Yismaw Gizachew, Yenesew Muluken Azage, Kebebaw Tegegn, Hinyard Leslie, Gizaw Asaminew, Mequanint Alemitu, Hendrix Christian, Abate Getahun
Amhara public health institute, Bahir Dar, Ethiopia.
School of Public Health, Bahir Dar University, Ethiopia.
J Migr Health. 2025 Feb 11;11:100304. doi: 10.1016/j.jmh.2025.100304. eCollection 2025.
The Amhara region in Ethiopia has been affected by a war that led to displacement of millions of people. This study was conducted with the objectives of evaluating HIV viral suppression rates, assessing viral load (VL) testing turnaround time (TAT) and pilot testing of a new webapp to make VL results available in real time while the health system is affected by large numbers of internally displaced people (IDP).
Data was obtained from 7 HIV VL testing centers that serve 378 anti-retroviral treatment centers. Viral load (VL) suppression rates and VL result turnaround time (TAT) were used as markers of effectiveness of HIV control.
A total of 98,957 records were analyzed. Patients at three of the seven VL testing sites including Debre-Birehan Referral Hospital (aOR 1.87, 95 CI [1.63-2.14]), Debre-Markos Referral Hospital (aOR 1.76, 95 CI [1.61-1.93]) and University of Gonder (aOR 2.28, 95 CI [2.07-2.51]) had increased risk of virologic failure. TAT between the time VL results were available to the time results were mailed to treatment centers was ≤ 1 week for 61,148 (63.4%) and 2 weeks for 25,172 (26.1%) tests. TAT vary among the 7 VL testing centers.
In a region with large numbers of IDP, virologic failure is more common in older age groups. VL and TAT vary by testing centers which could be reflective of ART default and delay in courier mail driven by internal displacement.
埃塞俄比亚的阿姆哈拉地区受到一场战争的影响，导致数百万人流离失所。本研究的目的是评估艾滋病毒病毒抑制率，评估病毒载量（VL）检测周转时间（TAT），并对一个新的网络应用程序进行试点测试，以便在卫生系统受到大量境内流离失所者（IDP）影响时实时提供VL结果。
数据来自为378个抗逆转录病毒治疗中心服务的7个艾滋病毒VL检测中心。病毒载量（VL）抑制率和VL结果周转时间（TAT）被用作艾滋病毒控制有效性的指标。
共分析了98,957条记录。七个VL检测地点中的三个地点的患者，包括德布雷-比雷汉转诊医院（调整后比值比1.87，95%置信区间[1.63-2.14]）、德布雷-马尔科斯转诊医院（调整后比值比1.76，95%置信区间[1.61-1.93]）和贡德尔大学（调整后比值比2.28，95%置信区间[2.07-2.51]）的病毒学失败风险增加。从VL结果可用到结果邮寄到治疗中心的TAT，61,148次检测（63.4%）≤1周，25,172次检测（26.1%）为2周。TAT在7个VL检测中心之间有所不同。
在一个有大量境内流离失所者的地区，病毒学失败在老年人群中更为常见。VL和TAT因检测中心而异，这可能反映了因境内流离失所导致的抗逆转录病毒治疗中断和快递邮件延迟。
