Ensuring Optimal Community HIV Testing Services in Nigeria Using an Enhanced Community Case-Finding Package (ECCP), October 2019-March 2020: Acceleration to HIV Epidemic Control.
Ensuring Optimal Community HIV Testing Services in Nigeria Using an Enhanced Community Case-Finding Package (ECCP), October 2019-March 2020: Acceleration to HIV Epidemic Control.
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DOI：
10.2147/hiv.s316480
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
CDC Nigeria ART Surge Team
中科院分区：
文献类型：
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作者：
Jahun I;Dirlikov E;Odafe S;Yakubu A;Boyd AT;Bachanas P;Nzelu C;Aliyu G;Ellerbrock T;Swaminathan M;CDC Nigeria ART Surge Team
2018年尼日利亚艾滋病毒/艾滋病指标和影响调查（NAIIS）显示，尼日利亚在实现联合国艾滋病规划署90-90-90目标方面取得了进展：47%的艾滋病毒阳性者知道自己的状况;其中，96%正在接受抗逆转录病毒治疗（ART）;其中，81%的病毒得到抑制。为了更好地查明艾滋病毒抗体阳性者，尼日利亚制定了一套加强社区病例调查方案。我们描述了ECCP在九个州的实施，并评估其效果。ECCP包括四个核心战略（艾滋病毒感染者[PLHIV]的小区域估计[SAE]，按居住地划分的艾滋病毒阳性患者地图，艾滋病毒风险筛查工具[HRST]和指数测试[IT]）和四个支持性战略（替代医疗保健网点，基于现场测试人员的绩效激励，社区医疗保健成果项目扩展和交互式仪表板）。在10个优先推广抗逆转录病毒疗法的州中，有9个州部署了ECCP。每周计划数据（2019年10月至2020年3月）进行跟踪和分析。在尼日利亚总共774个地方政府地区中，使用SAE，确定了103个（13.3%）高负担地方政府地区，其中9 294个热点地区中的2 605个（28.0%）通过按居住地址绘制新确定的艾滋病毒感染者地图而被优先考虑。在22周内，在使用HRST筛查的882，449人中，723，993人（82.0%）符合条件并进行了艾滋病毒检测（州范围，43.7-90.4%），其中20，616人呈阳性。通过信息技术，又确认了3 724名艾滋病毒感染者。总共确定了24，340名艾滋病毒感染者，其中97.4%与挽救生命的抗逆转录病毒治疗有关。新发现的艾滋病毒感染者数量在22周内增加了17倍（第1周：89;第22周：1，632）。按州分列的总体平均艾滋病毒阳性率为3.3%（范围：1.8-6.4%）。在尼日利亚的九个州使用ECCP增加了社区中了解自己状况的艾滋病毒感染者的数量，使他们能够获得挽救生命的护理，降低了艾滋病毒传播的风险。
The 2018 Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS) showed Nigeria’s progress toward the UNAIDS 90-90-90 targets: 47% of HIV-positive individuals knew their status; of these, 96% were receiving antiretroviral therapy (ART); and of these, 81% were virally suppressed. To improve identification of HIV-positive individuals, Nigeria developed an Enhanced Community Case-Finding Package (ECCP). We describe ECCP implementation in nine states and assess its effect. ECCP included four core strategies (small area estimation [SAE] of people living with HIV [PLHIV], map of HIV-positive patients by residence, HIV risk-screening tool [HRST], and index testing [IT]) and four supportive strategies (alternative healthcare outlets, performance-based incentives for field testers, Project Extension for Community Healthcare Outcomes, and interactive dashboards). ECCP was deployed in nine of 10 states prioritized for ART scale-up. Weekly program data (October 2019–March 2020) were tracked and analyzed. Of the total 774 LGAs in Nigeria, using SAE, 103 (13.3%) high-burden LGAs were identified, in which 2605 (28.0%) out of 9,294 hotspots were prioritized by mapping newly identified PLHIV by residential addresses. Over 22 weeks, among 882,449 individuals screened using HRST, 723,993 (82.0%) were eligible and tested for HIV (state range, 43.7–90.4%), out of which 20,616 were positive. Through IT, an additional 3,724 PLHIV were identified. In total, 24,340 PLHIV were identified and 97.4% were linked to life-saving antiretroviral therapy. The number of newly identified PLHIV increased 17-fold over 22 weeks (week 1: 89; week 22: 1,632). Overall mean HIV positivity rate by state was 3.3% (range, 1.8–6.4%). Using ECCP in nine states in Nigeria increased the number of PLHIV in the community who knew their status, allowing them to access life-saving care and decreasing the risk of HIV transmission.