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在艾滋病毒慢性病护理平台的基础上解决撒哈拉以南非洲的非传染性疾病:研究议程。

Building on the HIV chronic care platform to address noncommunicable diseases in sub-Saharan Africa: a research agenda.

机构信息

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

U.S. Centers for Disease Control and Prevention, Atlanta, Georgia.

出版信息

AIDS. 2018 Jul 1;32 Suppl 1(Suppl 1):S107-S113. doi: 10.1097/QAD.0000000000001898.

Abstract

OBJECTIVE

The remarkable progress made in confronting the global HIV epidemic offers a unique opportunity to address the increasing threat of noncommunicable diseases (NCDs). However, questions remain about how to enhance the HIV platforms to deliver integrated HIV and NCD care to people living with HIV (PLHIV) in sub-Saharan Africa (SSA). We aimed to develop a priority research agenda to advance this effort.

METHODS

Researchers, policymakers, and implementers from the United States and SSA conducted three scoping reviews on HIV/NCD prevention and care focused on clinical, health system, and community levels. Based on the review findings and expert inputs, we conducted iterative consensus-development activities to generate a prioritized research agenda.

RESULTS

Population-level data on NCD prevalence among PLHIV in SSA are sparse. The review identified NCD screening and management approaches that could be integrated into HIV programs in SSA. However, few studies focused on the effectiveness, cost, and best practices for integrated chronic care platforms, making it difficult to derive policy recommendations. To address these gaps, we propose a prioritized research agenda focused on developing evidence-based service delivery models, increasing human capacity through workforce education, generating data through informatics platforms and research, managing the medication supply chain, developing new financing and sustainability models, advancing research-informed policy, and addressing other crosscutting health system issues.

CONCLUSION

Based on collaborative, interdisciplinary efforts, a research agenda was developed to provide guidance that advances efforts to adapt the current health system to deliver integrated chronic care for PLHIV and the population at large.

摘要

目的

在应对全球艾滋病疫情方面取得的显著进展为应对非传染性疾病(NCD)日益增加的威胁提供了一个独特的机会。然而,关于如何加强艾滋病毒平台,以便向撒哈拉以南非洲(SSA)的艾滋病毒感染者(PLHIV)提供艾滋病毒和非传染性疾病综合护理,仍存在一些问题。我们旨在制定一项重点研究议程,以推动这方面的工作。

方法

来自美国和 SSA 的研究人员、政策制定者和实施者就艾滋病毒/非传染性疾病预防和护理进行了三次范围审查,重点关注临床、卫生系统和社区层面。根据审查结果和专家意见,我们进行了迭代共识制定活动,以制定优先研究议程。

结果

SSA 中 PLHIV 中 NCD 患病率的人群水平数据很少。审查确定了可以纳入 SSA 艾滋病毒规划的 NCD 筛查和管理方法。然而,很少有研究关注综合慢性护理平台的有效性、成本和最佳实践,因此难以得出政策建议。为了弥补这些空白,我们提出了一个优先研究议程,重点是制定基于证据的服务提供模式,通过劳动力教育增加人力,通过信息学平台和研究生成数据,管理药物供应链,开发新的融资和可持续性模式,推进基于研究的政策,并解决其他交叉的卫生系统问题。

结论

基于协作的跨学科努力,制定了一项研究议程,为调整现有卫生系统以提供综合慢性护理提供指导,以造福 PLHIV 和广大人群。

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