Do targeted HIV programs improve overall care for pregnant women? Antenatal syphilis management in Zambia before and after implementation of prevention of mother-to-child HIV transmission programs
Do targeted HIV programs improve overall care for pregnant women? Antenatal syphilis management in Zambia before and after implementation of prevention of mother-to-child HIV transmission programs
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DOI：
10.1097/qai.0b013e31815d2f71
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发表时间：
2008-01-01
影响因子：
3.6
通讯作者：
Vermund, Sten H.
中科院分区：
文献类型：
--
作者：
Potter, Dara;Goldenberg, Robert L.;Vermund, Sten H.
背景资料：针对特定疾病的研究或服务项目的实施可能会对常规临床服务产生辅助性的有益或有害影响。我们回顾了从1997年到2004年在卢萨卡22个产前诊所的5801个首次就诊记录，赞比亚和检查记录的梅毒快速血浆反应素（RPR）筛查和梅毒治疗之前和之后实施的研究和/或预防母婴传播（PMTCT）艾滋病毒的服务项目。与PMTCT项目实施前相比，记录的RPR筛查的患病率比值比（OR）和95%置信区间（CI）为0.9（0.7至1.1）研究实施后，0.7（0.6至0.8）服务后，和2.5（2.1至3.0）。结论：在实施预防母婴传播的研究和服务同时进行，而不是单独进行研究或服务后，记录在案的RPR筛查得到了改善。卫生政策制定者和研究人员应明确规划有针对性的艾滋病毒项目、服务和/或研究如何产生更广泛的初级保健影响。
Background: The implementation of disease-specific research or service programs may have an ancillary beneficial or harmful impact on routine clinical services.Methods: We reviewed the records of 5801 first visits to 22 antenatal clinics from 1997 to 2004 in Lusaka, Zambia and examined documented syphilis rapid plasma reagin (RPR) screening and syphilis treatment before and after implementation of research and/or service programs in prevention of mother-to-child (PMTCT) HIV transmission.Findings: Compared with before PMTCT program implementation, the prevalence odds ratios (PORs) and 95% confidence intervals (CIs) for documented RPR screening were 0.9 (0.7 to 1.1) after implementation of research, 0.7 (0.6 to 0.8) after service, and 2.5 (2.1 to 3.0) after research and service programs.Conclusions: Documented RPR screening was improved after implementation of PMTCT research and service were operating simultaneously and not with research or service alone. Health policy makers and researchers should plan explicitly for how the targeted HIV programs, service, and/or research can have a broader primary care impact.