非洲预防艾滋病母婴传播：赞比亚卢萨卡扩大基于奈韦拉平方案的成功与挑战
Prevention of mother-to-child transmission of HIV in Africa: successes and challenges in scaling-up a nevirapine-based program in Lusaka, Zambia.
作者信息
Stringer Elizabeth M, Sinkala Moses, Stringer Jeffrey S, Mzyece Elizabeth, Makuka Ida, Goldenberg Robert L, Kwape Pascal, Chilufya Martha, Vermund Sten H
机构信息
School of Medicine, University of Alabama at Birmingham, USA.
出版信息
AIDS. 2003 Jun 13;17(9):1377-82. doi: 10.1097/00002030-200306130-00012.
BACKGROUND
Nearly half of perinatal HIV infection is preventable with nevirapine (NVP), which has transformed the ability to confront this transmission route in resource-limited settings.
METHODS
A NVP-based perinatal HIV prevention program initiated in Lusaka, Zambia in November 2001.
RESULTS
The first 12 months cost US$221 000 and enabled 178 district health employees to be trained in voluntary counseling and testing: 17 263 pregnant women were counseled for HIV, 12 438 (72%) were tested, and 2924 (24%) were found to be infected with HIV. NVP has been taken by 1654 (57%) mothers and 1157 (40%) babies. It is estimated that at least 190 infants have been spared HIV infection (11 per 1000 counseled women or 65 per 1000 identified HIV-infected women).
CONCLUSIONS
Prevention of mother-to-child HIV transmission is feasible and cost effective in resource-limited settings. In Lusaka, thousands of women have received voluntary counseling and testing and NVP therapy under the present scheme. Patient attrition and non-adherence represented a major source of program inefficiency, which requires to be systematically addressed.
背景
使用奈韦拉平（NVP）可预防近一半的围产期艾滋病毒感染，这改变了在资源有限环境中应对这一传播途径的能力。
方法
2001年11月在赞比亚卢萨卡启动了一项基于NVP的围产期艾滋病毒预防项目。
结果
最初12个月花费22.1万美元，使178名地区卫生工作人员接受了自愿咨询和检测培训：为17263名孕妇提供了艾滋病毒咨询，12438人（72%）接受了检测，其中2924人（24%）被发现感染艾滋病毒。1654名（57%）母亲和1157名（40%）婴儿服用了NVP。据估计，至少有190名婴儿避免了艾滋病毒感染（每1000名接受咨询的妇女中有11名，或每1000名确诊感染艾滋病毒的妇女中有65名）。
结论
在资源有限的环境中预防母婴艾滋病毒传播是可行且具有成本效益的。在卢萨卡，根据目前的方案，数千名妇女接受了自愿咨询和检测以及NVP治疗。患者流失和不依从是项目效率低下的主要原因，需要系统地加以解决。
Zotero 插件