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阿姆哈拉地区预防母婴传播服务利用面临的挑战:一项比较性横断面研究。

Challenges of PMTCT Service Utilization in Amhara Region: A Comparative Cross-sectional Study.

作者信息

Feleke Berhanu Elfu, Wasie Belaynew

机构信息

Department of Epidemiology and Biostatistics, University of Bahir Dar, Bahir Dar, Ethiopia.

Department of Epidemiology and Biostatistics, University of Bahir Dar, Bahir Dar, Ethiopian.

出版信息

Ethiop J Health Sci. 2018 Nov;28(6):779-786. doi: 10.4314/ejhs.v28i6.13.

Abstract

BACKGROUND

Globally, 370,000 children became newly infected with HIV and an estimated 42,000-60,000 pregnant woman died because of HIV annually. Pediatric HIV infection in 90% of the cases was acquired from their mothers.

METHODS

Comparative cross-sectional study design was implemented. Epi-info software was used to calculate the sample size, and the estimated sample size was 2667 pregnant women. Data were collected using exit interview technique. Descriptive statistical techniques were used to identify the prevalence of PMTCT service utilization and binary logistic regression was used to identify the determinants of PMTCT service utilization.

RESULTS

A total of 2615 respondents were included for a response rate of 98.05%. Only 61.3% of the pregnant women attending ANC in the health facility were utilizing PMTCT services [95% CI: 59 %-63 %]. Around 3.22% of tested pregnant women did not receive their result. PMTCT service utilization was affected by knowledge of PMTCT [AOR 1.87, 95 % CI: 1.53-2.28], residence [AOR 0.67, 95 % CI: 0.51-0.89], internal referral system [AOR 3.06, 95% CI: 2.51-3.72], health professional client interaction [AOR 2.18, 95% CI: 1.75-2.76], fear [AOR 1.23, 95% CI: 1.03-1.47], long waiting time [AOR 0.74, 95% CI: 0.58-0.94], number of ANC visit [AOR 1.79, 95% CI: 1.4-2.29], gravidity [AOR 0.55, 95% CI: 0.46-0.66], educational status [AOR 1.43, 95% CI: 1.04-1.96] and involvement in PMTCT services [AOR 2.57, 95% CI: 1.51-4.4].

CONCLUSION

PMTCT service utilization was low in the study area. The presence of internal referral system significantly increases PMTCT service utilization.

摘要

背景

在全球范围内,每年有37万儿童新感染艾滋病毒,估计有4.2万至6万孕妇死于艾滋病毒。90%的儿童艾滋病毒感染是由其母亲传染的。

方法

采用比较横断面研究设计。使用Epi-info软件计算样本量,估计样本量为2667名孕妇。采用出院访谈技术收集数据。使用描述性统计技术确定预防母婴传播服务的利用率,并使用二元逻辑回归确定预防母婴传播服务利用率的决定因素。

结果

共纳入2615名受访者,回复率为98.05%。在医疗机构接受产前检查的孕妇中,只有61.3%的人使用了预防母婴传播服务[95%置信区间:59%-63%]。约3.22%接受检测的孕妇未收到检测结果。预防母婴传播服务的利用率受到预防母婴传播知识的影响[调整后比值比1.87,95%置信区间:1.53-2.28]、居住地[调整后比值比0.67,95%置信区间:0.51-0.89]、内部转诊系统[调整后比值比3.06,95%置信区间:2.51-3.72]、医护人员与患者的互动[调整后比值比2.18,95%置信区间:1.75-2.76]、恐惧[调整后比值比1.23,95%置信区间:1.03-1.47]、等待时间长[调整后比值比0.74,95%置信区间:0.58-0.94]、产前检查次数[调整后比值比1.79,95%置信区间:1.4-2.29]、妊娠次数[调整后比值比0.55,95%置信区间:0.46-0.66]、教育程度[调整后比值比1.43,95%置信区间:1.04-1.96]以及参与预防母婴传播服务的情况[调整后比值比2.57,95%置信区间:1.51-4.4]的影响。

结论

研究地区预防母婴传播服务的利用率较低。内部转诊系统的存在显著提高了预防母婴传播服务的利用率。

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