Analysis on the effect of different HIV/AIDS diagnosis and treatment services models in two counties of Guizhou Province
-
摘要: 目的 比较贵州省两县不同艾滋病诊断治疗服务模式效果。方法 利用D、P两县综合防治信息，以D县实施艾滋病诊断治疗“一站式服务”（简称“一站式服务”）前一年和后一年为观察时间，实行常规服务的P县为对照县，两县新报告且现住址在本地的成年人类免疫缺陷病毒（human immunodeficiency virus，HIV）感染者/获得性免疫缺陷综合征（acquired immunodeficiency syndrome，AIDS）患者（简称HIV/AIDS）为研究对象，比较确证到抗病毒治疗（antiretroviral therapy，ART）时间、CD4+T淋巴细胞（简称CD4）检测比例、ART比例等指标。结果 D县实行“一站式服务”后，确证到ART时间由55.00 d缩短为4.00 d，CD4检测比例由65.52%上升到100.00%，全部病例ART比例由31.03%上升到87.88%，差异均有统计学意义（均有P<0.05）。同期，P县确证到ART时间由68.00 d变为43.50 d，CD4检测比例由90.91%变为88.24%，全部病例ART比例由45.45%变为58.82%，差异均无统计学意义（均有P>0.05）。D县实行“一站式服务”后，与P县相比，全部病例ART比例上升，确证到ART时间缩短。结论 “一站式服务”优化了检测流程，缩短了确证到ART时间，减少HIV/AIDS的丢失。
-
关键词:
- 获得性免疫缺陷综合征 /
- 治疗效果 /
- 流行病学方法
Abstract: Objective To compare the effect of two different service models from HIV/AIDS diagnosis to Antiretroviral Therapy (ART) in two counties of Guizhou Province. Methods Information from the database system of D and P Counties was analyzed.County D performed the “one stop service” model from HIV/AIDS diagnosis to ART, while County P performed the standard model.The year when “one stop service” was performed and the year before were the observational years.The newly diagnosed HIV/AIDS adult residents reported by the two local counties were analyzed. The interval time from confirmation to ART, the proportion of CD4+T count testing(CD4 testing), the proportion of ART were used as the indexes for the effect comparison of the two counties. Results “One stop service”could sharply shorten the time from 55.00 days to 4.00 days. The proportion of CD4 testing of D County increased from 65.52% to 100.00%and the proportion of ART increased from 31.03% to 87.88%. The results were of statistical significance (all P<0.05). As a comparison, P County conducted the standard model during the two years. Its interval time from confirmation to ART changed from 68.00 days to 43.50 days. The proportion of CD4 testing changed from 90.91% to 88.24%. The proportion of ART varied from 45.45% to 58.82%.The results were of no statistical significance (all P>0.05). When compared to County P, D County's proportion of ART increased and the interval time was shortened. Conclusions “One stop service”simplified the streamline from diagnosis to ART. As a result it shortened the time from conformation to ART and reduced loss of HIV/AIDS cases. -
中国疾病预防控制中心.《全国艾滋病检测技术规范(2009年修订版)》 [Z]. 北京:中国疾病预防控制中心, 2009. 卫生部艾滋病临床专家工作组. 国家免费艾滋病抗病毒治疗手册(第三版)[M]. 北京:人民卫生出版社, 2012. Wu Z, Zhao Y,Ge X, et al. Simplified HIV testing and treatment in China: analysis of mortality rates before and after a structural intervention [J]. PLoS Med, 2015,12(9):e1001874. 中国疾病预防控制中心性病艾滋病预防控制中心. 《中国疾病预防控制中心性艾中心关于开展“一站式服务”降低艾滋病病死率试点工作的通知》 [Z]. 北京:中国疾病预防控制中心性病艾滋病预防控制中心, 2014. 独山县卫生和食品药品监督管理局. 《独山县卫生和食品药品监督管理局关于印发<独山县艾滋病“一站式服务”试点方案>的通知》 [Z]. 独山:独山县卫生和食品药品监督管理局,2014. 贵州省统计局国家统计局贵州调查总队.《贵州统计年鉴》 [M]. 北京:中国统计出版社, 2014. 吴革珍. 艾滋病治疗一站式服务依从性探讨 [J]. 医药前沿,2014,(10):14-15. 冼建民, 邱学俊, 农桂德,等. 广西钟山县艾滋病治疗“一站式服务”模式的探讨 [J]. 中国艾滋病性病, 2014,20(12):952-954. 赵敏,王夏,邱红艳,等. “一站式服务”模式对MSM中HIV/AIDS病人随访与治疗依从性的影响 [J]. 中国艾滋病性病, 2013,19(8):574. Cohen MS, Chen YQ, Mc auley M, et al. Prevention of HIV-1 Infection with Early Antiretroviral Therapy [J]. New England Journal of Medicine, 2011,365(6): 493-505. Sterne JA, May M, Costagliola D,et al. Timing of initiation of antiretroviral therapy in AIDS-free HIV-1-infected patients: a collaborative analysis of 18 HIV cohort studies [J]. Lancet, 2009,373(9672): 1352-63. 何海,李巧巧,周超,等. 重庆市2004-2013年艾滋病抗病毒治疗患者生存时间及影响因素分析 [J]. 中华疾病控制杂志, 2016,20(1):21-25. World Health Organization.Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV[K]. 2015. 杨文杰,樊盼英,梁妍,等. 2008-2013年河南省艾滋病患者抗病毒治疗对HIV的抑制效果及其影响因素分析 [J]. 中华预防医学杂志, 2015,49(1):13-20. -
点击查看大图
计量
- 文章访问数: 435
- HTML全文浏览量: 64
- PDF下载量: 45
- 被引次数: 0
下载: