尼日利亚伊巴丹的艾滋病延迟诊断的流行病学研究。
The epidemiology of delayed HIV diagnosis in Ibadan, Nigeria.
机构信息
Clinical Epidemiology Unit, Faculty of Medicine, Division of Community Health and Humanities Faculty of Medicine, 7512Memorial University, St John's, Canada.
University College Hospital, Ibadan, Nigeria.
出版信息
Int J STD AIDS. 2022 Aug;33(9):829-836. doi: 10.1177/09564624221106523. Epub 2022 Jun 30.
BACKGROUND
Human immunodeficiency virus infection (HIV) is one of the major health burdens in Nigeria. Delayed HIV diagnosis remains a significant driver of HIV transmission. The risk factors of delayed HIV diagnosis have not been widely studied in Nigeria. This observational study examined demographic risk factors for delayed HIV diagnosis and the trends in the annual total cases of delayed HIV diagnosis in Ibadan, Nigeria.
METHODS
We examined the data on HIV patients enrolled in care at the University College Hospital's Antiretroviral Therapy (ART) clinic in Ibadan, Nigeria. Delayed HIV diagnosis was defined as a Cluster of Differentiation 4 (CD4) count of less than 350 cells/mm³ at the time of diagnosis. The association between delayed HIV diagnosis and risk factors was analyzed using logistic regression. The trends in the annual total cases of delayed HIV diagnosis over time were examined.
RESULTS
This study included 3458 HIV patients. There were 1993/3458 prevalent cases of delayed HIV diagnosis (57.6%). The risk factors for delayed HIV diagnosis were older age, retirement, marriage separation, never married, and widowed female. The factors that were significantly associated with a low risk of delayed HIV diagnosis were student and tertiary education. There was a progressive decline in the annual cases of delayed HIV diagnosis.
CONCLUSIONS
Although the cases of delayed HIV diagnosis are still high, they are declining. Human immunodeficiency virus testing should be targeted at populations at risk of delayed diagnosis. Considerable public awareness and education programs about HIV testing may significantly reduce delayed HIV diagnosis in Nigeria.
背景
人类免疫缺陷病毒感染（HIV）是尼日利亚的主要健康负担之一。HIV 诊断延迟仍然是 HIV 传播的一个重要驱动因素。在尼日利亚，HIV 诊断延迟的危险因素尚未得到广泛研究。本观察性研究探讨了延迟 HIV 诊断的人口统计学危险因素，以及尼日利亚伊巴丹年度延迟 HIV 诊断总病例数的趋势。
方法
我们检查了在尼日利亚伊巴丹大学教学医院抗逆转录病毒治疗（ART）诊所登记的 HIV 患者的数据。延迟 HIV 诊断定义为诊断时 CD4 计数小于 350 个细胞/mm³。使用逻辑回归分析延迟 HIV 诊断与危险因素之间的关联。检查了随时间推移年度延迟 HIV 诊断总病例数的趋势。
结果
本研究纳入了 3458 例 HIV 患者。有 1993/3458 例（57.6%）为现患延迟 HIV 诊断病例。延迟 HIV 诊断的危险因素是年龄较大、退休、婚姻分居、未婚和丧偶女性。与延迟 HIV 诊断风险较低显著相关的因素是学生和高等教育。延迟 HIV 诊断的年度病例数呈下降趋势。
结论
尽管延迟 HIV 诊断的病例仍然很高，但它们正在下降。HIV 检测应针对有延迟诊断风险的人群。针对 HIV 检测的公众意识和教育计划可能会显著减少尼日利亚的延迟 HIV 诊断。
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