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坦桑尼亚难民营环境中预防艾滋病毒母婴传播

Prevention of mother-to-child transmission of HIV in a refugee camp setting in Tanzania.

作者信息

Rutta E, Gongo R, Mwansasu A, Mutasingwa D, Rwegasira V, Kishumbu S, Tabayi J, Masini T, Ramadhani H

机构信息

Norwegian People's Aid (NPA), Refugee Assistance Programme, Ngara, Tanzania.

出版信息

Glob Public Health. 2008;3(1):62-76. doi: 10.1080/17441690601111924.

DOI:10.1080/17441690601111924
PMID:19288360
Abstract

The objective of this article is to describe the results of a 2-year pilot programme implementing prevention of mother to child HIV transmission (PMTCT) in a refugee camp setting. Interventions used were: community sensitization, trainings of healthcare workers, voluntary counselling and HIV testing (VCT), infant feeding, counselling, and administration of Nevirapine. Main outcome measures include: HIV testing acceptance rates, percentage of women receiving post test counselling, Nevirapine uptake, and HIV prevalence among pregnant women and their infants. Ninety-two percent of women (n=9,346) attending antenatal clinics accepted VCT. All women who were tested for HIV received their results and posttest counselling. The HIV prevalence rate among the population was 3.2%. The overall Nevirapine uptake in the camp was 97%. Over a third of women were repatriated before receiving Nevirapine. Only 14% of male counterparts accepted VCT. Due to repatriation, parent's refusal, and deaths, HIV results were available for only 15% of infants born to HIV-infected mothers. The PMTCT programme was successfully integrated into existing antenatal care services and was acceptable to the majority of pregnant women. The major challenges encountered during the implementation of this programme were repatriation of refugees before administration of Nevirapine, which made it difficult to measure the impact of the PMTCT programme.

摘要

本文的目的是描述在难民营环境中实施预防母婴传播艾滋病毒(PMTCT)的一项为期两年的试点项目的结果。所采用的干预措施包括:社区宣传、医护人员培训、自愿咨询和艾滋病毒检测(VCT)、婴儿喂养咨询以及奈韦拉平的给药。主要结果指标包括:艾滋病毒检测接受率、接受检测后咨询的妇女百分比、奈韦拉平的服用率以及孕妇及其婴儿中的艾滋病毒流行率。在产前诊所就诊的92%的妇女(n = 9346)接受了VCT。所有接受艾滋病毒检测的妇女都收到了检测结果并接受了检测后咨询。该人群中的艾滋病毒流行率为3.2%。难民营中奈韦拉平的总体服用率为97%。超过三分之一的妇女在接受奈韦拉平治疗之前被遣返。只有14%的男性接受了VCT。由于遣返、父母拒绝以及死亡等原因,只有15%的感染艾滋病毒母亲所生婴儿的艾滋病毒检测结果可用。PMTCT项目成功地融入了现有的产前护理服务中,并且为大多数孕妇所接受。在实施该项目过程中遇到的主要挑战是在给予奈韦拉平之前难民被遣返,这使得难以衡量PMTCT项目的影响。

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