Offering integrated care for HIV/AIDS, diabetes and hypertension within chronic disease clinics in Cambodia
Offering integrated care for HIV/AIDS, diabetes and hypertension within chronic disease clinics in Cambodia
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DOI：
10.2471/blt.06.036574
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发表时间：
2007-11-01
期刊：
影响因子：
--
通讯作者：
Zachariah, R
中科院分区：
文献类型：
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作者：
Janssens, B;Van Damme, W;Zachariah, R
问题在柬埔寨，对艾滋病毒/艾滋病患者的护理（患病率1.9%）正在扩大，但对11型糖尿病患者的护理（患病率5-10%），动脉高血压和其他可治疗的慢性病仍然非常有限。方法我们描述了为艾滋病毒/艾滋病提供综合护理的经验和结果，在暹粒和茶胶的省级转诊医院设立了地方慢性病诊所，在接受护理24个月时，87.7%的艾滋病毒/艾滋病患者仍然存活，并正在积极接受随访。对于糖尿病患者，这一比例为71%。在艾滋病毒/艾滋病患者中，9.3%死亡，3%失访，而糖尿病患者中，这包括3例（0.1%）死亡和28.9%失访。在队列中停留超过3个月的所有糖尿病患者中，90%在24个月时仍在随访中。经验教训在最初的三年里，慢性病诊所已经证明了将艾滋病毒/艾滋病护理与柬埔寨的非传染性慢性病护理相结合的可行性。实践证明，坚持支持战略是相辅相成的，取得了良好的成果。病人很愿意接受这些服务，这对消除与艾滋病毒/艾滋病有关的耻辱感产生了积极影响。这一经验表明，对艾滋病毒/艾滋病患者的护理如何能够推动应对其他常见慢性病。
Problem In Cambodia, care for people with HIV/AIDS (prevalence 1.9%) is expanding, but care for people with type 11 diabetes (prevalence 5-10%), arterial hypertension and other treatable chronic diseases remains very limited.Approach We describe the experience and outcomes of offering integrated care for HIV/AIDS, diabetes and hypertension within the setting of chronic disease clinics.Local setting Chronic disease clinics were set up in the provincial referral hospitals of Siem Reap and Takeo, 2 provincial capitals in Cambodia.Relevant changes At 24 months of care, 87.7% of all HIV/AIDS patients were alive and in active follow-up. For diabetes patients, this proportion was 71 %. Of the HIV/AIDS patients, 9.3% had died and 3% were lost to follow-up, while for diabetes this included 3 (0.1 %) deaths and 28.9% lost to follow-up. Of all diabetes patients who stayed more than 3 months in the cohort, 90% were still in follow-up at 24 months.Lessons learned Over the first three years, the chronic disease clinics have demonstrated the feasibility of integrating care for HIV/AIDS with non-communicable chronic diseases in Cambodia. Adherence support strategies proved to be complementary, resulting in good outcomes. Services were well accepted by patients, and this has had a positive effect on HIV/AIDS-related stigma. This experience shows how care for HIV/AIDS patients can act as an impetus to tackle other common chronic diseases.