加纳上西部大区瓦市和劳拉区婴儿早期艾滋病毒诊断障碍。

Barriers to early infant diagnosis of HIV in the Wa Municipality and Lawra District of Upper West Region, Ghana.

机构信息

Ghana Field Epidemiology and Laboratory Training Program, Department of Epidemiology, School of Public Health, College of Health Sciences, University of Ghana Legon, Accra, Ghana.

Namibia Field Epidemiology and Laboratory Training Program, University of Namibia, Windhoek, Namibia.

出版信息

Ghana Med J. 2020 Jun;54(2 Suppl):83-90. doi: 10.4314/gmj.v54i2s.13.

DOI:10.4314/gmj.v54i2s.13

PMID:33536673

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7837354/

Abstract

OBJECTIVE

We identified socio-demographic, health system and psycho-social barriers to Early Infant Diagnosis (EID) of HIV in the Upper West Region of Ghana.

DESIGN

An unmatched case control study of 96 cases and 96 controls was conducted in the ART centers in Lawra district and Wa Municipality between December 2014 and April 2015.

SETTING

A public health facility.

PARTICIPANTS

We defined a case as an HIV positive mother with an exposed infant who received EID service between January 2011 and December 2014. A control was defined as HIV Positive Mother with an exposed infant who did not receive EID services between January 2011 and December 2014.

MAIN OUTCOME

EID by dry blood spot Deoxyribonucleic acid Polymerase chain reaction.

RESULTS

A total of 192 mother-infant pairs were assessed. The mean age of infants at testing for cases was 17.3±14.9 weeks. Mother-to-child-transmission-rate was 2.3%. Factors associated with EID testing included: mother being formally employed (cOR=2.0: 95%CI:1.1-3.8), maternal formal education (cOR=2.0, 95%CI: 1.1-3.6) and maternal independent source of income (cOR 2.2, 95%CI 1.2-4.1). After adjusting for confounders, maternal independent income source was associated with EID testing (aOR 2.2, 95%CI 1.2-4.1). Median turn-around time of EID result was 11 weeks (IQR 4-27 weeks).

CONCLUSION

Women need to be empowered to gain an independent source of income. This can help maximize the benefits of e-MTCT and increase EID in the Upper West Region of Ghana.

FUNDING

This work was funded by the authors.

摘要

目的

我们确定了加纳上西部地区在实施早期婴儿 HIV 诊断（EID）方面存在的社会人口学、卫生系统和心理社会障碍。

设计

2014 年 12 月至 2015 年 4 月，在劳拉区和瓦市的艾滋病治疗中心，我们对 96 例病例和 96 例对照进行了一项未经匹配的病例对照研究。

地点

公共卫生机构。

参与者

我们将 2011 年 1 月至 2014 年 12 月期间接受过 EID 服务的 HIV 阳性母亲所生的 HIV 暴露婴儿定义为病例，而将未接受过 EID 服务的 HIV 阳性母亲所生的 HIV 暴露婴儿定义为对照。

主要结局

干血斑脱氧核糖核酸聚合酶链反应的 EID。

结果

共评估了 192 对母婴对。病例组婴儿检测时的平均年龄为 17.3±14.9 周。母婴传播率为 2.3%。与 EID 检测相关的因素包括：母亲有正式工作（校正比值比[cOR]=2.0；95%可信区间[CI]：1.1-3.8）、母亲接受过正规教育（cOR=2.0；95%CI：1.1-3.6）和母亲有独立的收入来源（cOR 2.2；95%CI：1.2-4.1）。在调整了混杂因素后，母亲独立的收入来源与 EID 检测相关（调整比值比[aOR]=2.2；95%CI：1.2-4.1）。EID 结果的中位周转时间为 11 周（IQR 4-27 周）。