莫桑比克的艾滋病毒和乙型肝炎病毒双重感染问题:政策审查与卫生专业人员的知识和实践

Vanda Suzel Viana Dos Muchangos, Charlotta Nilsson, Esperanca Sevene, Lucia Chambal
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摘要

背景人类免疫缺陷病毒(HIV)和乙型肝炎病毒(HBV)合并感染是一个公共卫生问题,影响到全球 270 万人。在莫桑比克,这种合并感染的发病率为 9.1%,这就要求医疗机构在预防、诊断和适当管理艾滋病患者方面制定具体政策。本研究旨在审查现有政策,并评估医疗专业人员对 HIV/HBV 合并感染的认识和做法。方法:对莫桑比克有关 HIV/HBV 合并感染的现有政策和指南进行文件和文献审查。与主要信息提供者取得联系,以澄清或补充信息。在莫桑比克首都马普托市的四家医疗中心护理 HIV 阳性患者的医疗专业人员回答了有关这种合并感染的知识和实践的问卷。采用内容分析法进行了定性分析,以确定主要主题。使用 SPSS 程序第 20 版对社会人口学、知识和实践变量进行了描述性统计,并应用双变量分析来描述变量之间的关联。52 名参与者回答了调查问卷。只有一份政策文件明确提到了 HIV/HBV 合并感染治疗。大多数医疗专业人员(96%)都了解艾滋病毒/乙型肝炎病毒合并感染。尽管现有的唯一一份政策文件涉及治疗,但很少(33%)提及含有替诺福韦和拉米夫定的抗逆转录病毒制剂。只有 29% 的医疗专业人员报告对 HIV 患者进行了 HBV 筛查,21% 的医疗专业人员进行了 HIV/HBV 合并感染咨询。结论有关 HIV/HBV 合并感染的预防、诊断和临床管理的政策文件很少或根本没有。卫生专业人员对 HIV/HBV 合并感染知之甚少。制定适当的政策并对卫生专业人员进行培训可能有助于提高认识,增加对病人的疾病预防、诊断和适当管理咨询。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
HIV and Hepatitis B virus co-infection in Mozambique: Policy review and Health Professionals knowledge and practices
Background Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV) co-infection is a public health problem affecting 2.7 million worldwide. In Mozambique, the prevalence of this co-infection is 9,1%, calling for specific policies on prevention, diagnosis and adequate management in health facilities caring for HIV patients. This study aimed to review the existing policies and to assess the knowledge and practices of health professionals about HIV/HBV co-infection. Methods A document and literature review to describe the existing policies and guidelines on HIV/HBV co-infection in Mozambique was performed. Key informants were contacted to clarify or add information. Health professionals who care for HIV-positive patients in four health centers in Maputo City, the capital of Mozambique responded to a questionnaire on knowledge and practices about this co-infection. Qualitative analysis was done to identify main themes using content analysis. Descriptive statistics of sociodemographic, knowledge, practices variables was presented using the SPSS Program version 20 and bivariate analysis was applied to describe the association between variables. Results Twenty-one policy documents were found and five key informants were interviewed. Fifty-two participants answered the questionnaire. Only one policy document explicitly referred to HIV/HBV co-infection treatment. Most health professionals (96%) were aware of HIV/HBV co-infection. Although the only existing policy is on the treatment, few (33%) referenced antiretrovirals formulations containing Tenofovir and Lamivudine. Only 29% of health professionals reported screening HIV patients for HBV and 21% practiced HIV/HBV co-infection counseling. No statistically significant differences were found when relating the sociodemographic variables with knowledge and practices. Conclusion Policy documents relating to prevention, diagnosis and clinical management of HIV/HBV co-infection were rare or absent. Health professionals had little knowledge about HIV/HBV co-infection. Defining adequate policies and training of health professionals may help increase awareness, increase counselling of patients for disease prevention, diagnosis and proper management of HIV/HBV co-infected patients.
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