The outbreak no one is talking about
New Frontier:
Community-Centred Care
By Lily Dupuis
Bringing healthcare from clinic to community
Nolan Hill, gay men’s health specialist, says new rapid testing methods are the next step to making sexual health care more accessible. He explains that, for some, even getting to an STI clinic is challenging, as their hours and locations make their services unavailable to many Albertans.
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“Taking the care out of centralized spaces and bringing it out into the community with [point-of-care tests] is really the new frontier,” he says.
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Hill notes that community-focused care will be helpful to further break down barriers for hard-to-reach communities to access the testing that is needed.
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“The University of Alberta has a researcher who did combination rapid HIV and syphilis testing, and they had a really high success rate in terms of diagnosing and detecting new infections,” explains Hill.
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And that researcher is none other than Dr. Ameeta Singh.
“We need to look at multiple approaches, and to never forget the importance of the social determinants of health care.”
Dr. Ameeta Singh, Clinical Professor at the University of Alberta, when asked how Alberta can manage the syphilis outbreak
Photo supplied by Dr. Ameeta Singh
As an infectious disease specialist, Dr. Singh has been researching syphilis and focusing on developing new rapid testing approaches so people are able to receive testing and treatment in one sitting.
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Dr. Singh’s research showed that roughly 15 per cent of people who were tested syphilis either did not return for follow-up results, or experienced a significant delay – sometimes months – in returning for treatment after receiving their test results.
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This research highlighted the structural inequalities linked to why people weren’t following up.
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“The pandemic did severely limit our ability to take action on what has been happening with syphilis,” she says.
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Dr. Singh explains that, prior to the COVID-19 pandemic, she was part of a community outreach team consisting of nurses and Indigenous community health representatives. This team’s job was to provide community centred care outside of traditional hospital and clinic settings to potentially vulnerable persons and offer testing.
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“But of course, that was shut down during the pandemic. I'm hoping that we can get that going again,” she explains.
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“That team actually goes out into the community, to community-based organizations, inner city health centres, and inner city schools to offer testing and treatment in a single visit.”
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She says that this point-of-care rapid testing process gets people the help they need sooner.
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“I strongly believe at this point in time that, because of the populations we are trying to reach, the point-of-care tests have the potential to be a game changer here in Canada.”
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These point-of-care tests are administered by a healthcare professional, and a quick blood sample is taken, typically via a small finger prick, offering fast and effective results within 15 minutes.
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Dr. Singh explains that because of the global risk syphilis is posing, research is being done to get more rapid testing available to other parts of Canada, as well.
Stock image courtesy of Canva
Syphilis: Nation-wide
The Centre for Communicable Diseases and Infection Control (CCDR) reported that in 2019 the highest recorded rates of infectious syphilis were in Nunavut, Manitoba, the Northwest Territories, Alberta, and Saskatchewan.
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Then, while infectious syphilis rates declined in certain provinces and territories in 2020, they continued to rise in Alberta.
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Dr. Kami Kandola, chief public health officer of the Northwest Territories, says that attention must be paid towards the interconnection between provinces and territories in the Canada-wide spread of syphilis.
Dr. Kami Kandola
Chief Medical Officer, N.W.T.
Interview by Astrid Cunanan and Megan Creig