Quality of antiretroviral therapy services in Ghana: Implications for the HIV response in resource-constrained settings.
Quality of antiretroviral therapy services in Ghana: Implications for the HIV response in resource-constrained settings.
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DOI：
10.1177/20503121211036142
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发表时间：
2021
影响因子：
2.3
通讯作者：
Sarkodie E
中科院分区：
文献类型：
--
作者：
Alhassan RK;Ketor CE;Ashinyo A;Ashinyo ME;Nutor JJ;Adjadeh C;Sarkodie E
加纳感染人类免疫缺陷病毒的人数超过30万，抗逆转录病毒治疗的需求未得到满足的比例约为60%。本研究试图确定在加纳选定的抗逆转录病毒治疗点的抗逆转录病毒治疗服务的质量，使用的投入-过程-结果的方法。这是一个描述性的横断面病例研究，采用修改后的规范性评价，以评估艾滋病毒感染者（n = 384）和医疗服务提供者（n = 16）之间的抗逆转录病毒治疗服务的质量在加纳奥蒂和沃尔特地区。研究于2019年3月11日至5月9日进行。除了病毒载量机、CD 4计数试剂和氟康唑和复方新诺明等抗真菌药外，管理艾滋病毒感染者的资源基本上都有。在2周内接受抗逆转录病毒治疗的患者占71%，在入组后2周内继续接受治疗的患者占90%。大约26%的登记客户记录了病毒载量抑制; 33%没有参加国家健康保险计划的艾滋病毒感染者支付了一些抗逆转录病毒药物和复方新诺明。坚持ART和复方新诺明分别为95%和88%，使用药丸计数在他们的最后三次访问。与临床团队的时间是最差的评价（平均值= 2.98，标准差= 0.54）的质量指标的患者相反，人际关系与健康提供者是最好的评价（平均值= 3.25，标准差= 0.41）的指标。观察到的高质量的护理差距可能会逆转艾滋病毒预防和控制在加纳取得的成果，如果不及时解决，这项研究的一个重要的附加值是新的应用程序的投入-过程-结果的方法在加纳的抗逆转录病毒治疗服务。还需要就将预防性药物纳入国家健康保险计划的抗逆转录病毒治疗进行政策对话，以促进坚持和保留治疗。
Number of People Living with Human Immune-deficiency Virus in Ghana is over 300,000 and unmet need for antiretroviral therapy is approximately 60%. This study sought to determine the quality of antiretroviral therapy services in selected ART sites in Ghana using the input-process-outcome approach. This is a descriptive cross-sectional case study that employed modified normative evaluation to assess quality of antiretroviral therapy services in the Oti and Volta regions of Ghana among People Living with HIV (n = 384) and healthcare providers (n = 16). The study was conducted from 11 March to 9 May 2019. Resources for managing HIV clients were largely available with the exception of viral load machines, reagents for CD4 counts, and antifungals such as Fluconazole and Cotrimoxazole. Patients enrolled on antiretroviral therapy within 2 weeks was 71% and clients retained in care within 2 weeks of enrolment was 90%. Approximately 26% of enrolled clients recorded viral load suppression; 33% of People Living with HIV who were not insured with the National Health Insurance Scheme paid for some antiretrovirals and cotrimoxazole. Adherence to ART and Cotrimoxazole were 95% and 88%, respectively, using pill count on their last three visits. Time spent with clinical team was among the worst rated (mean = 2.98, standard deviation = 0.54) quality indicators by patients contrary to interpersonal relationship with health provider which was among the best rated (mean = 3.25, standard deviation = 0.41) indicators. Observed quality care gaps could potentially reverse gains made in HIV prevention and control in Ghana if not addressed timely; an important value addition of this study is the novel application of input-process-outcome approach in the context of antiretroviral therapy services in Ghana. There is also the need for policy dialogue on inclusion of medications for prophylaxis in antiretroviral therapy on the National Health Insurance Scheme to promote adherence and retention.
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影响因子：
3.7
作者：
Alhassan RK;Duku SO;Janssens W;Nketiah-Amponsah E;Spieker N;van Ostenberg P;Arhinful DK;Pradhan M;Rinke de Wit TF
通讯作者：
Rinke de Wit TF
影响因子：
2.4
作者：
Biressaw S;Abegaz WE;Abebe M;Taye WA;Belay M
通讯作者：
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影响因子：
11.8
作者：
Braun, Dominique L.;Kouyos, Roger D.;Guenthard, Huldrych F.
通讯作者：
Guenthard, Huldrych F.
影响因子：
4.5
作者：
Alhassan, Robert Kaba;Spieker, Nicole;de Wit, Tobias F. Rinke
通讯作者：
de Wit, Tobias F. Rinke
影响因子：
2.3
作者：
Alhassan, Robert Kaba;Nketiah-Amponsah, Edward;de Wit, Tobias F. Rinke
通讯作者：
de Wit, Tobias F. Rinke