Utilization of antiretroviral treatment in Ethiopia between February and December 2006: spatial, temporal, and demographic patterns.
Utilization of antiretroviral treatment in Ethiopia between February and December 2006: spatial, temporal, and demographic patterns.
复制标题
2006年2月至12月之间，埃塞俄比亚抗逆转录病毒治疗的利用：空间，时间和人口统计学模式。
DOI：
10.1186/1476-072x-6-45
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发表时间：
2007-09-25
影响因子：
4.9
通讯作者：
Mariam, Damen Haile
中科院分区：
文献类型：
--
作者：
Kloos, Helmut;Assefa, Yibeltal;Adugna, Aynalem;Mulatu, Mesfin Samuel;Mariam, Damen Haile
2003年，埃塞俄比亚卫生部开始实施国家抗逆转录病毒治疗方案。利用卫生部发布的每月艾滋病毒/艾滋病最新资料中的数据，本文研究了2006年2月至12月期间埃塞俄比亚城镇、行政区和地区抗逆转录病毒治疗在人口基础上的时空分布。2006年12月，101家公立抗逆转录病毒治疗医院治疗了44 446名患者，91家抗逆转录病毒治疗保健中心治疗了1 599名患者。2006年2月至12月期间，目前接受抗逆转录病毒疗法的患者人数翻了一番，15岁及以上的女性患者人数超过男性患者，这显然是由于提高了认识和提供免费抗逆转录病毒疗法。抗逆转录病毒疗法的人口覆盖率最高的是阿迪斯、哈拉里和德雷达瓦三个城市行政区、有转诊医院的区域中心以及有以前的使命或其他非政府组织经营的医院的几个路边小镇。阿迪斯的医院病人最多（平均850名病人），南部民族和少数民族人民共和国（212名病人）和索马里（130名病人）地区的医院病人最少。在双变量检验中，2006年接受治疗的患者人数与城镇人口规模、每个区的城市人口、每个区的医院数量和抗逆转录病毒治疗服务的持续时间显著相关（所有p < 0.001）。与城市人口的关系比与总地带人口的关系更强（p < 0.001 vs p = 0.014），以及44个卫生中心到最近的ART医院的距离与在这些卫生中心接受治疗的患者之间的正相关性可能是由于ART站点的可达性差异，患者知识和寻求健康行为的组合。2006年抗逆转录病毒疗法使用率的急剧增加主要是由于在更多地点提供免费治疗的迅速增加。城市和农村社区之间以及地区和区域之间抗逆转录病毒疗法使用模式的显著差异需要进一步研究。为进一步扩大抗逆转录病毒疗法的规模和可持续性提出了建议。
In 2003, the Ethiopian Ministry of Health (MOH) started to implement a national antiretroviral treatment (ART) program. Using data in the monthly HIV/AIDS Updates issued by the MOH, this paper examines the spatial and temporal distribution of ART on a population basis for Ethiopian towns and administrative zones and regions for the period February to December 2006. The 101 public ART hospitals treated 44,446 patients and the 91 ART health centers treated 1,599 patients in December 2006. The number of patients currently receiving ART doubled between February and December 2006 and the number of female patients aged 15 years and older surpassed male patients, apparently due to increased awareness and provision of free ART. Of 58,405 patients who ever started ART in December 2006, 46,045 (78.8%) were adhering to treatment during that month. Population coverage of ART was highest in the three urban administrative regions of Addis Ababa, Harari and Dire Dawa, in regional centers with referral hospitals, and in several small road side towns that had former mission or other NGO-operated hospitals. Hospitals in Addis Ababa had the largest patient loads (on average 850 patients) and those in SNNPR (Southern Nations and Nationalities Peoples Republic) (212 patients) and Somali (130 patients) regions the fewest patients. In bivariate tests, number of patients receiving treatment was significantly correlated with population size of towns, urban population per zone, number of hospitals per zone, and duration of ART services in 2006 (all p < 0.001). The stronger relationship with urban than total zonal populations (p < 0.001 versus p = 0.014) and the positive correlation between distance from 44 health centers to the nearest ART hospital and patients receiving treatment at these health centers may be due to a combination of differential accessibility of ART sites, patient knowledge and health-seeking behavior. The sharp increase in ART uptake in 2006 is largely due to the rapid increase in the provision of free treatment at more sites. The marked variation in ART utilization patterns between urban and rural communities and among zones and regions requires further studies. Recommendations are made for further expansion and sustainability of the ART scale-up.