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埃塞俄比亚费莱格希沃特综合专科医院接受一线抗逆转录病毒治疗患者的CD4细胞计数及信息披露状况相关影响因素

Determinants Associated With CD4 Cell Count and Disclosure Status Among First-Line Antiretroviral Therapy Patients Treated at Felege Hiwot Comprehensive Specialized Hospital, Ethiopia.

作者信息

Bekele Abdela Assefa, Tegegne Awoke Seyoum, Muhie Nurye Seid

机构信息

Department of Statistics, Assosa University, Assosa, Ethiopia.

Department of Bio-Statistics, Bahir Dar University, Bahir Dar, Ethiopia.

出版信息

J Trop Med. 2025 Apr 11;2025:5989447. doi: 10.1155/jotm/5989447. eCollection 2025.

Abstract

In the last two decades, Human immune deficiency virus has been a major health concern in sub-Saharan Africa particularly in Ethiopia. The objective of this study was to identify determinants associated with CD4 cell count and disclosure status among first-line antiretroviral therapy patients treated at Felege Hiwot Comprehensive Specialized Hospital, Ethiopia. This retrospective study was conducted at Felege Hiwot Comprehensive Specialized Hospital. Data analysis was conducted using Statistical System Analysis (SAS) software Version 9.4. In this study, quasi-Poisson mixed-effects model for CD4 cell count, a binary logistic regression model for disclosure status, and joint modeling were used. Out of 300 adult participants, around 76% of the patients were discloses their disease status to their family members. The correlation between CD4 cell count and disclosure was positive (0.4607). The current study indicates that among the predictor variables, noneducators ( = -0.6185, -value < 0.01), primary educators ( = -0.3687, -value < 0.01), employed patients ( = 0.3888, -value < 0.01), adherent patients ( = 0.2274, -value < 0.01), and patients who did not had social support ( = -0.1148, -value = 0.030) have a significant effect for CD4 cell count. Similarly, noneducators (AOR = 0.000145, -value < 0.01), primary educators (AOR = 0.004413, -value < 0.01), employed patients (AOR = 3.4562, -value = 0.021), adherent patients (AOR = 1.564, -value < 0.01), and patients who did not had social support (AOR = 0.075, -value = 0.0078) had a significant effect for disclosure status. This study concluded that patients who had disclosed their disease status to near relatives or families have a positive correlation with CD4 cell count through time. This study also concluded that significant determinants affected both the variables of interest were educational level, occupation, adherence, and social support. Health professionals should give more attention to these important determinants to create good status of patients. In addition, health staff should conduct health-related studies for individuals to understand better ART follow-up. Patients should be adhere to their prescribed HIV medication properly on time and disclose their disease status without fearing stigma and discrimination to the community; this may help to increase their CD4 cell count. The family members should give social support to the infected patients, and the government should work on education; this may help to improve their CD4 cell count and increase the prevalence of disclosure of the disease status. The authors also recommended that further studies of this nature include other important variables that are not included in this study such as income of the patients and many other covariates.

摘要

在过去二十年中,人类免疫缺陷病毒一直是撒哈拉以南非洲地区尤其是埃塞俄比亚的一个主要健康问题。本研究的目的是确定在埃塞俄比亚费莱格·希沃特综合专科医院接受一线抗逆转录病毒治疗的患者中,与CD4细胞计数和病情披露状况相关的决定因素。这项回顾性研究在费莱格·希沃特综合专科医院开展。使用统计系统分析(SAS)软件9.4版进行数据分析。在本研究中,对CD4细胞计数采用了准泊松混合效应模型,对病情披露状况采用了二元逻辑回归模型,并进行了联合建模。在300名成年参与者中,约76%的患者向其家庭成员披露了自己的病情。CD4细胞计数与病情披露之间呈正相关(0.4607)。当前研究表明,在预测变量中,非教育工作者(β = -0.6185,p值<0.01)、小学教育工作者(β = -0.3687,p值<0.01)、就业患者(β = 0.3888,p值<0.01)、依从性好的患者(β = 0.2274,p值<0.01)以及没有社会支持的患者(β = -0.1148,p值 = 0.030)对CD4细胞计数有显著影响。同样,非教育工作者(调整后比值比[AOR]=0.000145,p值<0.01)、小学教育工作者(AOR = 0.004413,p值<0.01)、就业患者(AOR = 3.4562,p值 = 0.021)、依从性好的患者(AOR = 1.564,p值<0.01)以及没有社会支持的患者(AOR = 0.075,p值 = 0.0078)对病情披露状况有显著影响。本研究得出结论,向近亲或家人披露病情的患者随着时间推移与CD4细胞计数呈正相关。本研究还得出结论,影响这两个感兴趣变量的重要决定因素是教育水平、职业、依从性和社会支持。卫生专业人员应更多关注这些重要决定因素,以创造患者的良好状况。此外,卫生工作人员应为个体开展与健康相关的研究,以更好地了解抗逆转录病毒治疗的随访情况。患者应按时正确服用规定的艾滋病毒药物,并向社区披露自己的病情而不惧怕耻辱和歧视;这可能有助于提高他们的CD4细胞计数。家庭成员应给予感染患者社会支持,政府应致力于教育;这可能有助于提高他们的CD4细胞计数并增加病情披露的发生率。作者还建议,此类进一步研究应纳入本研究未包括的其他重要变量,如患者收入和许多其他协变量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12e9/12009679/e8732b04edae/JTM2025-5989447.001.jpg

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