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乌干达医疗机构接受治疗的结核病患者中与人类免疫缺陷病毒检测相关的因素。

Factors associated with human immunodeficiency virus testing among tuberculosis patients receiving treatment at health facilities in Uganda.

机构信息

Makerere University School of Public Health, Kampala, Uganda.

出版信息

Int J Tuberc Lung Dis. 2010 Jul;14(7):896-902.

Abstract

SETTING

One peri-urban and four rural districts in Uganda.

OBJECTIVES

To determine the level of and factors associated with human immunodeficiency virus (HIV) testing among tuberculosis (TB) patients.

DESIGN

A cross-sectional study was conducted in five selected districts from August to November 2007. Patients aged > or = 18 years returning for TB treatment refills at facilities offering TB and HIV services were included. Patients were excluded if they were very sick or unable to speak English or any of the local study languages. The outcome was self-reported HIV testing after TB diagnosis, validated using clinic registers.

RESULTS

Of 261 patients analysed, 169 (65%) had been tested for HIV following TB diagnosis. In a multivariate analysis, age >45 years (OR 0.27, 95%CI 0.08-0.87), not receiving information about the TB-HIV association (OR 0.35, 95%CI 0.15-0.77), not being offered HIV testing by health provider (OR 0.02, 95%CI 0.006-0.042), dissatisfaction with privacy (OR 2.49, 95%CI 1.11-5.55) and spending 30-60 min at the clinic (OR 4.48, 95%CI 1.66-12.10) significantly influenced level of HIV testing.

CONCLUSION

The level of HIV testing among TB patients was suboptimal, as per policy all patients should be tested. The Uganda Ministry of Health should continue to scale-up HIV testing and other collaborative TB-HIV services at health facilities.

摘要

背景

乌干达一个城郊地区和四个农村地区。

目的

确定结核病(TB)患者中人类免疫缺陷病毒(HIV)检测的水平和相关因素。

设计

2007 年 8 月至 11 月在五个选定的地区进行了一项横断面研究。纳入在提供 TB 和 HIV 服务的机构中返回进行 TB 治疗续药的年龄>或=18 岁的患者。如果患者病情非常严重或无法说英语或任何当地研究语言,则将其排除在外。结果是自我报告的 HIV 检测,经诊所登记处验证。

结果

在分析的 261 名患者中,有 169 名(65%)在 TB 诊断后接受了 HIV 检测。在多变量分析中,年龄>45 岁(OR 0.27,95%CI 0.08-0.87)、未获得有关 TB-HIV 关联的信息(OR 0.35,95%CI 0.15-0.77)、未获得卫生提供者提供的 HIV 检测(OR 0.02,95%CI 0.006-0.042)、对隐私不满意(OR 2.49,95%CI 1.11-5.55)和在诊所花费 30-60 分钟(OR 4.48,95%CI 1.66-12.10)显著影响了 HIV 检测水平。

结论

根据政策,所有患者均应接受 HIV 检测,但结核病患者的 HIV 检测水平并不理想。乌干达卫生部应继续扩大卫生设施的 HIV 检测和其他合作性 TB-HIV 服务。

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