientific Research in Suriname, Paramaribo, Suriname.
Social Solutions, Paramaribo, Suriname.
Am J Trop Med Hyg. 2024 Aug 27;112(4_Suppl):109-118. doi: 10.4269/ajtmh.23-0734. Print 2025 Apr 1.
Gold mining communities in the Amazon region typically have limited access to public health services. In Suriname, the Ministry of Health Malaria Program (MoH-MP) works with community health workers (CHWs), people from mining communities without a formal medical degree, to provide malaria diagnostic and treatment services. During the COVID-19 pandemic, the MoH-MP trained 21 of these CHWs in COVID-19 outreach and testing, using rapid antigen tests for symptomatic persons in their communities; afterward, a mixed methods research approach was used to investigate whether including COVID-19 services in the tasks of the CHWs was feasible and accepted among gold mining populations. Also, CHWs took part in active case detection missions to proactively offer COVID-19 testing to all inhabitants of specific mining areas, regardless of symptoms. In the 6 months of field implementation (May-October 2022), 1,300 persons were tested for COVID-19, among whom 28.7% were women. Eight percent tested positive. Of the 312 asymptomatic persons tested, 2.2% tested positive. Qualitative semi-structured interviews with the CHWs and quantitative pre- and postintervention surveys revealed that the communities appreciated the nearby and free COVID-19 testing opportunity. The intervention motivated individuals who otherwise would not have been tested to test for COVID-19. Twenty-nine percent of those who had tested at least once for COVID-19 reported that their most recent test was conducted through the services of the CHWs. The results suggest that integrating COVID-19 testing into other CHW services can lower health access barriers in difficult-to-reach populations in remote communities.
亚马逊地区的金矿社区通常难以获得公共卫生服务。在苏里南，卫生部疟疾项目（MoH-MP）与社区卫生工作者（CHWs）合作，这些社区卫生工作者来自金矿社区，没有正规医学学位，负责提供疟疾诊断和治疗服务。在新冠疫情期间，卫生部疟疾项目对21名社区卫生工作者进行了新冠疫情外展和检测培训，使用快速抗原检测为其社区中有症状的人员进行检测；之后，采用混合方法研究途径来调查将新冠服务纳入社区卫生工作者的任务在金矿人群中是否可行且被接受。此外，社区卫生工作者还参与主动病例检测任务，主动为特定矿区的所有居民提供新冠检测，无论其有无症状。在实地实施的6个月（2022年5月至10月）中，1300人接受了新冠检测，其中28.7%为女性。8%的检测结果呈阳性。在312名无症状检测者中，2.2%检测呈阳性。对社区卫生工作者进行的定性半结构化访谈以及干预前后的定量调查显示，社区对附近免费的新冠检测机会表示赞赏。该干预措施促使那些原本不会接受检测的人去进行新冠检测。在至少接受过一次新冠检测的人中，29%报告称他们最近一次检测是通过社区卫生工作者的服务进行的。结果表明，将新冠检测纳入其他社区卫生工作者服务可以降低偏远社区难以接触到的人群获得医疗服务的障碍。
