Implementing an integrated community based health systems strengthening approach to improve HIV survival in Northern Togo.
Implementing an integrated community based health systems strengthening approach to improve HIV survival in Northern Togo.
复制标题
实施基于社区的综合卫生系统强化方法，以提高多哥北部的艾滋病毒生存率。
DOI：
10.1080/09540121.2019.1626342
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发表时间：
2020
期刊：
影响因子：
1.7
通讯作者：
Pitche,VincentPalokinam
中科院分区：
文献类型：
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作者：
Fiori,KevinP;Belli,HayleyM;Lauria,MollyE;Hirschhorn,LisaR;Schechter,Jennifer;Hansman,Emily;Rajshekhar,Nandita;Katin,Venance;Gbeleou,Sesso;Grunitsky-Bekele,Meskerem;Pitche,VincentPalokinam
为了传播从公私部门伙伴关系的实施经验中吸取的教训，我们描述了一个全面的艾滋病毒/艾滋病规划，包括2010年至2015年在多哥开始抗逆转录病毒治疗（ART）治疗的个人的5年生存结果。对多哥卡拉地区一家艾滋病毒/艾滋病护理诊所接受抗逆转录病毒治疗的患者队列进行了回顾性病例研究分析。使用Kaplan-Meier曲线和Log rank检验比较人口学特征和临床特征的估计生存曲线。生存率与年龄、性别、世界卫生组织（WHO）疾病分期和开始抗逆转录病毒治疗的时间有关。采用Cox比例风险模型确定死亡率预测因子。自ART治疗开始约5年后（1780天），有114例死亡，生存率为75.3% （95% CI: 70.3-80.6%）。世卫组织疾病晚期患者的死亡风险比世卫组织1期患者高，4期患者的死亡风险约为9倍（aHR 9.22, 95% CI 4.29-19.84）。我们的研究表明，通过公私伙伴关系提供全面的艾滋病毒护理可以作为扩大和改善艾滋病毒/艾滋病护理以及高质量初级保健的模式。
To disseminate lessons learned from the implementation experience of a public-private sector partnership, we describe a comprehensive HIV/AIDS program including 5-year survival outcomes for individuals who initiated antiretroviral therapy (ART) treatment in Togo from 2010 to 2015. A retrospective case study analysis was conducted from a cohort of patients receiving ART at an HIV/AIDS care clinic in Kara Region, Togo. Kaplan-Meier curves with Log rank tests were used to compare estimated survival curves by demographic and clinical characteristics. Associations were described between survival probability and age, gender, World Health Organization (WHO) disease stage, and timing of ART initiation. Cox proportional hazard model was used to determine predictors of mortality. After approximately five-years since ART initiation (1780 days), there were 114 deaths, with a survival probability of 75.3% (95% CI: 70.3–80.6%). Participants with advanced WHO disease stage were more likely at risk of death relative to patients categorized as WHO Stage 1, with Stage 4 approximately 9 times more likely (aHR 9.22, 95% CI 4.29–19.84). Our study suggests that delivering comprehensive HIV care through a private-public partnership may serve as a model to expand and improve HIV/AIDS care as well as high quality primary care.