Chitete Lusungu, Puoane Thandi
School of Public Health, University of the Western Cape, Cape Town, Western Cape Province, Republic of South Africa.
PLoS One. 2015 May 1;10(5):e0123021. doi: 10.1371/journal.pone.0123021. eCollection 2015.
The Community-based Management of Acute Malnutrition is the national program for treating acute malnutrition in Malawi. Under this program's guidelines all children enrolled should undergo an HIV test, so that those infected can receive appropriate treatment and care. However, the national data of 2012 shows a low delivery of testing. Prior studies have investigated client-related factors affecting uptake of HIV testing in Community-based Management of Acute Malnutrition program. Lacking is the information on the service provider factors that are associated with the delivery of testing. This study investigated service provider factors that affect delivery of HIV testing among children enrolled in the program and explored ways in which this could be improved.
A descriptive study that used qualitative methods of data collection. Client registers were reviewed to obtain the number of children enrolled in Community-based Management of Acute Malnutrition and the number of children who were tested for HIV over a 12-month period. In-depth interviews were conducted with Community-based Management of Acute Malnutrition and HIV Testing and Counselling focal persons to investigate factors affecting HIV test delivery. Descriptive statistics were used to analyze data from client registers. Information from interviews was analyzed using a thematic approach.
Quantitative data revealed that 1738 (58%) of 2981 children enrolled in Community-based Management of Acute Malnutrition were tested for HIV. From in-depth interviews four themes emerged, that is, lack of resources for HIV tests; shortage of staff skilled in HIV testing and counseling; lack of commitment among staff in referring children for HIV testing; and inadequately trained staff.
There is a need for a functioning health system to help reduce child mortality resulting from HIV related conditions.
基于社区的急性营养不良管理是马拉维治疗急性营养不良的国家项目。根据该项目指南，所有登记在册的儿童都应接受艾滋病毒检测，以便感染者能够获得适当的治疗和护理。然而，2012年的国家数据显示检测率较低。先前的研究调查了影响基于社区的急性营养不良项目中艾滋病毒检测接受率的客户相关因素。但缺乏与检测提供相关的服务提供者因素的信息。本研究调查了影响该项目登记儿童艾滋病毒检测提供情况的服务提供者因素，并探索了改善这一情况的方法。
一项采用定性数据收集方法的描述性研究。查阅客户登记册，以获取在12个月期间登记参加基于社区的急性营养不良管理的儿童数量以及接受艾滋病毒检测的儿童数量。对基于社区的急性营养不良管理以及艾滋病毒检测与咨询的重点人员进行深入访谈，以调查影响艾滋病毒检测提供的因素。使用描述性统计分析客户登记册中的数据。访谈信息采用主题分析法进行分析。
定量数据显示，在2981名登记参加基于社区的急性营养不良管理的儿童中，有1738名（58%）接受了艾滋病毒检测。从深入访谈中得出了四个主题，即缺乏艾滋病毒检测资源；缺乏艾滋病毒检测和咨询方面的技术人员；工作人员在转诊儿童进行艾滋病毒检测方面缺乏积极性；以及工作人员培训不足。
需要一个运转良好的卫生系统来帮助降低因艾滋病毒相关疾病导致的儿童死亡率。
