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撒哈拉以南非洲地区将艾滋病病毒与非传染性疾病护理整合的模式:经验教训和证据空白。

Models of integration of HIV and noncommunicable disease care in sub-Saharan Africa: lessons learned and evidence gaps.

机构信息

Department of Pharmacy, Moi Teaching and Referral Hospital, Eldoret, Kenya.

Fogarty International Center, National Institutes of Health, Bethesda, Maryland.

出版信息

AIDS. 2018 Jul 1;32 Suppl 1(Suppl 1):S33-S42. doi: 10.1097/QAD.0000000000001887.

Abstract

OBJECTIVE

To describe available models of HIV and noncommunicable disease (NCD) care integration in sub-Saharan Africa (SSA).

DESIGN

Narrative review of published articles describing various models of HIV and NCD care integration in SSA.

RESULTS

We identified five models of care integration across various SSA countries. These were integrated community-based screening for HIV and NCDs in the general population; screening for NCDs and NCD risk factors among HIV patients enrolled in care; integration of HIV and NCD care within clinics; differentiated care for patients with HIV and/or NCDs; and population healthcare for all. We illustrated these models with descriptive case studies highlighting the lessons learned and evidence gaps from the various models.

CONCLUSION

Leveraging existing HIV infrastructure for NCD care is feasible with various approaches possible depending on available program capacity. Process and clinical outcomes for existing models of care integration are not yet described but are urgently required to further advise policy decisions on HIV/NCD care integration.

摘要

目的

描述撒哈拉以南非洲(SSA)地区现有的艾滋病毒和非传染性疾病(NCD)综合护理模式。

设计

对描述 SSA 地区艾滋病毒和 NCD 综合护理各种模式的已发表文章进行叙述性综述。

结果

我们在不同的 SSA 国家确定了五种护理整合模式。这些模式包括在普通人群中进行艾滋病毒和非传染性疾病的综合社区筛查;对接受护理的艾滋病毒患者进行非传染性疾病和非传染性疾病风险因素筛查;在诊所内整合艾滋病毒和非传染性疾病护理;为艾滋病毒和/或非传染性疾病患者提供差异化护理;以及全民医疗保健。我们用描述性案例研究说明了这些模式,突出了各种模式中吸取的经验教训和证据差距。

结论

利用现有的艾滋病毒基础设施来提供非传染性疾病护理是可行的,具体方法取决于现有项目能力。现有护理整合模式的流程和临床结果尚未描述,但迫切需要进一步为艾滋病毒/非传染性疾病护理整合的政策决策提供建议。

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