针对晚期艾滋病毒病的优化护理模式的影响:马拉维的一项非随机集群研究
Thulani Maphosa1, Lise Denoeud-Ndam2,3, Lloyd Chilikutali4
1Elizabeth Glaser Pediatric AIDS Foundation, Lilongwe, Lilongwe, Malawi. tmaphosa@pedaids.org.
BMC public health
|August 16, 2025
概括
一个优化的护理包改善了高级艾滋病毒疾病 (AHD) 患者的机会性感染的查和诊断. 这种干预增加了结核病和加密球菌脑膜炎的诊断,但没有影响患者的留守率或死亡率.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 艾滋病毒/艾滋病管理
背景情况:
- 尽管在艾滋病毒诊断和治疗方面取得了进展,但许多患者仍然存在先进的艾滋病毒疾病 (AHD).
- 机会性感染 (OI) 对患有AHD的个体构成重大威胁.
- 有效的查和诊断策略对于管理AHD至关重要.
研究的目的:
- 评估优化AHD护理套餐对AHD患者查和诊断机会性疾病的影响.
- 为了评估一个枢纽和分支模型在提供AHD护理方面的有效性.
- 为了比较干预和非干预地点之间的诊断产量和患者结果.
主要方法:
- 一个非随机的集群设计,利用马拉维22个卫生设施的枢纽和分支模型.
- 干预站点 (IS) 获得了优化的AHD护理包,包括增强的CD4检测,结核病 (TB) 和密码球菌抗原 (CrAg) 查.
- 从2021年6月至12月期间963名患有AHD的患者的数据从常规临床记录中抽象出来.
主要成果:
- 干预站点发现了较高比例的AHD客户和在5岁以下的儿童中增加了查.
- 在IS的患者更有可能接受结核病症状查,尿液横向流量利波拉比诺曼南测试和结核病诊断.
- 与非干预地点 (NIS) 相比,IS中神经学症状的查和加密球菌脑膜炎的诊断显著改善.
结论:
- 优化的AHD护理包显著改善了机会性感染的查和诊断,包括结核病和密码球菌病.
- 枢纽和分支模式有效地促进了提供增强的AHD护理.
- 在12个月后,干预和非干预地点之间没有观察到保留或死亡率的显著差异.
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