Apidechkul Tawatchai
J Med Assoc Thai. 2016 Jun;99(6):702-10.
A retrospective cohort study was conducted to determine the situation and factors related to the death among the HIV/AIDS Hill tribe in Northern Thailand.
A systematic data-reviewing approach was used to identify the information from the rosters of ARV clinics, OPD cards, and laboratory reports from 16 hospitals in Chiang Rai Province, Thailand. The data were collected from the first reported HIV/AIDS case of the Hill tribe to the end of 2010. A logistic regression models were used to identify associations. A p-value <0.05 was considered as a statistical significance in multiple logistic regression models
Three thousand one hundred thirty cases were included in the present study. The majority of patients were Akha (46.0%) followed by Lahu (19.7%), 54.6% were males, 44.6% were 26 to 35 years old. The major risk factor of HIV infection was sexual intercourse (91.7%); 33.3% were still alive at the date of data collection, 30.7% were diagnosed with pulmonary TB. Regarding survival status, females had a better surviving rate than males with adjusted OR = 1.41, 95% CI = 1.19-1.66. Those that had the route of transmission as “mother-to-child” and “IDU” had greater chance of survival compared to those who contracted HIV from “sexual intercourse”, with adjusted OR = 2.05, 95% CI = 1.56-2.18, and adjusted OR = 8.45, 95% CI = 1.55-46.13, respectively.
Thailand needs to develop an appropriate model for providing care at the earlier stage of HIV/AIDS infection to prevent early death for the Hill tribe population.
开展一项回顾性队列研究,以确定泰国北部山区部落艾滋病毒/艾滋病患者的死亡情况及相关因素。
采用系统的数据审查方法,从泰国清莱府16家医院的抗逆转录病毒诊所名册、门诊病历卡和实验室报告中识别信息。数据收集时间为该山区部落首例报告的艾滋病毒/艾滋病病例至2010年底。使用逻辑回归模型确定关联。在多重逻辑回归模型中,p值<0.05被视为具有统计学意义。
本研究纳入3130例病例。大多数患者为阿卡族(46.0%),其次是拉祜族(19.7%),54.6%为男性,44.6%年龄在26至35岁之间。艾滋病毒感染的主要危险因素是性交(91.7%);在数据收集时,33.3%的患者仍然存活,30.7%被诊断患有肺结核。关于生存状况,女性的生存率高于男性,调整后的比值比(OR)=1.41,95%置信区间(CI)=1.19 - 1.66。与通过“性交”感染艾滋病毒的患者相比,传播途径为“母婴传播”和“注射吸毒”的患者生存机会更大,调整后的OR分别为2.05,95%CI = 1.56 - 2.18,以及调整后的OR = 8.45,95%CI = 1.55 - 46.13。
泰国需要制定一个合适的模式,以便在艾滋病毒/艾滋病感染的早期阶段提供护理,从而防止山区部落人群过早死亡。