Implementation of evaluation committees of deaths from AIDS as a strategy for programmatic interventions in the state of Sao Paulo, Brazil
R.A. Souza1, A. Tayra1, D.L. Estevam1, C.S.B. Domingues1, A.T.L. Plaça2, A.M. Rodrigues3, M.C.G.G. Ribeiro1
1STD/AIDS Reference and Training Center, São Paulo State STD/Aids Program, São Paulo, Brazil, São Paulo, Brazil, 2Epidemiological Surveillance Group, Secretary of State of Health, São Paulo, Brazil, 3STD/AIDS Program, São José do Rio Preto, Brazil
Issues: AIDS mortality in São Paulo had an 157% reduction from 1996 to 2008, as result of universal distribution of antiretroviral therapy and prevention and control. However, we still live with a high mortality rate of 8/100,000 and several municipalities have higher than state average rates .A need to know the causes of deaths, making it possible to design interventions for change it scenary led to coordination of STD / AIDS to propose the formation of these committees.
Description: The committees are made up of representatives of regional and local coordinators of programs for STD / AIDS, and health professionals in the areas of epidemiological surveillance and service. Two priorities regions, in countryside of São Paulo, were involved, the Atlantic Coast with 9 cities, and Sao Jose do Rio Preto, the average mortality respectively by 100,000 were compared to the years 2005 and 2006 15,1 and 12,7 for Santos and 16.7 and 14,5 in Sao Jose do Rio Preto compared with rates of 8.8 and 8:4 for the state of Sao Paulo.
It has produced a form for collecting information, held meetings with participation all staf include the state coordination of program to do data analysis and identification of problem situations and interventions.
Lessons learned: The difficulties in adhering ART with development of multidrug resistance and late diagnosis were the main problems to be faced, demanding action to expand health diagnosis by extending the offer of testing and promotion of adherence to medicines. To support local activities are primarily related to construction of databases, epidemiological methods for analysis and availability of professionals to supervise the procedure were difficulties have limited the results.
Next steps: Recommendation for implementation of the committee that persist in regions with high rates of mortality. Monitoring of the entire implementation process by the team coordination and provision of technological resources.
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