Promising outcomes of a national programme for the prevention of Mother-to-Child HIV transmission in Addis Ababa: a retrospective study.
Promising outcomes of a national programme for the prevention of Mother-to-Child HIV transmission in Addis Ababa: a retrospective study.
复制标题
DOI：
10.1186/1472-6963-10-267
复制
发表时间：
2010-09-09
影响因子：
2.8
通讯作者：
Mørkve O
中科院分区：
文献类型：
--
作者：
Mirkuzie AH;Hinderaker SG;Mørkve O
预防艾滋病毒母婴传播仍然是防治新的艾滋病毒感染的最有效干预措施。2008年，经修订的国家防止母婴传播准则在埃塞俄比亚生效，其中纳入了关于艾滋病毒咨询和检测、抗逆转录病毒预防疗法和婴儿艾滋病毒诊断的新政策。在本研究中，我们审查了预防母婴传播服务利用的趋势，并评估了与国家预防母婴传播方案政策变化有关的母婴传播率。在埃塞俄比亚阿迪斯的10个分城市审查了2004年2月至2009年8月的报告。数据收集于2009年5月至10月。在转向常规选择退出检测后，接受艾滋病毒咨询和检测的妇女在新的产前护理参与者中的比例从2007年的50.7%（95% CI 50.2-51.2）增加到2009年的84.5%（95% CI 84.1-84.9）。然而，在2009年，只有53.7%的阳性妇女和40.7%的婴儿接受了抗逆转录病毒预防。在接受产前检查的妇女中，艾滋病毒感染率从2004年的10.5%大幅下降到2009年的4.6%，同时接受检测的妇女人数也有所增加。与2004年相比，2009年艾滋病毒抗体呈阳性的妇女被转诊接受治疗、护理和支助的可能性增加了18倍以上（RR 18.5，p < 0.0001）。与2004年相比，2009年接受艾滋病毒检测的伴侣比例下降了14%，但绝对数量逐年增加。只有10.6%（95%置信区间9.9-11.2）的艾滋病毒阳性妇女完成了婴儿艾滋病毒检测的随访。2007年，接受单剂量奈韦拉平方案且在≥ 18个月时接受检测的婴儿中HIV感染的累积概率为15.0%（95%CI 9.8-22.1），而2009年接受齐多夫定方案且在≥ 45天时接受检测的婴儿中HIV感染的累积概率为8.2%（95%CI 5.55-11.97）。该文件展示了与政策变化有关的预防母婴传播服务利用趋势。艾滋病毒咨询和检测服务的利用率有了明显改善，特别是在政策转向常规选择不接受检测之后。然而，尽管政策发生了变化，但抗逆转录病毒预防接种、失访和伴侣检测数多年来保持不变。这应该是一个紧迫的问题，也是一个需要进一步研究的课题。
Prevention of Mother-to-Child HIV Transmission (PMTCT) is still the most effective intervention in combating new HIV infections. In 2008, revised national PMTCT guidelines that incorporated new policies on HIV counselling and testing, antiretroviral prophylaxis regimen and infant HIV diagnosis came into effect in Ethiopia. In the present study we have examined trends in PMTCT service utilization and assessed the rate of MTCT in relation to policy changes in the national PMTCT programme. Reports from February 2004 to August 2009 were reviewed in 10 sub-cities in Addis Ababa, Ethiopia. The data was collected from May to October 2009. The proportion of women who received HIV counselling and testing among new antenatal care attendees increased from 50.7% (95% CI 50.2-51.2) in 2007 to 84.5% (95% CI 84.1-84.9) in 2009 following the shift to routine opt-out testing. Nevertheless, in 2009 only 53.7% of the positive women and 40.7% of their infants received antiretroviral prophylaxis. The HIV prevalence among antenatal attendees decreased significantly from 10.5% in 2004 to 4.6% in 2009 in parallel to the increased number of women being tested. The HIV positive women were over 18 times (RR 18.5, p < 0.0001) more likely to be referred for treatment, care and support in 2009 than in 2004. The proportion of partners tested for HIV decreased by 14% in 2009 compared to 2004, although the absolute number was increasing year by year. Only 10.6% (95% CI 9.9-11.2) of the HIV positive women completed their follow up to infant HIV testing. The cumulative probability of HIV infection among babies on single dose nevirapine regimen who were tested at >=18 months was 15.0% (95% CI 9.8-22.1) in 2007, whereas it was 8.2% (95% CI 5.55-11.97) among babies on Zidovudine regimen who were tested at >=45 days in 2009. The paper demonstrates trends in PMTCT service utilization in relation to changing policy. There is marked improvement in HIV counselling and testing service utilization, especially after the policy shift to routine opt-out testing. However, despite policy changes, the ARV prophylaxis uptake, the loss to follow up and the partner testing have remained unchanged across the years. This should be a matter of immediate concern and a topic for further research.
登录
查看更多内容
影响因子：
168.9
作者：
Jackson, JB;Musoke, P;Mmiro, F
通讯作者：
Mmiro, F
影响因子：
3.3
作者：
Manzi, M;Zachariah, R;Humblet, P
通讯作者：
Humblet, P
DOI：
10.1097/01.qai.0000148081.38331.92
发表时间：
2005-07-01
影响因子：
3.6
作者：
Mpairwe, H;Muhangi, L;Elliott, AM
通讯作者：
Elliott, AM
影响因子：
3.3
作者：
Anand, Abhijeet;Shiraishi, Ray W.;Diaz, Theresa
通讯作者：
Diaz, Theresa
影响因子：
--
作者：
Desgrees-du-Lou, Annabel;Orne-Gliemann, Joanna
通讯作者：
Orne-Gliemann, Joanna