(P480) PILOT IMPLANTATION OF A MOLECULAR BIOLOGY NETWORK TO DETECT CHLAMYDIA TRACHOMATIS AND NEISSERIA GONORRHOEAE IN THE BRAZILIAN NATIONAL HEALTHCARE SYSTEM

Wednesday, July 26, 2023

16:00 – 18:00 CST

Primary Presenter(s)

Pamela Cristina Gaspar, MSc

Technical Consultant
Department of HIV/AIDS, Tuberculosis, Viral Hepatitis, and Sexually Transmitted Infections at Brazilian Ministry of Health/ Public Health Postgraduate Program at Brasília University
Brasilia, Distrito Federal, Brazil

JM

José Athayde V M Morais

Technical Consultant
Department of HIV/AIDS, Tuberculosis, Viral Hepatitis, and Sexually Transmitted Infections / Ministry of Health / Brasília / Brazil, United States
Pamela Cristina Gaspar, MSc

Technical Consultant
Department of HIV/AIDS, Tuberculosis, Viral Hepatitis, and Sexually Transmitted Infections at Brazilian Ministry of Health/ Public Health Postgraduate Program at Brasília University
Brasilia, Distrito Federal, Brazil
MG

Mayra Gonçalves Aragón

Department of HIV/AIDS, Tuberculosis, Viral Hepatitis, and Sexually Transmitted Infections / Ministry of Health / Brasília / Brazil, United States
MV

Mariana Villares Martins

Department of HIV/AIDS, Tuberculosis, Viral Hepatitis, and Sexually Transmitted Infections / Ministry of Health / Brasília / Brazil, United States
JN

José B A N Neto

Department of HIV/AIDS, Tuberculosis, Viral Hepatitis, and Sexually Transmitted Infections / Ministry of Health / Brasília / Brazil, United States
�B

Álisson Bigolin, Ph.D

Department of HIV/AIDS, Tuberculosis, Viral Hepatitis, and Sexually Transmitted Infections / Ministry of Health / Brasília / Brazil, United States
Angélica E. Miranda, MD, PhD (she/her/hers)

Coordinator
Department of HIV/AIDS, Tuberculosis, Viral Hepatitis, and Sexually Transmitted Infections at Brazilian Ministry of Health
Brasilia, Brazil

Project: Despite the protocols of the Brazilian Ministry of Health (MoH) recommending molecular tests to detect Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) since 2017, Brazil stills offer only syndromic management for CT/NG infection in most scenarios, which makes the diagnosis of asymptomatic infection unfeasible. For this reason, MoH carried out a pilot implementation of a laboratory network with molecular biology tests for CT/NG detection between August/2021 and August/2022. The key populations for this initiative were PrEP users, pregnant women with high vulnerability to STIs, PLWHA at the time of HIV diagnosis, and people assisted at STI Reference sites.

Issue: Assess the feasibility and identify the demand and challenges to offer the CT/NG diagnosis using molecular biology in public health.

Results: Thirty-three laboratories were selected and trained to compose the CT/NG Network and participated in the initiative. A total of 13,193 exams were released, 68% performed on males and 57% on people among 18-33 years. The monthly average for releasing results was 1,579 exams/month. The average time to release the results was 14 days. The stratification of the detection rate by sample type used during the project for each gender is described in Table 1. The main challenge reported was the sample flow establishment, which is related to difficulties in articulating new flows in health centers and between points in the network. There were also problems in demand generation, which depended on healthcare professionals' self-awareness about the test's importance.

Lessons Learned: The pilot allowed the MoH to collect key information about the broad implementation of CT/NG tests, such as the most used sample on the network, population profile, logistics, and healthcare professionals' adherence to requesting the exams. By identifying the challenges for the implementation, it was possible to outline a strategic plan to implement a definitive national laboratory network. This experience may also help the future implementation of Rapid Molecular Point-of-Care Testing at the time of clinical consultation to promote the etiological approach of symptomatic cases as one more strategy to face STIs.