Geospatial assessment of the voluntary medical male circumcision programme in Tanzania, 2011-2016
Geospatial assessment of the voluntary medical male circumcision programme in Tanzania, 2011-2016
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DOI：
10.1136/bmjgh-2019-001922
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发表时间：
2019-11-01
影响因子：
8.1
通讯作者：
Cuadros, Diego F.
中科院分区：
文献类型：
--
作者：
Kim, Hana;Branscum, Adam;Cuadros, Diego F.
简介坦桑尼亚是撒哈拉以南非洲的14个优先国家之一，扩大自愿医疗男性包皮环切术(VMMC)以预防艾滋病毒。在这项研究中，我们通过评估男性包皮环切术(MC)患病率的空间结构变化和确定MC使用率较低的年龄组来评估VMMC的进展。方法我们使用2011-2012年和2015-2016年在坦桑尼亚进行的两次人口与健康调查(DHS)的数据。MC发病率是使用一种从连续两次横断面调查中计算发病率的方法来估计的。结果坦桑尼亚全国MC患病率从2011-2012年的73.5%上升到2015-2016年的80.0%。据估计，全国MC发病率为每100人年4.6例包皮环切术。包皮环切率最低的是20-24岁的男性，每100岁包皮环切率为0.61次。2015-2016年间，估计有1567 253名居住在MC低发区的15-49岁男性未割包皮。结论坦桑尼亚在实施VMMC方面取得了实质性进展。然而，该国MC患病率仍然存在广泛的空间差异，一些地区存在MC患病率。
Introduction Tanzania is one of the 14 priority countries in sub-Saharan Africa scaling up voluntary medical male circumcision (VMMC) for HIV prevention. In this study, we assessed the progress of VMMC by evaluating changes in the spatial structure of male circumcision (MC) prevalence and identifying age groups with low MC uptake.Methods We use data from two waves of the Demographic and Health Survey (DHS) conducted in Tanzania in 2011-2012 and 2015-2016. MC incidence rate was estimated using a method developed to calculate incidence rates from two successive cross-sectional surveys. Continuous surface maps of MC prevalence were generated for both DHS waves and compared with identified areas with high MC prevalence changes and high density of uncircumcised males.Results National MC prevalence in Tanzania increased from 73.5% in 2011-2012 to 80.0% in 2015-2016. The estimated national MC incidence rate was 4.6 circumcisions per 100 person-years (py). The lowest circumcision rate was observed in males aged 20-24 years, with 0.61 circumcisions per 100 py. An estimated 1 567 253 males aged 15-49 years residing in low-MC prevalence areas were uncircumcised in 2015-2016.Conclusion Tanzania has shown substantial progress in the implementation of VMMC. However, extensive spatial variation of MC prevalence still exists in the country, with some areas having an MC prevalence