撒哈拉以南非洲艾滋病毒护理环境中的结核病诊断能力。
TB diagnostic capacity in sub-Saharan African HIV care settings.
机构信息
ICAP, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
出版信息
J Acquir Immune Defic Syndr. 2012 Oct 1;61(2):216-20. doi: 10.1097/QAI.0b013e3182638ec7.
As HIV care services continue to scale-up in sub-Saharan Africa, adequate tuberculosis diagnostic capacity is vital to reduce mortality among HIV-infected persons. A structured survey was administered at 663 health facilities providing HIV care to 908,043 patients in across 9 sub-Saharan African countries to estimate the proportion of facilities and HIV patients at these facilities with access TB-related diagnostic tests. Sputum smear microscopy was available at 87% of facilities (representing 97% of patients), chest x-ray at 26% of facilities (representing 56% of patients), tuberculin skin tests were available at 12% of facilities (representing 33% of patients). Acid-fast bacillus culture was available on-/off-site at 53% of facilities (representing 77% of patients). Primary health facilities had lower availability of tuberculosis diagnostic tests compared with secondary and tertiary health facilities. As HIV care continues to decentralize to primary health facilities, a corresponding expansion of diagnostic capacity to lower levels of the health system will be essential.
随着抗逆转录病毒治疗服务在撒哈拉以南非洲地区不断扩大，充分的结核病诊断能力对于降低艾滋病毒感染者的死亡率至关重要。在 9 个撒哈拉以南非洲国家的 663 个提供艾滋病毒护理的卫生机构中进行了一项结构性调查，以估计能够进行结核病相关诊断检测的卫生机构和接受艾滋病毒治疗的患者的比例。87%的卫生机构（占 97%的患者）提供痰涂片显微镜检查，26%的卫生机构（占 56%的患者）提供 X 光胸片检查，12%的卫生机构（占 33%的患者）提供结核菌素皮肤试验。53%的卫生机构（占 77%的患者）能够提供或不提供现场/场外的抗酸杆菌培养。与二级和三级卫生机构相比，初级卫生机构的结核病诊断检测手段较少。随着艾滋病毒护理继续向初级卫生机构分散，必须相应地扩大诊断能力，以覆盖更广泛的卫生系统。
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