Comparison on treatment outcomes of patients enrolled on anti-retroviral therapy at different levels of the health-care system in a high HIV/AIDS setting.

IF 1.9 4区 医学 Q4 IMMUNOLOGY AIDS reviews Pub Date : 2023-01-01 DOI:10.24875/AIDSRev.23000016
Bokwena Moali, Lebapotswe B Tlale, Bornapate Nkomo, Moses Otieno, Nathanael Sirili, Marius Nsoh, Avelina Mgasa, Anissette Ngum-Busi, Ketshepile Taylor, Nokuthula Majingo, Esther Seloilwe, Yohana Mashalla
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Abstract

HIV/AIDS prevalence in Botswana is amongst the highest in the world and remains a significant public health problem. however, the introduction of anti-retroviral therapy (ART) lead to a significant reduction in morbidity and mortality. Decentralization of anti-retroviral therapy has improved access to treatment for people living with HIV. Treatment outcomes for patient initiated on treatment at different levels of care is unknown and this study seeks to compare treatment outcomes of patients enrolled on ART at different levels of the health care. This is a retrospective cross-sectional study that included review of data from January 2017 to December 2018. The study was conducted in 2 health districts in the country. Nine hundred and sixty (960) patient's record were included in analysis. More than half (63%) of patients were enrolled at primary care level while 37% were at tertiary level. Sixty one percent (n = 587) were female while 39% (n = 373) were males. There were no statistically significant differences in viral load suppression after 12 months of treatment between patients enrolled at tertiary level and primary care level, x2 = 0.75, p value = 0.56. Time to initiation was longer at tertiary (median = 126) compared to primary are level (median = 18), p < 0.001. We reccommend further decentralization of ART services to lower levels of the health care system to initiate PLWHIV early on treatment and improve their health outcomes and reduce transmission through treatment by prevention.

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在艾滋病毒/艾滋病高发地区,比较在不同级别医疗保健系统接受抗逆转录病毒疗法的患者的治疗效果。
博茨瓦纳是世界上艾滋病毒/艾滋病流行率最高的国家之一,这仍然是一个重大的公共卫生问题。然而,抗逆转录病毒疗法(ART)的引入大大降低了发病率和死亡率。抗逆转录病毒疗法的权力下放改善了艾滋病毒感染者获得治疗的机会。在不同医疗机构接受治疗的患者的治疗效果尚不清楚,本研究旨在比较在不同医疗机构接受抗逆转录病毒疗法的患者的治疗效果。这是一项回顾性横断面研究,包括对 2017 年 1 月至 2018 年 12 月的数据进行回顾。研究在该国的两个卫生区进行。九百六十(960)份患者记录被纳入分析。半数以上(63%)的患者在初级医疗机构登记,37%的患者在三级医疗机构登记。61%(n = 587)为女性,39%(n = 373)为男性。在三级医疗机构和初级医疗机构注册的患者在治疗 12 个月后的病毒载量抑制率上没有明显的统计学差异(x2 = 0.75,P 值 = 0.56)。与基层医疗机构(中位数 = 18)相比,三级医疗机构的起始治疗时间更长(中位数 = 126),p < 0.001。我们建议进一步将抗逆转录病毒疗法服务下放到医疗保健系统的较低层级,以便让艾滋病毒感染者尽早开始治疗,改善他们的健康状况,并通过预防治疗减少传播。
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来源期刊
AIDS reviews
AIDS reviews 医学-传染病学
CiteScore
3.40
自引率
4.50%
发文量
41
审稿时长
>12 weeks
期刊介绍: AIDS Reviews publishes papers reporting original scientific, clinical, epidemiologic and social research which contribute to the overall knowledge of the field of the acquired immunodeficiency syndrome and human retrovirology. Currently, the Journal publishes review articles (usually by invitation, but spontaneous submitted articles will also be considered). Manuscripts submitted to AIDS Reviews will be accepted on the understanding that the authors have not submitted the paper to another journal or published the material elsewhere.
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