Reaching underserved South Africans with integrated chronic disease screening and mobile HIV counselling and testing: A retrospective, longitudinal study conducted in Cape Town.
Reaching underserved South Africans with integrated chronic disease screening and mobile HIV counselling and testing: A retrospective, longitudinal study conducted in Cape Town.
复制标题
DOI：
10.1371/journal.pone.0249600
复制
发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Bekker LG
中科院分区：
文献类型：
--
作者：
Smith PJ;Davey DJ;Green H;Cornell M;Bekker LG
以社区为基础的流动艾滋病毒咨询和检测(HCT)和非传染性疾病(NCDs)筛查可能会改善服务不足人群的早期诊断和转诊。我们评估了HCT/NCD数据，并描述了2008至2016年间在南非开普敦高艾滋病毒疾病负担环境下前往流动诊所就诊的人群特征。训练有素的咨询师在一家流动诊所为12岁的患者登记，该诊所提供红细胞压积和血压、糖尿病(血糖测试)和肥胖(体重指数)筛查。一名护士介绍了需要艾滋病毒治疗或非传染性疾病护理的患者。使用多变量Logistic回归，我们估计了根据性别、年龄和年份调整后的新HIV诊断的相关性。总体而言，有43,938人(男性占50%，25岁占29%，年龄中位数为31岁)在流动诊所接受了艾滋病毒检测，其中27%的患者(66%的男性，34%的女性)报告说自己是初次检测艾滋病毒的人。以前没有进行过艾滋病毒检测的男性的艾滋病毒阳性率(11%)高于女性(7%)。超过一半(55%，n=1,343)以前被诊断为HIV阳性的人没有开始抗逆转录病毒治疗。超过四分之一(26%)的患者高血压筛查呈阳性(男性28%，女性24%，p<；0.001)。女性更有可能超重(25%比20%)或肥胖(43%比9%)，并出现比男性更多的糖尿病症状(8%比4%)。女性(3%)报告的性传播感染症状多于男性(1%)。报告性病症状(AOR=3.45，95%CI=2.84，4.20)、糖尿病症状(AOR=1.61，95%CI=1.35，1.92)和结核病症状(AOR=4.40，95%CI=3.85，5.01)与新诊断HIV的几率较高。调查结果表明，提供综合HCT和NCD筛查的流动诊所可以为推迟筛查的人提供早期诊断和转诊的机会，包括以前未进行检测的艾滋病毒携带者。
Community-based, mobile HIV counselling and testing (HCT) and screening for non-communicable diseases (NCDs) may improve early diagnosis and referral for care in underserved populations. We evaluated HCT/NCD data and described population characteristics of those visiting a mobile clinic in high HIV disease burden settings in Cape Town, South Africa, between 2008 and 2016. Trained counsellors registered patients ≥12 years old at a mobile clinic, which offered HCT and blood pressure, diabetes (glucose testing) and obesity (body mass index) screening. A nurse referred patients who required HIV treatment or NCD care. Using multivariable logistic regression, we estimated correlates of new HIV diagnoses adjusting for gender, age and year. Overall, 43,938 individuals (50% male; 29% <25 years; median age = 31 years) tested for HIV at the mobile clinic, where 27% of patients (66% of males, 34% of females) reported being debut HIV testers. Males not previously tested for HIV had higher rates of HIV positivity (11%) than females (7%). Over half (55%, n = 1,343) of those previously diagnosed HIV-positive had not initiated ART. More than one-quarter (26%) of patients screened positive for hypertension (males 28%, females 24%, p<0.001). Females were more likely overweight (25% vs 20%) or obese (43% vs 9%) and presented with more diabetes symptoms than males (8% vs 4%). Females (3%) reported more symptoms of STIs than males (1%). Reporting symptoms of sexually transmitted infections (aOR = 3.45, 95% CI = 2.84, 4.20), diabetes symptoms (aOR = 1.61, 95% 1.35, 1.92), and TB symptoms (aOR = 4.40, 95% CI = 3.85, 5.01) were associated with higher odds of a new HIV diagnosis after adjusting for covariates. Findings demonstrate that mobile clinics providing integrated HCT and NCD screening may offer the opportunity of early diagnosis and referral for care for those who delay screening, including men living with HIV not previously tested.
登录
查看更多内容
影响因子：
4.5
作者：
Callaghan M;Ford N;Schneider H
通讯作者：
Schneider H
DOI：
10.1080/09540121.2017.1344350
发表时间：
2018-01-01
影响因子：
1.7
作者：
Haldane, Victoria;Legido-Quigley, Helena;Perel, Pablo
通讯作者：
Perel, Pablo
影响因子：
5.5
作者：
Drewnowski, A
通讯作者：
Drewnowski, A
影响因子：
6.4
作者：
Bedelu, Martha;Ford, Nathan;Reuter, Hermann
通讯作者：
Reuter, Hermann
影响因子：
1.7
作者：
Bogart LM;Chetty S;Giddy J;Sypek A;Sticklor L;Walensky RP;Losina E;Katz JN;Bassett IV
通讯作者：
Bassett IV