HIV status determination among tuberculosis patients from California during 2008.

HIV status determination among tuberculosis patients from California during 2008.
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2008 年加利福尼亚州结核病患者的 HIV 状况测定。

DOI:
10.1097/phh.0b013e3182550a83
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发表时间:
2013
期刊:
Journal of public health management and practice : JPHMP
影响因子:
--
通讯作者:
Flood,Jennifer
Flood,Jennifer
中科院分区:
--
文献类型:
--
作者:
Kong,DarrylG;Watt,JamesP;Marks,Suzanne;Flood,Jennifer

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目的:我们评估结核病患者的艾滋病病毒状态确定的完整性,并确定在adherence.Design的关键差距:我们进行了一项回顾性审查的公共卫生图表,以确定艾滋病病毒状态的所有结核病患者报告在加州在2008年。然后,我们使用逻辑回归来确定与已知(阳性或阴性)HIV状态相关的因素。随机选择结核病患者进行二次审查,以描述HIV状态确定的时间和有机会进行HIV检测的提供者。设置:加州结核病项目。参与者:2008年加州报告的所有结核病患者。主要结果测量:已知HIV状态的患者比例,已知HIV状态的调整优势比,结核病诊断前已知HIV状态的患者比例,以及不同提供者类型诊断为结核病的患者比例。结果:2667例结核病患者中只有1752例(66%)已知HIV状态。具有已知的艾滋病毒状况与年龄在15至44岁之间的人密切相关,并与任何公共提供者参与管理。在随机抽样的292名患者中,12名患者(4%)在结核病诊断前就已知道艾滋病毒感染状况。在其余的280例患者中,187例(67%)被诊断为结核病的私人provider.Conclusions:结核病患者的HIV状态确定是选择性的,而不是常规的建议。私人提供者可以在结核病诊断时检测艾滋病毒方面发挥关键作用。加州结核病规划应通过颁布国家建议、教育私人提供者对结核病患者进行艾滋病毒检测的好处以及监测艾滋病毒状态确定的完整性,确保所有结核病患者都具有艾滋病毒状态。
Objective:We assessed completeness of HIV status determination among TB patients and identified key gaps in adherence.Design:We conducted a retrospective review of public health charts to determine the HIV status for all TB patients reported in California during 2008. We then used logistic regression to determine the factors associated with a known (positive or negative) HIV status. A random sample of TB patients was selected for secondary review to characterize the timing of HIV status determination and the providers who had opportunity to test for HIV.Setting:California TB programs.Participants:All TB patients reported from California in 2008.Main Outcome Measures:Proportion of patients with a known HIV status, adjusted odds ratios for having a known HIV status, proportion of patients with a known HIV status before TB diagnosis, and proportion of patients diagnosed with TB by different provider types.Results:Only 1752 (66%) of 2667 TB patients had a known HIV status. Having a known HIV status was strongly associated with those aged between 15 and 44 years and being managed with any public provider involvement. Of 292 patients in the random sample, 12 patients (4%) had a known HIV status before TB diagnosis. Among the remaining 280 patients, 187 patients (67%) were diagnosed with TB by a private provider.Conclusions:The HIV status determination of TB patients was selective and not routine as recommended. Private providers can play a key role in testing for HIV at TB diagnosis. California TB programs should ensure that all TB patients have an HIV status by promulgating national recommendations, educating private providers on the benefits of testing TB patients for HIV, and monitoring completeness of HIV status determination.
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