Evaluation of the effectiveness of surveillance policies to control the COVID-19 pandemic in São Paulo,Brazil

作     者：Lorena G.Barberia Natália de P.Moreira Brigina Kemp Maria Amelia de Sousa Mascena Veras Marcela Zamudio Isabel Seelaender Costa Rosa Rebeca de J.Carvalho Tatiane C.M.Sousa 

作者机构：Department of Political ScienceUniversity of São PauloAvenida Professor Luciano Gualberto315-Sala 2067-Cidade UniversitáriaSão PauloSP 05508-900Brazil Conselho de Secretários Municipais de Saúde-SPAvenida Angélica2466-17°floor-ConsolaçãoSão PauloSP 01228200Brazil Departamento de Saúde ColetivaFaculdade de Ciências Médicas da Santa Casa de São PauloDr Cesario Mota Jr St.61São PauloSP 01221-020Brazil Department of Public Administration and GovernmentFGV EAESP Business Administration School of São PauloAvenida 9 de julho2029Bela VistaSão PauloSP 01313-902Brazil Fundação Oswaldo CruzENSPRio de JaneiroRJBrazil 

出 版 物：《Global Health Research and Policy》 (全球健康研究与政策（英文）)

年 卷 期：2022年第7卷第1期

页      面：242-257页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：COVID-19 Surveillance RT-PCR public health testing policies 

摘      要：Background:Surveillance efforts are essential to pandemic control,especially where the state is the primary health provider,such as *** public health testing guidelines limit molecular tests,there are reductions in detection efforts aimed at early recognition,isolation,and treatment of those infected with the *** study evaluates the effectiveness of surveillance policies to control the COVID-19 pandemic in São ***:We conducted an interrupted time series analysis with a segmented regression model to analyze if changes in the state’s guidelines improved RT-PCR testing outcomes in Brazil’s most affluent and largest state,São *** daily data on the RT-PCR tests conducted in public laboratories belonging to the state-wide network from March 1,2020 to June 5,2021 were extracted from the Sao Paulo State open-source database,while the data on the genomic sequences were obtained from *** then aggregated these data for the 17 regional health departments in the state to evaluate regional-level ***:The public health system restricted RT-PCR testing to hospitalized cases in the first *** was expanded to permit symptomatic testing of non-hospitalized persons only in July 2020,but a statistically significant increase in surveillance efforts was not *** definition was expanded to allow case confirmation based on clinical,laboratory and image data criteria other than an RT-PCR test without increasing the testing effort for asymptomatic suspicious cases in September *** was an increase in the mean volume of testing in each RHD,but the test positivity rate increased due to insufficient testing *** also show an uneven improvement in testing outcomes following these changes across the state’s regional health ***:Evidence suggests that lower RT-PCR testing and genomic surveillance efforts are associated with areas characterized by a higher population concentration and a g