Leveraging rapid community-based HIV testing campaigns for non-communicable diseases in rural Uganda.
Leveraging rapid community-based HIV testing campaigns for non-communicable diseases in rural Uganda.
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在乌干达农村地区利用基于社区的快速艾滋病毒检测活动来检测非传染性疾病。
DOI：
10.1371/journal.pone.0043400
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
SEARCH Collaboration
中科院分区：
文献类型：
--
作者：
Chamie G;Kwarisiima D;Clark TD;Kabami J;Jain V;Geng E;Petersen ML;Thirumurthy H;Kamya MR;Havlir DV;Charlebois ED;SEARCH Collaboration
在撒哈拉以南非洲，未确诊的艾滋病毒造成的沉重负担限制了治疗和预防工作。以社区为基础的艾滋病毒检测运动可以应对这一挑战，并为查明非传染性疾病提供一个尚未利用的机会。我们测试了将非传染性疾病和传染性疾病纳入乌干达农村教区所有居民的快速艾滋病毒检测和转诊运动的可行性和诊断率。2011年5月开展了为期五天的多疾病运动，提供诊断、预防、治疗和转诊服务。服务包括艾滋病毒、疟疾、结核病、高血压和糖尿病的护理点筛查。手指针刺诊断消除了静脉切开术的需要。艾滋病毒感染的成年人在现场会见了诊所工作人员和同伴辅导员; CD 4 ≤100/µL的人接受了强化咨询和快速转诊接受抗逆转录病毒治疗（ART）。社区参与，病例发现率，并连接到护理运动后三个月进行了分析。在6，300名居民中，2，323/3，150（74%）名成年人和2，020/3，150（69%）名儿童参加了活动。估计95%和52%的成年女性和男性居民分别参加。成人艾滋病毒感染率为7.8%，新诊断的艾滋病毒感染成人占46%。39%的新艾滋病毒诊断与护理有关。在CD 4 ≤100的试点亚组中，83%的患者在10天内联系并开始ART。10%的儿童被发现患有疟疾，28%和3.5%的成年人分别被发现患有高血压和糖尿病。65%的高血压患者和23%的糖尿病患者是新诊断的，其中43%和61%分别与护理有关。筛查发现87%的艾滋病毒感染者和19%的未感染艾滋病毒的成年人疑似结核病; 52%的未感染艾滋病毒的结核病疑似患者与护理有关。在一项涉及74%成年居民的综合运动中，我们发现了未确诊的艾滋病毒、高血压和糖尿病的高负担。提高男性护理和优化与护理的联系需要新的方法。该运动表明，将高血压、糖尿病和传染病纳入艾滋病毒倡议是可行的。
The high burden of undiagnosed HIV in sub-Saharan Africa limits treatment and prevention efforts. Community-based HIV testing campaigns can address this challenge and provide an untapped opportunity to identify non-communicable diseases (NCDs). We tested the feasibility and diagnostic yield of integrating NCD and communicable diseases into a rapid HIV testing and referral campaign for all residents of a rural Ugandan parish. A five-day, multi-disease campaign, offering diagnostic, preventive, treatment and referral services, was performed in May 2011. Services included point-of-care screening for HIV, malaria, TB, hypertension and diabetes. Finger-prick diagnostics eliminated the need for phlebotomy. HIV-infected adults met clinic staff and peer counselors on-site; those with CD4≤100/µL underwent intensive counseling and rapid referral for antiretroviral therapy (ART). Community participation, case-finding yield, and linkage to care three months post-campaign were analyzed. Of 6,300 residents, 2,323/3,150 (74%) adults and 2,020/3,150 (69%) children participated. An estimated 95% and 52% of adult female and male residents participated respectively. Adult HIV prevalence was 7.8%, with 46% of HIV-infected adults newly diagnosed. Thirty-nine percent of new HIV diagnoses linked to care. In a pilot subgroup with CD4≤100, 83% linked and started ART within 10 days. Malaria was identified in 10% of children, and hypertension and diabetes in 28% and 3.5% of adults screened, respectively. Sixty-five percent of hypertensives and 23% of diabetics were new diagnoses, of which 43% and 61% linked to care, respectively. Screening identified suspected TB in 87% of HIV-infected and 19% of HIV-uninfected adults; 52% percent of HIV-uninfected TB suspects linked to care. In an integrated campaign engaging 74% of adult residents, we identified a high burden of undiagnosed HIV, hypertension and diabetes. Improving male attendance and optimizing linkage to care require new approaches. The campaign demonstrates the feasibility of integrating hypertension, diabetes and communicable diseases into HIV initiatives.
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影响因子：
4.5
作者：
Bovet P;Gervasoni JP;Mkamba M;Balampama M;Lengeler C;Paccaud F
通讯作者：
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影响因子：
2.7
作者：
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通讯作者：
Tuomilehto, J
影响因子：
4.9
作者：
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通讯作者：
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影响因子：
2.8
作者：
Kahn JG;Harris B;Mermin JH;Clasen T;Lugada E;Grabowksy M;Vestergaard Frandsen M;Garg N
通讯作者：
Garg N
影响因子：
3.7
作者：
Lugada E;Millar D;Haskew J;Grabowsky M;Garg N;Vestergaard M;Kahn JG;Muraguri N;Mermin J
通讯作者：
Mermin J