Integration of non-communicable disease and HIV/AIDS management: a review of healthcare policies and plans in East Africa.
Integration of non-communicable disease and HIV/AIDS management: a review of healthcare policies and plans in East Africa.
复制标题
DOI：
10.1136/bmjgh-2020-004669
复制
发表时间：
2021-05
影响因子：
8.1
通讯作者：
Garrib A
中科院分区：
文献类型：
--
作者：
Adeyemi O;Lyons M;Njim T;Okebe J;Birungi J;Nana K;Claude Mbanya J;Mfinanga S;Ramaiya K;Jaffar S;Garrib A
低收入和中等收入国家正在努力管理越来越多的慢性非传染性疾病患者，同时为艾滋病毒感染患者提供的服务已经建立起来。有人呼吁整合艾滋病毒和非传染性疾病服务，以提高效率并改善非传染性疾病护理的覆盖面，尽管有效性的证据尚不清楚。在这次审查中，我们评估了东非国家艾滋病毒和非传染性疾病政策在多大程度上反映了艾滋病毒-非传染性疾病服务一体化的呼吁。在2018年4月至2020年12月期间，我们在布隆迪、肯尼亚、卢旺达、南苏丹、坦桑尼亚和乌干达搜索了与艾滋病毒和非传染性疾病方案有关的政策、战略和指导方针。对文件进行了人工搜索，以确定艾滋病毒和非传染性疾病服务整合计划。采用文献分析的方法对数据进行定性分析。筛选了31份文件，其中13份文件载有艾滋病毒和非传染性疾病服务一体化行动计划。在东非区域的四个国家--肯尼亚、卢旺达、坦桑尼亚和乌干达--的高级别保健政策和治疗准则中建议综合提供艾滋病毒和非传染性疾病护理，主要涉及将非传染性疾病护理纳入艾滋病毒方案。非传染性疾病日益加重的负担，以及向艾滋病毒感染者提供以人为中心的差异化服务的努力，是最近通过艾滋病毒和非传染性疾病综合服务提供计划的一个因素。南苏丹和布隆迪都报告将重点放在建设其医疗基础设施和提高医疗服务的覆盖率和质量上，没有关于艾滋病毒和非传染性疾病护理整合的计划。尽管有效性的证据有限，但一些东非国家已经采取步骤，实现艾滋病毒和非传染性疾病服务一体化。有必要密切监测和评价艾滋病毒和非传染性疾病综合方案，以便深入了解相关的益处和风险，并为今后的服务发展提供信息。
Low-income and middle-income countries are struggling to manage growing numbers of patients with chronic non-communicable diseases (NCDs), while services for patients with HIV infection are well established. There have been calls for integration of HIV and NCD services to increase efficiency and improve coverage of NCD care, although evidence of effectiveness remains unclear. In this review, we assess the extent to which National HIV and NCD policies in East Africa reflect the calls for HIV-NCD service integration. Between April 2018 and December 2020, we searched for policies, strategies and guidelines associated with HIV and NCDs programmes in Burundi, Kenya, Rwanda, South Sudan, Tanzania and Uganda. Documents were searched manually for plans for integration of HIV and NCD services. Data were analysed qualitatively using document analysis. Thirty-one documents were screened, and 13 contained action plans for HIV and NCDs service integration. Integrated delivery of HIV and NCD care is recommended in high level health policies and treatment guidelines in four countries in the East African region; Kenya, Rwanda, Tanzania and Uganda, mostly relating to integrating NCD care into HIV programmes. The increasing burden of NCDs, as well as a move towards person-centred differentiated delivery of services for people living with HIV, is a factor in the recent adoption of integrated HIV and NCD service delivery plans. Both South Sudan and Burundi report a focus on building their healthcare infrastructure and improving coverage and quality of healthcare provision, with no reported plans for HIV and NCD care integration. Despite the limited evidence of effectiveness, some East African countries have already taken steps towards HIV and NCD service integration. Close monitoring and evaluation of the integrated HIV and NCD programmes is necessary to provide insight into the associated benefits and risks, and to inform future service developments.
登录
查看更多内容
影响因子：
3.8
作者：
El-Sadr, Wafaa M.;Goosby, Eric
通讯作者：
Goosby, Eric
影响因子：
4.5
作者：
Achwoka, Dunstan;Waruru, Anthony;De Cock, Kevin M.
通讯作者：
De Cock, Kevin M.
DOI：
10.1093/trstmh/trv038
发表时间：
2015-07-01
影响因子：
2.2
作者：
Edwards, Jeffrey K.;Bygrave, Helen;Reid, Tony
通讯作者：
Reid, Tony
在乌干达农村地区利用基于社区的快速艾滋病毒检测活动来检测非传染性疾病。
影响因子：
3.7
作者：
Chamie G;Kwarisiima D;Clark TD;Kabami J;Jain V;Geng E;Petersen ML;Thirumurthy H;Kamya MR;Havlir DV;Charlebois ED;SEARCH Collaboration
通讯作者：
SEARCH Collaboration
DOI：
10.1016/s0140-6736(18)31070-5
发表时间：
2018-07-28
期刊：
Lancet (London, England)
影响因子：
--
作者：
Bekker LG;Alleyne G;Baral S;Cepeda J;Daskalakis D;Dowdy D;Dybul M;Eholie S;Esom K;Garnett G;Grimsrud A;Hakim J;Havlir D;Isbell MT;Johnson L;Kamarulzaman A;Kasaie P;Kazatchkine M;Kilonzo N;Klag M;Klein M;Lewin SR;Luo C;Makofane K;Martin NK;Mayer K;Millett G;Ntusi N;Pace L;Pike C;Piot P;Pozniak A;Quinn TC;Rockstroh J;Ratevosian J;Ryan O;Sippel S;Spire B;Soucat A;Starrs A;Strathdee SA;Thomson N;Vella S;Schechter M;Vickerman P;Weir B;Beyrer C
通讯作者：
Beyrer C