Makombe Sd, Lowrance Dw, Kamoto K, Kabuluzi S, Zoya J, Schouten Ej, Bizuneh K, Harries Ad
Clinical HIV Unit, Ministry of Health, PO Box 30377, Lilongwe, Malawi.
Malawi Med J. 2007 Sep;19(3):111-5. doi: 10.4314/mmj.v19i3.10938.
HIV infection and malaria, two of the most common and important health problems in sub-Saharan Africa, have been demonstrated to have interactive pathology. In Malawi, where malaria is endemic, and antiretroviral therapy (ART) delivery is scaling up, we piloted integration of long-lasting insecticide-treated bednets (ITN) provision in three ART clinics. In July 2006, 1,910 ITNs were delivered to pilot sites, and ART clinic staff personnel were briefed on ITN provision and use of a monitoring system. Sites were assessed using a structured questionnaire in December 2006. During the pilot period, 1,282 ITNs were distributed to patients. A large proportion (70%) of ART patients at these sites received pilot study ITNs. Site adherence to the monitoring system was variable. Seventeen patients were interviewed, 14 of whom were ART patients who had received ITNs; 11 of these (79%) had slept under the net the previous night. This pilot demonstrates the feasibility of ITN distribution to patients attending ART clinics in Malawi. Programmatic and policy considerations for national roll-out include the need to: 1) adopt a standardized monitoring system, 2) develop information, education, and communication materials, 3) develop in-service training for ART clinicians, and 4) identify systems for forecasting, procuring and distributing ITNs.
艾滋病毒感染和疟疾是撒哈拉以南非洲最常见且最重要的两个健康问题，已被证明存在相互作用的病理学机制。在疟疾流行且抗逆转录病毒疗法（ART）推广力度不断加大的马拉维，我们在三家ART诊所试点整合了长效驱虫蚊帐（ITN）的发放工作。2006年7月，向试点地点发放了1910顶ITN，并向ART诊所工作人员介绍了ITN的发放情况及监测系统的使用方法。2006年12月，使用结构化问卷对各试点进行了评估。在试点期间，共向患者发放了1282顶ITN。这些试点地点很大一部分（70%）接受ART治疗的患者收到了试点研究用的ITN。各试点对监测系统的遵守情况不一。对17名患者进行了访谈，其中14名是接受了ITN的ART患者；其中11名（79%）前一晚睡在了蚊帐下。该试点证明了在马拉维向接受ART治疗的诊所患者发放ITN的可行性。全国推广所需考虑的方案和政策因素包括：1）采用标准化监测系统；2）制作信息、教育和宣传材料；3）为ART临床医生开展在职培训；4）确定ITN的预测、采购和分发系统。
