即使在HAART干预策略时代,病毒发病率和死亡率的上升趋势:尼日尔三角洲一些选定设施中获得护理的单一和合并感染受试者的研究

A. Obioma, Ihua Nnenna, Eze Evelyn Mgebeoma
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引用次数: 0

摘要

在全球范围内,弱势群体承受着艾滋病毒、乙型肝炎和丙型肝炎病毒感染的单一感染;然而,随着对早期诊断、预防和其他管理策略的强烈认识和干预宣传的趋势日益增强,预计在我们社区的弱势群体中,感染的流行率将显著降低。尽管如此,人们坚信,如果必须将这场斗争提升到一个强有力的卫生保健优先结果的新水平,那么对合并感染进行相应的防范、早期发现和明智管理,特别是在发展中社区,仍然是至关重要的。然而,似乎有实际证据表明,该地区缺乏信息,也可能缺乏强有力的可靠数据,因此,本研究调查了一些选定设施中选定受试者的病毒单一感染和合并感染(双重和三重)。尽管如此,这项观察性横断面研究招募了3062名受试者,其中约250名来自HIV受试者队列。实验室诊断包括使用定性(MP快速试剂盒和ELISA)和定量(分子引物设计q16实时PCR)进行顺序检测。尽管如此,使用Gpower 3.2版本来估计样本量,即使定性和定量数据分析涉及使用频率和百分比结果进行描述性分析,而使用SPSS 21版本探索卡方,关联相关性和奇数比,即使假设在0.05显著水平上进行检验。单发感染率与合并感染率有显著性差异;教育程度、婚姻状况和体重指数也有显著性差异(p<0.05)。此外,对大多数危险因素的暴露程度较小,血清患病率普遍较低。此外,乙型肝炎和丙型肝炎的发病率分别为2.8%和2.4%。大多数危险因素与病毒感染有关。使用奇数比进一步的风险估计显示,暴露者的风险增加了两倍或两倍以上,尽管这里报告的发病率很低,但来自该地区的回顾性审查显示,发病率要低得多,因此存在进行性疾病频率转变;必须采取谨慎措施,包括遵守普遍的安全做法和预防措施。然而,如果我们必须及时检查和管理偏远社区日益增长的趋势,就必须大力支持将肝炎感染疫苗接种作为一项预防措施,并将其强制纳入艾滋病毒管理程序。
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Increasing trend of Viral Morbidity and Mortality even in an Era of HAART Intervention Strategies: A Study of Mono and Co-infection of Subjects Accessing Care in Some Selected Facilities in Niger Delta
Across the globe, vulnerable subjects are burdened with mono infections of HIV, Hepatitis B and C virus infections; however, with the increasing trend of robust awareness and intervention advocacy targeted towards early diagnosis, prevention and other management strategies in place, it is expected that the prevalence of the infection would be drastically reduced in an appreciable manner among vulnerable groups in our communities. Nonetheless, it is strongly believed that commensurate preparedness and early detection and smart management of co-infections, especially in the developing communities’ remains key and paramount, if the fight must be moved to the next level of robust health care priority outcome. However, there seems to be practical evidence of scarcity of information and probably dearth of robust reliable data in the region, thus this present study investigated viral mono and co-infections (dual and triple) among selected subjects in some selected facilities. Nonetheless, this observational cross sectional study recruited 3,062 subjects, with about 250 from a cohort of HIV subjects. Laboratory diagnosis involved sequential testing using both qualitative (MP rapid kits and ELISA) and quantitative (Molecular-primer design q16 real-time PCR). Nevertheless, Gpower version 3.2 was used to estimate the sample size, even as the qualitative and quantitative data analysis involved the use of frequency and percentage outcome for descriptive analysis, while Chi square, correlation for association and odd ratio were explored using SPSS version 21, even as hypothesis were tested at 0.05 significant level. Significant difference was observed between the mono and coinfection rates; education, marital status and body mass index also showed evidence of significance (p<0.05) with chi square. Furthermore, exposure to most risk factors appeared small and general low sero-prevalence. Moreover, low incidence rates of 2.8% and 2.4% for Hepatitis B and C were observed respectively. Most risk factors correlated with viral infection. Further risk estimate using odd ratio showed two or more-fold increase for the exposed, although low disease frequency was reported here, but a retrospective review from this region showed much lower rate meaning, there is a progressive disease frequency transition therefore; care must be taken including adherence to the universal safe practices and precautionary measures. However, vaccination against Hepatitis infection as a preventive measure and its compulsory incorporation in the HIV management procedure must be strongly underpinned in the region, if we must check and manage the increasing trend in our remote communities in good time.
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