Surveillance of HIV assisted partner services using routine health information systems in Kenya.
Surveillance of HIV assisted partner services using routine health information systems in Kenya.
复制标题
使用肯尼亚的常规健康信息系统对HIV辅助合作伙伴服务的监视。
DOI：
10.1186/s12911-016-0337-9
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发表时间：
2016-07-20
影响因子：
3.5
通讯作者：
Farquhar C
中科院分区：
文献类型：
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作者：
Cherutich P;Golden M;Betz B;Wamuti B;Ng'ang'a A;Maingi P;Macharia P;Sambai B;Abuna F;Bukusi D;Dunbar M;Farquhar C
撒哈拉以南地区利用常规卫生信息系统 (HIS) 监测艾滋病毒辅助合作伙伴服务 (aPS) 的情况并不理想，部分原因是数据质量差和信息技术的使用有限。因此，人们对 HIV aPS 的覆盖范围、范围和质量知之甚少。然而，现在撒哈拉以南非洲地区可以广泛使用负担得起的电子数据工具、软件和数据传输基础设施。我们利用艾滋病毒检测平台在肯尼亚 18 个卫生机构设计并实施了基于病例的监测系统。该系统的组成部分包括电子艾滋病毒检测和咨询 (HTC) 登记表、全球移动通信系统 (GSM) 上的数据传输以及使用开放数据套件 (ODK) 平台的数据收集。我们定义了新的艾滋病毒诊断率，并描述了艾滋病毒感染病例的特征。我们还确定了报告艾滋病毒检测的客户比例，因为a）他们是由性伴侣通知的，b）他们是由医疗服务提供者通知的，或者c）他们是由其他其他来源告知的。评估了数据收集时间。在 4351 名客户中，艾滋病毒感染率为 14.2%，各机构的艾滋病毒感染率在 4.4% 至 25.4% 之间。无论检测的其他原因如何，所有参与者中只有 107 名 (2.5%) 在得到医疗服务提供者或性伴侣的通知后报告进行了检测。类似比例（1.8%）（4351 人中的 79 人）表示，伴侣通知是寻求 HIV 检测的唯一原因。在 79 名报告艾滋病毒伴侣服务作为检测原因的客户中，大多数 (78.5%) 是由其性伴侣通知的。大多数 (52.8%) 的 HIV 感染者开始进行 HIV 检测，其中 57.2% 在位于医疗机构的自愿咨询和检测 (VCT) 站点进行了检测。数据采集的中位时间为 4 分钟（IQR：3-15），感染 HIV 的参与者的持续时间更长，并且没有报告数据丢失。使用新技术进行 aPS 监测是可行的，并且可以轻松扩展到肯尼亚和其他撒哈拉以南国家的艾滋病毒登记处。肯尼亚的合作伙伴服务未得到充分利用，但需要进一步记录艾滋病毒和 aPS 服务的覆盖范围和实施差距。
The utilization of routine health information systems (HIS) for surveillance of assisted partner services (aPS) for HIV in sub-Saharan is sub-optimal, in part due to poor data quality and limited use of information technology. Consequently, little is known about coverage, scope and quality of HIV aPS. Yet, affordable electronic data tools, software and data transmission infrastructure are now widely accessible in sub-Saharan Africa. We designed and implemented a cased-based surveillance system using the HIV testing platform in 18 health facilities in Kenya. The components of this system included an electronic HIV Testing and Counseling (HTC) intake form, data transmission on the Global Systems for Mobile Communication (GSM), and data collection using the Open Data Kit (ODK) platform. We defined rates of new HIV diagnoses, and characterized HIV-infected cases. We also determined the proportion of clients who reported testing for HIV because a) they were notified by a sexual partner b) they were notified by a health provider, or c) they were informed of exposure by another other source. Data collection times were evaluated. Among 4351 clients, HIV prevalence was 14.2 %, ranging from 4.4–25.4 % across facilities. Regardless of other reasons for testing, only 107 (2.5 %) of all participants reported testing after being notified by a health provider or sexual partner. A similar proportion, 1.8 % (79 of 4351), reported partner notification as the only reason for seeking an HIV test. Among 79 clients who reported HIV partner services as the reason for testing, the majority (78.5 %), were notified by their sexual partners. The majority (52.8 %) of HIV-infected patients initiated their HIV testing, and 57.2 % tested in a Voluntary Counseling and Testing (VCT) site co-located in a health facility. Median time for data capture was 4 min (IQR: 3–15), with a longer duration for HIV-infected participants, and there was no reported data loss. aPS surveillance using new technologies is feasible, and could be readily expanded into HIV registries in Kenya and other sub-Saharan countries. Partner services are under-utilized in Kenya but further documentation of coverage and implementation gaps for HIV and aPS services is required.