Increasing the uptake of prevention of mother-to-child transmission of HIV services in a resource-limited setting.
Increasing the uptake of prevention of mother-to-child transmission of HIV services in a resource-limited setting.
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DOI：
10.1186/1472-6963-10-29
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发表时间：
2010-01-28
影响因子：
2.8
通讯作者：
Mukadi YD
中科院分区：
文献类型：
--
作者：
Torpey K;Kabaso M;Kasonde P;Dirks R;Bweupe M;Thompson C;Mukadi YD
与在其他资源有限的情况下一样，赞比亚卫生部面临的挑战是使人们能够获得和获得负担得起和可接受的防止母婴传播干预措施。赞比亚艾滋病毒感染率为14.3%，卫生部估计，赞比亚有超过100万人艾滋病毒呈阳性。赞比亚每年约有500,000名儿童出生，如果不提供干预措施，每年有40,000名儿童垂直感染。这项研究试图审查在引入针对具体情况的干预措施后，在资源有限的情况下对母婴预防(母婴传播)服务的接受情况。2005年7月，在赞比亚38个提供防止母婴传播服务的地点采取了干预措施，以提高对母婴传播的认识。截至2008年9月，每月收集一次基线和后续服务数据。使用内置到用于数据管理的数据库中的逻辑检查数据的内部和外部一致性。进行了数据审计，以确定准确性和可靠性。对干预前后的变化趋势进行分析。在13个季度(39个月)的观察中，孕妇的吸毒率有所增加，特别是在接受咨询和艾滋病毒检测的情况下，从第一年的45%增加到90%(p值=0.00)，到第三年从99%增加到99%(p值=0.00)。全程抗逆转录病毒(ARV)预防的接受率从第一年的29%增加到第一年的66%(p=0.00)，到第三年增加到97%(p值=0.00)。转诊为临床护理的艾滋病毒阳性孕妇的百分比也有显著改善。在资源有限的情况下，可以通过利用创新的替代办法来减轻人力资源短缺的影响，例如，在常规培训课程之外提供技术援助和指导，将防止母婴传播服务纳入现有的妇幼保健结构，解决信息差距，动员传统和舆论领袖，并与政府建立牢固的关系，从而改善防止母婴传播服务。这些以卫生系统为基础的办法可持续改善服务的能力和接受程度。
As in other resource limited settings, the Ministry of Health in Zambia is challenged to make affordable and acceptable PMTCT interventions accessible and available. With a 14.3% HIV prevalence, the MOH estimates over one million people are HIV positive in Zambia. Approximately 500,000 children are born annually in Zambia and 40,000 acquire the infection vertically each year if no intervention is offered. This study sought to review uptake of prevention of mother-to-child (PMTCT) services in a resource-limited setting following the introduction of context-specific interventions. Interventions to improve PMTCT uptake were introduced into 38 sites providing PMTCT services in Zambia in July 2005. Baseline and follow up service data were collected on a monthly basis through September 2008. Data was checked for internal and external consistency using logic built into databases used for data management. Data audits were conducted to determine accuracy and reliability. Trends were analyzed pre- and post- intervention. Uptake among pregnant women increased across the 13 quarters (39 months) of observation, particularly in the case of acceptance of counseling and HIV testing from 45% to 90% (p value = 0.00) in the first year and 99% by year 3 (p value = 0.00). Receipt of complete course of antiretroviral (ARV) prophylaxis increased from 29% to 66% (p = 0.00) in the first year and 97% by year 3 (p value = 0.00). There was also significant improvement in the percentage of HIV positive pregnant women referred for clinical care. Uptake of PMTCT services in resource-limited settings can be improved by utilizing innovative alternatives to mitigate the effects of human resource shortage such as by providing technical assistance and mentorship beyond regular training courses, integrating PMTCT services into existing maternal and child health structures, addressing information gaps, mobilizing traditional and opinion leaders and building strong relationships with the government. These health system based approaches provide a sustainable improvement in the capacity and uptake of services.
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影响因子：
11.8
作者：
Giaquinto, C;Ruga, E;Horban, A
通讯作者：
Horban, A
DOI：
10.1097/01.qai.0000225032.52766.c2
发表时间：
2006-06-01
影响因子：
3.6
作者：
Homsy, Jaco;Kalamya, Julius N.;Mermin, Jonathan
通讯作者：
Mermin, Jonathan
DOI：
10.1097/01.qai.0000163196.36199.89
发表时间：
2005-12-01
影响因子：
3.6
作者：
Welty, TK;Bulterys, M;Wilfert, CM
通讯作者：
Wilfert, CM
影响因子：
4.9
作者：
Anderson, JE;Koenig, LJ;Saul, J
通讯作者：
Saul, J
印度安得拉邦公共部门预防艾滋病毒母婴传播中心的产出、成本和效率。
影响因子：
2.8
作者：
Dandona, Lalit;Kumar, Sg Prem;Ramesh, Yk;Rao, M. Chalapathi;Marseille, Elliot;Kahn, James G.;Dandona, Rakhi
通讯作者：
Dandona, Rakhi