Japan International Cooperation Agency, Zambia Office, Lusaka, Zambia.
Int J Tuberc Lung Dis. 2013 Apr;17(4):540-5. doi: 10.5588/ijtld.12.0432. Epub 2013 Feb 7.
Free antiretroviral therapy (ART) services in Zambia were introduced in hospitals beginning in 2005 and in selected rural health centres (RHCs) beginning in 2007 through the mobile ART programme.
To analyse the impact of scaling up ART services on tuberculosis (TB) treatment outcomes in Mumbwa District, Zambia.
TB patients registered at all RHCs in the district between July 2006 and September 2009 were reviewed. RHCs were divided into two groups: 'ART sites', which provided ART services after 2007, and 'non-ART sites', which did not provide such services even after 2007. A before-after comparison analysis of TB patients was conducted between the groups.
A total of 732 patients were enrolled (median age 34.5 years; female 44.4%). The overall human immunodeficiency virus (HIV) testing rate was 72.3% and 66.7% of these patients were HIV-positive. The TB treatment success rate at the ART sites increased significantly compared to non-ART sites after the mobile ART programme was started (P < 0.01). The HIV testing acceptance rate also increased dramatically at ART sites, which facilitated intensified case finding (P = 0.02).
Scaling up ART services in rural health facilities through the mobile ART programme was found to be associated with greatly improved anti-tuberculosis treatment outcomes.
赞比亚于 2005 年开始在医院提供免费抗逆转录病毒治疗（ART）服务，并于 2007 年通过流动 ART 项目开始在选定的农村卫生中心（RHC）提供该服务。
分析扩大 ART 服务对赞比亚姆万巴区结核病（TB）治疗结果的影响。
对 2006 年 7 月至 2009 年 9 月期间在该地区所有 RHC 登记的 TB 患者进行了回顾性分析。将 RHC 分为两组：“ART 点”，即在 2007 年后提供 ART 服务的地点；“非 ART 点”，即在 2007 年后仍未提供此类服务的地点。对两组患者进行了 TB 患者的前后对比分析。
共纳入 732 例患者（中位年龄 34.5 岁；女性占 44.4%）。总体 HIV 检测率为 72.3%，其中 66.7%的患者 HIV 阳性。流动 ART 项目启动后，ART 点的结核病治疗成功率与非 ART 点相比显著提高（P < 0.01）。ART 点的 HIV 检测接受率也大幅上升，这有助于强化病例发现（P = 0.02）。
通过流动 ART 项目在农村卫生机构扩大 ART 服务与大大改善抗结核治疗结果相关。
