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2022 年,在埃塞俄比亚西北部阿姆哈拉地区北戈贾姆地区,对 18 个月大的哺乳期妇女进行了一项多中心横断面研究,以评估男性伴侣参与和相关因素对 B+PMTCT 药物依从性的影响。

Level of option B+PMTCT drug adherence with male partner involvement and associated factors among breastfeeding women until 18 months in North Gojjam Zone, Amhara region, Northwest Ethiopia, 2022: a multicentre cross-sectional study.

机构信息

Midwifery, Debre Tabor University, Debre Tabor, Amhara, Ethiopia

Midwifery, Debre Tabor University, Debre Tabor, Amhara, Ethiopia.

出版信息

BMJ Open. 2024 Oct 22;14(10):e086374. doi: 10.1136/bmjopen-2024-086374.

Abstract

BACKGROUND

Adherence to option B+antiretroviral therapy medication is crucial for the effective implementation of the Prevention of Mother-to-Child Transmission (PMTCT) programme. Ethiopia has adopted the WHO's target of achieving over 95% adherence. However, research conducted in southern Ethiopia found that only 81.4% of women adhered to option B+medication, which reflects a poor level of adherence and remains a concern.

OBJECTIVE

The objective of the study was to assess the level of option B+PMTCT drug adherence and associated factors among women who were breast feeding for up to 18 months in government health facilities of North Gojjam Zone, Amhara region, Northwest Ethiopia, 2022 DESIGN: An institution-based cross-sectional study was conducted.

SETTING

The study was carried out in hospitals located in the North Gojjam Zone of Northwest Ethiopia.

PARTICIPANTS

The study was conducted with 223 HIV-positive women who were breast feeding for up to 18 months, from 1 March 2022 to 30 April 2022.

PRIMARY AND SECONDARY OUTCOMES

The primary outcome was to assess the level of option B+PMTCT drug adherence, while the secondary outcome was to identify factors associated with option B+PMTCT drug adherence among HIV-positive women who were breast feeding for up to 18 months. Associations between variables were analysed using both bivariate and multivariable logistic regression models, with a p<0.05 considered statistically significant at the 95% confidence level.

RESULTS

A total of 223 participants were included, yielding a response rate of 97.8%. The adherence to option B+PMTCT drugs was 62.8%. The type of health facility (adjusted OR, AOR=0.17 (95% CI: 0.008 to 0.35)), partner support involvement (AOR=3.03 (95% CI: 1.12 to 9.13)) and the time taken to reach the facility from home (AOR=6.34 (95% CI: 2.92 to 13.75)) were significantly associated with the level of option B+PMTCT drug adherence.

CONCLUSION

Option B+PMTCT drug adherence was lower than the recommended level. The type of health facility, partner support and the time required to travel from home to the facility were factors associated with adherence to option B+PMTCT medication. Support from a partner is crucial for improving adherence to option B+medication.

摘要

背景

坚持使用 B 方案+抗逆转录病毒疗法药物对于有效实施预防母婴传播(PMTCT)计划至关重要。埃塞俄比亚已经采用了世界卫生组织(WHO)实现超过 95%的坚持率的目标。然而,在埃塞俄比亚南部进行的研究发现,只有 81.4%的女性坚持使用 B 方案+药物,这反映出坚持率较低,仍然令人担忧。

目的

本研究旨在评估在埃塞俄比亚西北部北戈贾姆地区政府卫生机构中,接受母乳喂养长达 18 个月的 HIV 阳性妇女中 B 方案+PMTCT 药物的坚持程度及其相关因素。

设计

这是一项基于机构的横断面研究。

地点

该研究在埃塞俄比亚西北部北戈贾姆地区的医院进行。

参与者

这项研究共纳入了 223 名接受母乳喂养长达 18 个月的 HIV 阳性妇女,时间为 2022 年 3 月 1 日至 2022 年 4 月 30 日。

主要和次要结果

主要结局是评估 B 方案+PMTCT 药物坚持程度,次要结局是确定与接受母乳喂养长达 18 个月的 HIV 阳性妇女 B 方案+PMTCT 药物坚持程度相关的因素。采用单变量和多变量逻辑回归模型分析变量之间的关联,以 95%置信水平下 p<0.05 为统计学显著水平。

结果

共有 223 名参与者被纳入,响应率为 97.8%。B 方案+PMTCT 药物的坚持率为 62.8%。卫生机构类型(调整后的比值比,AOR=0.17(95%可信区间:0.008 至 0.35))、伴侣支持的参与(AOR=3.03(95%可信区间:1.12 至 9.13))和从家到机构所需的时间(AOR=6.34(95%可信区间:2.92 至 13.75))与 B 方案+PMTCT 药物坚持率显著相关。

结论

B 方案+PMTCT 药物的坚持率低于推荐水平。卫生机构类型、伴侣支持以及从家到机构所需的时间是与 B 方案+抗逆转录病毒药物坚持相关的因素。伴侣的支持对于提高 B 方案药物的坚持率至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b40/11499856/38cbc498da20/bmjopen-14-10-g001.jpg

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