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在乌干达,对一组艾滋病毒和高血压患者的糖尿病护理链进行回顾性队列研究。

Diabetes mellitus care cascade among a cohort of persons living with HIV and hypertension in Uganda: A retrospective cohort study.

机构信息

Makerere University, Joint AIDS Program (MJAP), Kampala, Uganda.

Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.

出版信息

Int J STD AIDS. 2023 Sep;34(10):728-734. doi: 10.1177/09564624231179497. Epub 2023 Jun 3.

Abstract

BACKGROUND

In Uganda, it is recommended that persons with HIV receive integrated care to address both hypertension and diabetes. However, the extent to which appropriate diabetes care is delivered remains unknown and was the aim of this study.

METHODS

We conducted a retrospective study among participants receiving integrated care for HIV and hypertension for at least 1 year at a large urban HIV clinic in Mulago, Uganda to determine the diabetes care cascade.

RESULTS

Of the 1115 participants, the majority were female ( = 697, 62.5%) with a median age of 50 years (Inter Quartile Range: 43, 56). Six hundred twenty-seven participants (56%) were screened for diabetes mellitus, 100 (16%) were diagnosed and almost all that were diagnosed ( = 94, 94%) were initiated on treatment. Eighty-five patients (90%) were retained and all were monitored (100%) in care. Thirty-two patients (32/85, 38%) had glycaemic control. Patients on a Dolutegravir-based regimen (OR = 0.31, 95% CI = 0.22-0.46, < 0.001) and those with a non-suppressed viral load (OR = 0.24, 95% CI = 0.07-0.83, = 0.02) were less likely to be screened for diabetes mellitus.

CONCLUSIONS

In very successful HIV care programs, large gaps still linger for the management of non-communicable diseases necessitating uniquely designed intervention by local authorities and implementing partners addressing the dual HIV and non-communicable diseases burden.

摘要

背景

在乌干达,建议艾滋病毒感染者接受综合护理,以同时治疗高血压和糖尿病。然而,适当的糖尿病护理的实施程度尚不清楚,这也是本研究的目的。

方法

我们在乌干达穆拉戈市的一个大型城市艾滋病毒诊所中,对至少接受了 1 年艾滋病毒和高血压综合护理的参与者进行了回顾性研究,以确定糖尿病护理的情况。

结果

在 1115 名参与者中,大多数为女性(697 名,占 62.5%),中位年龄为 50 岁(四分位间距:43,56)。627 名参与者(56%)接受了糖尿病筛查,100 名(16%)被诊断出患有糖尿病,几乎所有被诊断出患有糖尿病的患者(94 名,占 94%)都开始接受治疗。85 名患者(90%)得到了保留,所有患者都在护理中得到了监测(100%)。32 名患者(32/85,38%)的血糖得到了控制。接受多替拉韦方案治疗的患者(OR=0.31,95%CI=0.22-0.46,<0.001)和病毒载量未得到抑制的患者(OR=0.24,95%CI=0.07-0.83,=0.02),他们被筛查出患有糖尿病的可能性较低。

结论

在非常成功的艾滋病毒护理项目中,管理非传染性疾病仍然存在很大差距,需要当地当局和实施伙伴专门设计干预措施,同时应对艾滋病毒和非传染性疾病的双重负担。

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