撒哈拉以南非洲地区成人中，在艾滋病病毒与结核病综合治疗背景下抗逆转录病毒治疗的采用障碍及促成因素和依从性：一项系统文献综述方案

Barriers to and enablers of uptake of and adherence to antiretroviral therapy in the context of integrated HIV and tuberculosis treatment among adults in sub-Saharan Africa: a protocol for a systematic literature review.

作者信息

Momo Kadia Benjamin, Takah Noah Fongwen, Akem Dimala Christian, Smith Adrian

机构信息

Department of Public Health for Development, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK

Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK.

出版信息

BMJ Open. 2019 Oct 28;9(10):e031789. doi: 10.1136/bmjopen-2019-031789.

DOI:10.1136/bmjopen-2019-031789

PMID:31662398

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6830592/

Abstract

INTRODUCTION

The scale-up of integrated Human Immunodeficiency Virus (HIV) and tuberculosis (TB) treatment has been an important intervention to curb the burden of HIV and TB co-infection worldwide. Uptake of and adherence to antiretroviral therapy (ART) are key determinants of the quality and therapeutic endpoints of this intervention. This study aims to conduct an up-to-date collection and synthesis of evidence on barriers to and facilitators of uptake of and adherence to ART in HIV/TB integrated treatment programs in sub-Saharan Africa (SSA).

METHOD

A systematic review of peer-reviewed literature on the uptake of and adherence to ART in the context of integrated therapy for HIV and TB in SSA will be performed. We will review qualitative and quantitative studies reporting on the uptake of and adherence to ART during integrated treatment for TB and HIV among adults. These will include studies that involve HIV-infected TB patients initiating ART and studies involving PLWHA already on ART who are newly diagnosed with TB. Qualitative studies, quantitative studies, randomised trials and observational studies will be included. Six databases including Medline and Embase will be searched for relevant studies published from March 2004 to July 2019. Two authors will independently screen the search output and retrieve full texts of eligible studies. Disagreements between the two authors will be resolved by arbitration by a third author. Data will be abstracted from the eligible studies and synthesis will be done through descriptive synthesis for qualitative data and meta-analysis for quantitative data.

ETHICS AND DISSEMINATION

This study will be a review of the literature and will not involve primary collection of individuals' data. Amendments to the protocol will be documented in the final review. The final study will be published in a peer-reviewed journal and presented at conferences. The review is expected to contribute to improving strategies to enhance uptake of and adherence to ART in integrated care.

PROSPERO REGISTRATION NUMBER

CRD42019131933.

摘要

引言

扩大人类免疫缺陷病毒（HIV）和结核病（TB）综合治疗规模，是全球范围内遏制HIV与TB合并感染负担的一项重要干预措施。抗逆转录病毒疗法（ART）的接受情况和依从性，是该干预措施质量及治疗终点的关键决定因素。本研究旨在对撒哈拉以南非洲（SSA）地区HIV/TB综合治疗项目中ART接受和依从的障碍及促进因素的证据进行最新收集和综合分析。

方法

将对SSA地区HIV和TB综合治疗背景下ART接受和依从情况的同行评审文献进行系统综述。我们将回顾定性和定量研究，这些研究报告了成人在TB和HIV综合治疗期间ART的接受和依从情况。这些研究将包括涉及开始接受ART的HIV感染TB患者的研究，以及涉及已接受ART且新诊断为TB的艾滋病毒感染者的研究。将纳入定性研究、定量研究、随机试验和观察性研究。将检索包括Medline和Embase在内的六个数据库，以查找2004年3月至2019年7月发表的相关研究。两名作者将独立筛选检索结果并检索符合条件研究的全文。两位作者之间的分歧将由第三位作者仲裁解决。将从符合条件的研究中提取数据，并通过定性数据的描述性综合分析和定量数据的荟萃分析进行综合。