Scaling Up Antiretroviral Therapy in Malawi-Implications for Managing Other Chronic Diseases in Resource-Limited Countries
Scaling Up Antiretroviral Therapy in Malawi-Implications for Managing Other Chronic Diseases in Resource-Limited Countries
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DOI：
10.1097/qai.0b013e3181bbc99e
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发表时间：
2009-11-01
影响因子：
3.6
通讯作者：
Kamoto, Kelita
中科院分区：
文献类型：
--
作者：
Harries, Anthony D.;Zachariah, Rony;Kamoto, Kelita
马拉维在全国范围内扩大抗逆转录病毒疗法（ART）是基于公共卫生方法，其原则和做法借鉴了成功的短程直接观察治疗（DOTS）结核病控制框架。主要原则包括政治承诺、免费护理以及病例发现、治疗、记录和报告以及药物采购的标准化系统。2004年6月开始扩大抗逆转录病毒治疗，到2008年12月，在资源严重不足的卫生系统内登记了223,437名患者接受治疗。马拉维提供终身抗逆转录病毒治疗的模式可以加以调整，并用于管理慢性非传染性疾病患者，低收入和中等收入国家的慢性非传染性疾病负担已经很高，而且还在继续增加。本文讨论了如何将马拉维成功提供抗逆转录病毒治疗模式背后的原则应用于资源有限环境中其他慢性病的管理，以及如何将这种模式用于加强卫生系统。
The national scale-up of antiretroviral therapy (ART) in Malawi is based on the public health approach, with principles and practices borrowed from the successful DOTS (directly observed treatment, short course) tuberculosis control framework. The key principles include political commitment, free care, and standardized systems for case finding, treatment, recording and reporting, and drug procurement. Scale-up of ART started in June 2004, and by December 2008, 223,437 patients were registered for treatment within a health system that is severely underresourced. The Malawi model for delivering lifelong ART can be adapted and used for managing patients with chronic noncommunicable diseases, the burden of which is already high and continues to grow in low-income and middle-income countries. This article discusses how the principles behind the successful Malawi model of ART delivery can be applied to the management of other chronic diseases in resource-limited settings and how this paradigm can be used for health systems strengthening.