Moges Sisay, Lajore Bereket Aberham, Debesay Betelhem Asmerom, Belato Degefa Tadele
Department of Family Health, Hossana College of Health Science, Hosanna, Ethiopia.
Self Employed, Ontario, Canada.
J Epidemiol Glob Health. 2025 Aug 1;15(1):101. doi: 10.1007/s44197-025-00422-w.
The universal test and treat (UTT) program, is a strategy for eliminating HIV and, it involves screening all populations at risk for HIV infection, initiating early treatment for those diagnosed HIV positive, monitoring and maintaining treatment, and Retaining patients in care. Therefore, this meta-analysis evaluates the impact of the Test-and-Treat strategy on HIV-positive patients in Ethiopia, focusing on mortality rates and disease progression.
A systematic literature search was conducted using databases such as PubMed, Embase, African Journals Online (AJOL), Google Scholar, and Web of Science. Data were classified into two periods: 2005 to 2015 (before test and treat era) and 2016-2024 (after test and treat strategy). Eligible studies included cohort and cross-sectional designs providing distinct data for these timeframes, irrespective of publication year, to assess reductions in mortality and disease progression (WHO Stage III or IV). Study quality and bias were assessed using the Newcastle-Ottawa Scale (NOS), ensuring rigorous evaluation across selection, comparability, and outcome domains. A random-effects model was employed for the meta-analysis.
The pooled mortality rate decreased significantly from 21% (95% CI: 14-29%) in the before test and treat period to 9% (95% CI: 6-12%) after the test and treat period, representing a 57.14% reduction. The proportion of patients in WHO Stage III declined from 47% (95% CI: 39-54%) to 21% (95% CI: 16-26%), a reduction of 55.32%. Similarly, the prevalence of WHO Stage IV decreased from 14% (95% CI: 12-16%) to 8% (95% CI: 5-10%), reflecting a 42.86% reduction.
The test and treat strategy in Ethiopia has substantial reductions in mortality and disease progression. These results underscore the effectiveness of early, universal treatment initiation in improving patient survival and reducing the burden of HIV-related complications.
普遍检测与治疗（UTT）计划是一项消除艾滋病病毒的策略，它包括筛查所有有感染艾滋病病毒风险的人群，对诊断为艾滋病病毒阳性者尽早开始治疗，监测并维持治疗，以及使患者持续接受护理。因此，本荟萃分析评估了检测与治疗策略对埃塞俄比亚艾滋病病毒阳性患者的影响，重点关注死亡率和疾病进展情况。
使用PubMed、Embase、非洲期刊在线数据库（AJOL）、谷歌学术和科学网等数据库进行系统的文献检索。数据分为两个时期：2005年至2015年（检测与治疗时代之前）和2016年至2024年（检测与治疗策略实施之后）。符合条件的研究包括队列研究和横断面研究设计，这些研究提供了这两个时间段的不同数据，无论其发表年份如何，以评估死亡率和疾病进展（世界卫生组织III期或IV期）的降低情况。使用纽卡斯尔-渥太华量表（NOS）评估研究质量和偏倚，确保在选择、可比性和结果领域进行严格评估。荟萃分析采用随机效应模型。
汇总死亡率从检测与治疗前时期的21%（95%置信区间：14%-29%）显著降至检测与治疗后时期的9%（95%置信区间：6%-12%），降幅为57.14%。世界卫生组织III期患者比例从47%（95%置信区间：39%-54%）降至21%（95%置信区间：16%-26%），降幅为55.32%。同样，世界卫生组织IV期患病率从14%（%置信区间：12%-16%）降至8%（95%置信区间：5%-10%），降幅为42.86%。
埃塞俄比亚的检测与治疗策略在死亡率和疾病进展方面有大幅降低。这些结果强调了早期普遍开始治疗在改善患者生存和减轻艾滋病病毒相关并发症负担方面的有效性。
