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本文引用的文献

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HIV-1 mother-to-child transmission in Brazil (1994-2016): a time series modeling.巴西 1994-2016 年母婴传播 HIV-1:时间序列建模。
Braz J Infect Dis. 2019 Jul-Aug;23(4):218-223. doi: 10.1016/j.bjid.2019.06.012. Epub 2019 Jul 22.
2
Model-based prediction of CD4 cells counts in HIV-infected adults on antiretroviral therapy in Northwest Ethiopia: A flexible mixed effects approach.基于模型的埃塞俄比亚西北部接受抗逆转录病毒治疗的 HIV 感染成人 CD4 细胞计数预测:灵活的混合效应方法。
PLoS One. 2019 Jul 10;14(7):e0218514. doi: 10.1371/journal.pone.0218514. eCollection 2019.
3
Inappropriate infant feeding practices of HIV-positive mothers attending PMTCT services in Oromia regional state, Ethiopia: a cross-sectional study.埃塞俄米亚奥罗米亚地区接受预防母婴传播服务的艾滋病毒阳性母亲不适当的婴儿喂养做法:一项横断面研究
Int Breastfeed J. 2018 Aug 17;13:37. doi: 10.1186/s13006-018-0181-x. eCollection 2018.
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A systematic review and meta-analysis of vertical transmission route of HIV in Ethiopia.一项关于 HIV 在埃塞俄比亚垂直传播途径的系统评价和荟萃分析。
BMC Infect Dis. 2018 Jun 22;18(1):283. doi: 10.1186/s12879-018-3189-3.
5
Rate of HIV transmission and associated factors among HIV-exposed infants in selected health facilities of East and West Gojjam Zones, Northwest Ethiopia; retrospective cohort study.埃塞俄比亚西北部戈贾姆东部和西部区域部分医疗机构中暴露于艾滋病毒的婴儿的艾滋病毒传播率及相关因素;回顾性队列研究。
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6
Program Implementation of Option B+ at a President's Emergency Plan for AIDS Relief-Supported HIV Clinic Improves Clinical Indicators But Not Retention in Care in Mbarara, Uganda.在乌干达姆巴拉拉一家由总统艾滋病紧急救援计划支持的艾滋病毒诊所实施“B+方案”,改善了临床指标,但未提高护理留存率。
AIDS Patient Care STDS. 2017 Aug;31(8):335-341. doi: 10.1089/apc.2017.0034. Epub 2017 Jun 26.
7
Levels of adherence and factors associated with adherence to option B+ prevention of mother-to-child transmission among pregnant and lactating mothers in selected government health facilities of South Wollo Zone, Amhara Region, northeast Ethiopia, 2016.2016年埃塞俄比亚东北部阿姆哈拉州南沃洛地区部分政府卫生机构中,孕妇和哺乳期母亲对预防母婴传播方案B+的依从性水平及与依从性相关的因素
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Mother-to-Child Transmission of HIV Infection and Its Determinants among Exposed Infants on Care and Follow-Up in Dire Dawa City, Eastern Ethiopia.埃塞俄比亚东部德雷达瓦市接受护理及随访的暴露婴儿中HIV感染的母婴传播及其决定因素
AIDS Res Treat. 2016;2016:3262746. doi: 10.1155/2016/3262746. Epub 2016 Feb 16.
9
The missed HIV-positive children of Ethiopia.埃塞俄比亚未被发现的艾滋病毒呈阳性儿童。
PLoS One. 2015 Apr 16;10(4):e0124041. doi: 10.1371/journal.pone.0124041. eCollection 2015.
10
Prevention of mother-to-child transmission of HIV type 1: the role of neonatal and infant prophylaxis.预防1型人类免疫缺陷病毒母婴传播:新生儿及婴儿预防用药的作用
Expert Rev Anti Infect Ther. 2015 Feb;13(2):169-81. doi: 10.1586/14787210.2015.999667.

