埃塞俄比亚严重精神障碍患者中未确诊的 HIV、乙型肝炎和丙型肝炎感染。

Undiagnosed HIV, hepatitis B, and hepatitis C infections in people with severe psychiatric disorders in Ethiopia.

机构信息

Research and Training Department, Amanuel Mental Specialized Hospital, PO Box 171, Addis Ababa, Ethiopia.

School of Public Health, Curtin University, Perth, Westen Australia, Australia.

出版信息

BMC Infect Dis. 2020 Feb 27;20(1):180. doi: 10.1186/s12879-020-4907-1.

DOI:10.1186/s12879-020-4907-1

PMID:32106864

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7045486/

Abstract

BACKGROUND

Worldwide, there is limited epidemiologic evidence on the seroprevalence of undiagnosed chronic viral infections including HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among patients with severe psychiatric disorders. To our knowledge, this is the first study to explore and compare undiagnosed seroprevalence rates of HIV, HBV, and HCV infections among patients with severe psychiatric disorders.

METHOD

In this study, we included a random sample of 309 patients with severe psychiatric disorders selected by systematic sampling technique. We used a structured clinical interview for DSM-IV (SCID) to confirm the diagnosis of severe psychiatric disorders among the participants. Binary and multivariable logistic regression models, adjusting for the potential confounding factors was used to explore the potential determinants of chronic viral infections.

RESULT

The prevalence estimates of HIV infection among patients with severe psychiatric disorders in this study (3.24%) was roughly 3 times the estimated population prevalence of HIV infection in Ethiopia (1.1%). This study showed that the prevalence rates of HBV and HCV infections among patients with severe psychiatric disorders were 4.85 and 1.29%, respectively. Our results also showed that among patients with chronic viral infections, HIV, HBV and HCV, 76.92, 60, 80, and 75% respectively were undiagnosed. Regarding associated factors, the presence of chronic viral infection was found to be significantly associated with the age of the participants (ranging between 30 and 40 years) after adjusting for the possible confounding factors [AOR = 3.95 (95%CI.18-13.17)].

CONCLUSION

Even though the prevalence estimates of HIV (3.24%), HBV (4.85%), and HCV (1.29%) infections were high among patients with severe psychiatric disorders, the majority of them remained undiagnosed. HBV was found to be the commonly undiagnosed infection (4 out of 5) followed by HCV (3 out of 4) and HIV (6 out of 10). The present study provided evidence of a significant association between the age of the participant (between 30 and 40 years) and chronic viral infections in patients with severe psychiatric disorders. Increasing the awareness of psychiatry professionals and early screening, as well as interventions of chronic viral infections among patients with severe psychiatric disorders are imperative.

摘要

背景

在全球范围内，针对包括 HIV、乙型肝炎病毒 (HBV) 和丙型肝炎病毒 (HCV) 在内的未确诊慢性病毒感染，患有严重精神疾病患者的流行率的流行病学证据有限。据我们所知，这是第一项探索和比较患有严重精神疾病患者的未确诊 HIV、HBV 和 HCV 感染流行率的研究。

方法

在这项研究中，我们通过系统抽样技术随机抽取了 309 名患有严重精神疾病的患者作为研究对象。我们使用 DSM-IV 结构临床访谈 (SCID) 来确认参与者的严重精神疾病诊断。使用二元和多变量逻辑回归模型，调整潜在混杂因素，以探索慢性病毒感染的潜在决定因素。

结果

本研究中严重精神疾病患者 HIV 感染的患病率估计值（3.24%）大约是埃塞俄比亚 HIV 感染人群患病率（1.1%）的 3 倍。本研究表明，严重精神疾病患者的 HBV 和 HCV 感染率分别为 4.85%和 1.29%。我们的研究结果还表明，在患有慢性病毒感染的患者中，HIV、HBV 和 HCV 的未确诊率分别为 76.92%、60%、80%和 75%。关于相关因素，在调整了可能的混杂因素后，我们发现慢性病毒感染的存在与参与者的年龄（30 至 40 岁之间）显著相关（AOR=3.95[95%CI.18-13.17]）。

结论

尽管严重精神疾病患者的 HIV（3.24%）、HBV（4.85%）和 HCV（1.29%）感染的患病率估计值较高，但大多数仍未被诊断。HBV 是最常见的未确诊感染（5 例中有 4 例），其次是 HCV（4 例中有 3 例）和 HIV（10 例中有 6 例）。本研究提供了证据表明，患有严重精神疾病患者的年龄（30 至 40 岁之间）与慢性病毒感染之间存在显著关联。提高精神病学专业人员的认识，以及对严重精神疾病患者进行慢性病毒感染的早期筛查和干预是当务之急。