Barriers and facilitators to HIV and syphilis rapid diagnostic testing in antenatal care settings in low-income and middle-income countries: a systematic review.
Barriers and facilitators to HIV and syphilis rapid diagnostic testing in antenatal care settings in low-income and middle-income countries: a systematic review.
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DOI：
10.1136/bmjgh-2022-009408
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发表时间：
2022-11
影响因子：
8.1
通讯作者：
Lafferty, Lise
中科院分区：
文献类型：
--
作者：
Zhang, Ye;Guy, Rebecca;Camara, Hawa;Applegate, Tanya L.;Wiseman, Virginia;Treloar, Carla;Lafferty, Lise
怀孕期间的检测和治疗是一项行之有效的、具有成本效益的预防战略，主要依赖于快速诊断检测的使用。然而，在许多低收入和中等收入国家，RDT的吸收情况并不理想。进行了定性综合分析，以确定低收入和中等收入国家孕妇使用艾滋病毒和梅毒RDT的障碍和促进因素。该审查是根据PRISMA指南进行的。符合条件的研究包括同行评议的出版物，这些出版物使用定性方法探讨低收入和中等收入国家产前保健诊所的艾滋病毒和梅毒RDT。研究侧重于孕妇，医护人员和/或利益相关者的观点。我们使用了一种归纳的方法，通过修改后的社会生态模型来综合数据。62份手稿符合资格标准。对孕妇而言，最初接受RDT并继续接受产前护理取决于这样一种观念，即参与检测对其婴儿和她们自己都是有益的经历，这往往受到提供对性别问题有敏感认识、保密、尊重、灵活并考虑到她们未来福祉的服务的影响。当地关于怀孕和疾病的社会文化观念、对疾病的认识和社会中的性别角色也影响到孕妇对RDT的接受程度。对于医疗工作者来说，提供高质量RDT护理的能力需要持续的培训，准确和易于使用的测试，来自主管和社区的支持，足够的资源和人员提供服务，以及可靠的工资。在利益攸关方一级，完善的准则和卫生系统基础设施对于产前诊所提供RDT至关重要。我们的研究结果突出了使用RDT提供可持续和文化上可接受的孕产妇艾滋病毒和/或梅毒筛查的明显差距。此外，需要更加关注社区利益攸关方在产前诊所推广RDT。CRD 42018112190。
Testing and treatment during pregnancy is a well-established and cost-effective prevention strategy, which relies largely on use of rapid diagnostic tests (RDTs). Yet, in many low-income and-middle-income countries, the uptake of RDTs is suboptimal. A qualitative meta-synthesis was conducted to identify the barriers and enablers to use of HIV and syphilis RDTs among pregnant women in low-income and middle-income countries. This review was conducted using PRISMA guidelines. Eligible studies included peer-reviewed publications, which used qualitative methods to explore HIV and syphilis RDT in antenatal care clinics in low-income and middle-income countries. Studies focusing on perspectives of pregnant women, healthcare workers and/or stakeholders were included. We used an inductive approach informed by a modified socioecological model to synthesise the data. 62 manuscripts met the eligibility criteria. For pregnant women, initial acceptance of the RDT and continuation in antenatal care depends on the perception that engaging in testing will be a beneficial experience for their baby and themselves, often influenced by the provision of services that are gender-sensitive, confidential, respectful, flexible and considers their well-being into the future. Local sociocultural beliefs about pregnancy and diseases, awareness of diseases and gender roles in society also influenced RDT acceptability among pregnant women. For healthcare workers, the ability to provide high-quality RDT care required ongoing training, accurate and easy to use tests, support from supervisors and communities, sufficient resources and staffing to provide services, and reliable salary. At the stakeholder level, well-developed guidelines and health system infrastructures were imperative to the delivery of RDT in antenatal clinics. Our findings highlight clear gaps to the provision of sustainable and culturally acceptable maternal HIV and/or syphilis screening using RDTs. In addition, greater attention needs to be paid to community stakeholders in promoting the uptake of RDT in antenatal clinics. CRD42018112190.
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DOI：
10.11694/pamj.supp.2014.17.1.3423
发表时间：
2014-01-01
期刊：
The Pan African medical journal
影响因子：
--
作者：
Bocoum, Fadima Yaya;Kouanda, Seni;Zarowsky, Christina
通讯作者：
Zarowsky, Christina
影响因子：
1.7
作者：
Groves AK;Maman S;Msomi S;Makhanya N;Moodley D
通讯作者：
Moodley D
影响因子：
2.8
作者：
An, Selena J.;George, Asha S.;Kilewo, Charles
通讯作者：
Kilewo, Charles
影响因子：
6
作者：
Falnes EF;Moland KM;Tylleskär T;de Paoli MM;Msuya SE;Engebretsen IM
通讯作者：
Engebretsen IM
影响因子：
4.5
作者：
An, Selena J.;George, Asha S.;Kilewo, Charles
通讯作者：
Kilewo, Charles