2017年埃塞俄比亚北谢瓦地区卫生中心接受B+方案治疗的感染艾滋病毒母亲的母婴传播纵向和生存数据的联合与单独分析

Joint and Separate Analysis for Longitudinal and Survival Data on Mother-to-Child Transmission of HIV Among Infected Mothers on Option B+ at Health Centers in North Shewa Zone, Ethiopia, 2017.

作者信息

Mekuria Abinet Dagnaw, Sisay Assefa Legesse, Hailegiorgies Kassa Ketsela, Abebe Ayele Mamo

机构信息

Department of Public Health, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia.

Department of Epidemiology and Bio-Statistics, Jimma University, Jimma, Ethiopia.

出版信息

J Multidiscip Healthc. 2020 Oct 20;13:1179-1189. doi: 10.2147/JMDH.S269558. eCollection 2020.

DOI:10.2147/JMDH.S269558
PMID:33116563
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7585812/
Abstract

BACKGROUND

Prevention of mother-to-child transmission of HIV (PMTCT) is a frequently used word for programs and intervention methods to decrease the risk of mother-to-child transmission of HIV. The aim of this study was to identify determinants of the reduction of CD4 count through time and the maternal transmission of HIV to their child on the PMTCT program at health centers in North Shewa Zone, Ethiopia.

METHODS

The cohort study design was conducted by using secondary data collected from the cohort register of PMTCT starting from September 1, 2014 to November 30, 2017. In this study, a longitudinal study was conducted for two types of result; these were longitudinal response measurements of HIV infected women CD4 count and the time to maternal transmission of HIV taken from 203 patients.

RESULTS

The prevalence rate of HIV infection among exposed infants was 5.58%. Baseline CD4 count, visiting times, weight, and interaction between visiting time and baseline CD4 count had a statistically significant effect on the longitudinal biomarker. From the Weibull AFT model, ART start, partner test, clinical stage, educational status, place of delivery, and MUAC were statistically significant. Hence, as a measurement unit decreased in square root CD4 cell count by 1.18 elevates the risk of maternal transmission of HIV.

CONCLUSION

In this study, the determinant of mother-to-child transmission of HIV including loss of weight, ART start (ANC), place of delivery at home, illiterate and mother with severe malnutrition, had a significant effect. The longitudinal biomarker also had a strong association with baseline CD4 and the risk of maternal transmission of HIV. Health education should be given about balanced diet, weight control, and take medication for HIV positive patients by the responsible bodies.

摘要

背景

预防母婴传播艾滋病毒(PMTCT)是用于描述降低艾滋病毒母婴传播风险的项目和干预方法的常用术语。本研究的目的是确定在埃塞俄比亚北谢瓦地区的卫生中心,参与预防母婴传播艾滋病毒项目的妇女随着时间推移CD4细胞计数下降的决定因素以及艾滋病毒的母婴传播情况。

方法

采用队列研究设计,使用从2014年9月1日至2017年11月30日的预防母婴传播艾滋病毒队列登记中收集的二手数据。在本研究中,针对两种类型的结果进行了纵向研究;这些结果是对203名艾滋病毒感染妇女的CD4细胞计数的纵向反应测量以及艾滋病毒母婴传播的时间。

结果

暴露婴儿中的艾滋病毒感染率为5.58%。基线CD4细胞计数、就诊次数、体重以及就诊次数与基线CD4细胞计数之间的相互作用对纵向生物标志物有统计学上的显著影响。从威布尔加速失效时间模型来看,开始抗逆转录病毒治疗、性伴侣检测、临床分期、教育状况、分娩地点和上臂中部周长具有统计学意义。因此,作为测量单位,CD4细胞计数平方根每减少1.18,艾滋病毒母婴传播的风险就会升高。

结论

在本研究中,艾滋病毒母婴传播的决定因素包括体重减轻、开始抗逆转录病毒治疗(产前护理)、在家分娩、文盲以及患有严重营养不良的母亲,这些因素具有显著影响。纵向生物标志物也与基线CD4细胞计数以及艾滋病毒母婴传播风险密切相关。相关责任机构应开展关于均衡饮食、体重控制以及为艾滋病毒阳性患者提供药物治疗的健康教育。