Atlaw Daniel, Sahiledengle Biniyam, Degno Sisay, Mamo Ayele, Gudisa Zewudie, Zenbaba Demisu, Shiferaw Zerihun, Gezahegn Habtamu
Department of Biomedical Sciences, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia.
Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia.
Trop Med Health. 2022 Apr 18;50(1):29. doi: 10.1186/s41182-022-00420-9.
BACKGROUND: Provider-initiated HIV testing, and counseling (PITC) is a service in which health professionals provide HIV testing to all patients in health facilities. Provider-initiated HIV testing, and counseling is an important opportunity for early screening of individuals, and it is fundamental for both HIV treatment and prevention. Although there are studies conducted in different parts of Ethiopia, their findings are variable. Therefore, this systematic review and meta-analysis aimed to summarize the pooled utilization of PITC in Ethiopia. METHOD: All studies conducted on utilization of provider-initiated HIV testing and counseling at outpatient departments (OPD), inpatient departments (IPD), antenatal clinic care (ANC), and tuberculosis (TB) clinics in Ethiopia are eligible for these meta-analyses. A systematic search of the literature was conducted by the authors to identify all relevant primary studies. The databases used to search for studies were PubMed, Science Direct, POPLINE, HENARI, Google Scholar, and Scopus. The extracted data were imported into STATA version 14 software for statistical analysis. The risk of bias was assessed using the Joana Briggs Institute (JBI) criteria for prevalence studies. The heterogeneity among all included studies was assessed by I statistics and the Cochran's Q test. Pooled utilization along with its corresponding 95% CI was presented using a forest plot. RESULT: About 1738 studies were retrieved from initial electronic searches using international databases and Google, and a total of 10,676 individual clients were included in the meta-analysis. The pooled utilization of PITC in Ethiopia using the random effects model was estimated to be 78.9% (95% CI 73.87-83.85) with a significant level of heterogeneity (I = 98.5%; P < 0.001). Subgroup analysis conducted on PITC showed the highest percentage among studies conducted in Addis Ababa (93.5%), while lower utilization was identified from a study conducted in the Tigray Region (35%). LIMITATION OF THE STUDY: The drawbacks of this review and meta-analysis were being reported with significant heterogeneity, and the protocol was not registered. CONCLUSION: About 21% of health facility clients missed opportunities for PITC in Ethiopia.
背景：医务人员主动提供的HIV检测与咨询服务（PITC）是指卫生专业人员在医疗机构为所有患者提供HIV检测。医务人员主动提供的HIV检测与咨询是早期筛查个体的重要契机，对HIV治疗和预防均至关重要。尽管埃塞俄比亚不同地区都开展过相关研究，但其结果各不相同。因此，本系统评价和荟萃分析旨在总结埃塞俄比亚PITC的综合利用率。 方法：所有关于埃塞俄比亚门诊（OPD）、住院部（IPD）、产前保健门诊（ANC）和结核病（TB）诊所中医务人员主动提供HIV检测与咨询服务利用率的研究均符合本荟萃分析的条件。作者对文献进行了系统检索，以确定所有相关的原始研究。用于检索研究的数据库有PubMed、Science Direct、POPLINE、HENARI、谷歌学术和Scopus。提取的数据被导入STATA 14版软件进行统计分析。使用乔安娜·布里格斯研究所（JBI）的患病率研究标准评估偏倚风险。通过I统计量和 Cochr an Q检验评估所有纳入研究之间的异质性。使用森林图展示综合利用率及其相应的95%置信区间。 结果：通过使用国际数据库和谷歌进行初步电子检索，共检索到约1738项研究，荟萃分析共纳入10676名个体客户。采用随机效应模型估计，埃塞俄比亚PITC的综合利用率为78.9%（95%置信区间73.87 - 83.85），异质性水平显著（I = 98.5%；P < 0.001）。对PITC进行的亚组分析显示，在亚的斯亚贝巴开展的研究中该比例最高（93.5%），而在提格雷地区开展的一项研究中利用率较低（35%）。 研究局限性：本综述和荟萃分析的缺点是报告存在显著异质性，且未登记方案。 结论：在埃塞俄比亚，约21%的医疗机构客户错失了接受PITC的机会。
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