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高效抗逆转录病毒疗法对坦桑尼亚成年接受者健康相关生活质量的效用。

Usefulness of highly active antiretroviral therapy on health-related quality of life of adult recipients in Tanzania.

作者信息

Magafu Mgaywa G M D, Moji Kazuhiko, Igumbor Ehimario U, Hashizume Masahiro, Mizota Tsutomu, Komazawa Osuke, Cai Guoxi, Yamamoto Taro

机构信息

Department of International Health, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.

出版信息

AIDS Patient Care STDS. 2009 Jul;23(7):563-70. doi: 10.1089/apc.2008.0278.

Abstract

This study assessed health-related quality of life (HRQOL) of highly active antiretroviral therapy (HAART) recipients aged 18 or older and associated factors, 2 years after HAART administration had started in Kagera, Tanzania. Using the 36-Item Short Form Health Survey (SF-36), 329 HAART recipients were interviewed in May 2007. Questions on sociodemographic characteristics, chronic diseases (besides HIV/AIDS), HAART side effects and adherence to antiretroviral drugs were added. Treatment data, the first and latest available CD4 counts were retrieved from patients' records. Gender and age-adjusted mean scale scores of the sample were compared to those of the general Tanzanian population of the late 1990 s using t test. Logistic regression was used to explore the effect of sex, age, education level, income, chronic diseases, CD4 count, HAART side effects and adherence to antiretroviral drugs on recipients' physical functioning and mental health scale scores. The mean scale scores of HAART recipients were generally lower than those of the general population except for general health perceptions (p = 0.191) and mental health (p = 0.161). HAART recipients with chronic disease comorbidity were more likely to score below the general population's mean score for mental health (p = 0.007). While the effect of chronic disease comorbidity on physical functioning among those who recorded a CD4 count increase was negative (odds ratio [OR] = 13.6, 95% confidence interval [CI] = 3.7, 49.9), there was no effect on those who did not have such an increase. The control of chronic diseases among recipients should be given priority to improve their HRQOL.

摘要

本研究评估了在坦桑尼亚卡盖拉开始高效抗逆转录病毒治疗(HAART)两年后,18岁及以上HAART接受者的健康相关生活质量(HRQOL)及其相关因素。2007年5月,使用36项简明健康调查问卷(SF-36)对329名HAART接受者进行了访谈。此外还增加了关于社会人口学特征、慢性病(除艾滋病毒/艾滋病外)、HAART副作用以及对抗逆转录病毒药物依从性的问题。从患者记录中获取治疗数据、首次和最新可用的CD4细胞计数。使用t检验将样本的性别和年龄调整后的平均量表得分与20世纪90年代末坦桑尼亚普通人群的得分进行比较。采用逻辑回归分析来探讨性别、年龄、教育水平、收入、慢性病、CD4细胞计数、HAART副作用以及对抗逆转录病毒药物的依从性对接受者身体功能和心理健康量表得分的影响。除了总体健康感知(p = 0.191)和心理健康(p = 0.161)外,HAART接受者的平均量表得分普遍低于普通人群。患有慢性病合并症的HAART接受者在心理健康方面得分低于普通人群平均得分的可能性更大(p = 0.007)。虽然慢性病合并症对CD4细胞计数增加者的身体功能有负面影响(优势比[OR]=13.6,95%置信区间[CI]=3.7,49.9),但对CD4细胞计数未增加者没有影响。应优先控制接受者的慢性病,以改善他们的健康相关生活质量。

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