British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada.
Public Health Nutr. 2012 May;15(5):938-47. doi: 10.1017/S136898001100125X. Epub 2011 Aug 2.
To examine the availability of nutritional support services in HIV care and treatment sites across sub-Saharan Africa.
In 2008, we conducted a cross-sectional survey of sites providing antiretroviral therapy (ART) in nine sub-Saharan African countries. Outcomes included availability of: (i) nutritional counselling; (ii) micronutrient supplementation; (iii) treatment for severe malnutrition; and (iv) food rations. Associations with health system indicators were explored using bivariate and multivariate methods.
President's Emergency Plan for AIDS Relief-supported HIV treatment and care sites across nine sub-Saharan African countries.
A total of 336 HIV care and treatment sites, serving 467 175 enrolled patients.
Of the sites under study, 303 (90 %) offered some form of nutritional support service. Nutritional counselling, micronutrient supplementation, treatment for severe acute malnutrition and food rations were available at 98 %, 64 %, 36 % and 31 % of sites, respectively. In multivariate analysis, secondary or tertiary care sites were more likely to offer nutritional counselling (adjusted OR (AOR): 2.2, 95 % CI 1.1, 4.5). Rural sites (AOR: 2.3, 95 % CI 1.4, 3.8) had increased odds of micronutrient supplementation availability. Sites providing ART for >2 years had higher odds of availability of treatment for severe malnutrition (AOR: 2.4, 95 % CI 1.4, 4.1). Sites providing ART for >2 years (AOR: 1.6, 95 % CI 1.3, 1.9) and rural sites (AOR: 2.4, 95 % CI 1.4, 4.4) had greater odds of food ration availability.
Availability of nutritional support services was high in this large sample of HIV care and treatment sites in sub-Saharan Africa. Further efforts are needed to determine the uptake, quality and effectiveness of these services and their impact on patient and programme outcomes.
考察撒哈拉以南非洲地区艾滋病毒护理和治疗点的营养支持服务提供情况。
2008 年，我们对九个撒哈拉以南非洲国家提供抗逆转录病毒疗法（ART）的地点进行了横断面调查。结果包括：（i）营养咨询；（ii）微量营养素补充；（iii）严重营养不良的治疗；以及（iv）食物配给。使用双变量和多变量方法探讨了与卫生系统指标的关系。
总统艾滋病紧急救援计划支持的九个撒哈拉以南非洲国家的艾滋病毒治疗和护理点。
共 336 个艾滋病毒护理和治疗点，服务于 467175 名登记患者。
在所研究的 336 个地点中，有 303 个（90%）提供了某种形式的营养支持服务。98%、64%、36%和 31%的地点提供营养咨询、微量营养素补充、严重急性营养不良治疗和食物配给。多变量分析显示，二级或三级保健点更有可能提供营养咨询（调整后的比值比（AOR）：2.2，95%置信区间 1.1，4.5）。农村地点（AOR：2.3，95%置信区间 1.4，3.8）获得微量营养素补充的可能性增加。提供 ART 超过 2 年的地点，严重营养不良治疗的可能性更高（AOR：2.4，95%置信区间 1.4，4.1）。提供 ART 超过 2 年的地点（AOR：1.6，95%置信区间 1.3，1.9）和农村地点（AOR：2.4，95%置信区间 1.4，4.4）获得食物配给的可能性更大。
在这个大型的撒哈拉以南非洲地区艾滋病毒护理和治疗点样本中，营养支持服务的提供情况很高。需要进一步努力确定这些服务的利用率、质量和效果，以及它们对患者和方案结果的影响。
