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Project for implantation of a "Care treatment line" for Children with changing in the "Red Reflex examination" in São Paulo State, Brazil


Main objective: To create a "Care treatment line" for Children with changing in the "Red Reflex examination (RRT)" in the São Paulo State Public Health System (PHS) linked to the Neonatal Screening Department (NS). Secondary objective: Show the difficulties found in the implementation of the "Care treatment lines", build and test semi-automated device for RRT evaluation, provide objective data regarding the number of newborn with RRE abnormalities by live birth and know the percentage of diseases responsible for changes in the exam and strengthen the PHS's hierarchy. Methods: Six Medical Schools from the State will coordinate the implementation of the "Red Reflex care treatment line" in the RRAS from their coverage area, three of them from the countryside and three in the capital, and will be the Reference Center (RC) for the treatment of children with confirmed abnormal RRE. The São Paulo State Health Secretary, through the NS, using an information system (IS) and the SomaSUS, will monitor and control the "Red Reflex care treatment line". Each RRAS will have at least one state ophthalmology center (destination 1) that will re-test the newborns' abnormal or doubtful RRE seen in RRASs Maternity/ Hospitals. The re-test will be done within 15 days of the first examination. If the change is confirmed, the child will be referred to the RC (destination 2) in the maximum period of 15 days for etiologic diagnosis and treatment. The RCs and the RRASs "supporters" will coordinate the "Red Reflex care treatment line" implementation and will be responsible for human resources training and technical support. The NS will actively search for patients who do not show up for appointments in the destinations 1 or 2. The RRASs will be responsible for inputting the IS with data from their maternity/ hospitals and re-testing centers. (AU)

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