CD4分级服务模式对南非实验室间转诊距离的影响。

IF 0.8 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Journal of Public Health in Africa Pub Date : 2025-09-23 eCollection Date: 2025-01-01 DOI:10.4102/jphia.v16i1.1357
Naseem Cassim, Manuel P da Silva, Deborah K Glencross, Lindi-Marie Coetzee, Wendy S Stevens
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引用次数: 0

摘要

背景:南非是世界上人类免疫缺陷病毒(HIV)流行最严重的国家。CD4细胞聚类检测的大多数服务缺口以前已得到解决。目的:本研究旨在评估分级服务对实验室间转诊距离的影响。环境:报告来自国家实验室网络的CD4检测数据。方法:提取2012 - 2021年源实验室和检测实验室的检测卷。计算欧几里得距离(EDs),报告年度和省级中位数并进行分类(50公里,51公里- 99公里,100公里- 199公里,200公里- 299公里和≥300公里)。分析ED、转诊和周转时间(TAT)之间的关系。计算了2012年至2021年各省平均ED的变化。结果:数据包括14 487 006名转诊患者。ED的中位数为55至60公里。51公里~ 99公里、100公里~ 199公里、200公里~ 299公里和≥300公里的ED类型分别为35.1%、13.2%、3.5%和0.3%。ED与转诊量(-0.1540)和TAT(-0.2305)呈负线性相关。各省平均平均教育量从16公里(豪登省)到186公里(北开普省)不等。除北开普省外,报告的省级ED≤100公里。2012年至2021年间,ED中位数的变化百分比从-55.7%(自由邦)到0.8%(姆普马兰加)不等。两个源实验室(Springbok和Beaufort West)在2021年报告了中位ED bb0 300公里。结论:研究结果表明,服务的分散化使全国ED中位数降至60公里以下。贡献:分层实现改进了可访问性,但是仍然存在一些覆盖差距。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

The impact of a CD4 tiered service model on interlaboratory referral distances in South Africa.

The impact of a CD4 tiered service model on interlaboratory referral distances in South Africa.

The impact of a CD4 tiered service model on interlaboratory referral distances in South Africa.

The impact of a CD4 tiered service model on interlaboratory referral distances in South Africa.

Background: South Africa has the world's largest human immunodeficiency virus (HIV) pandemic. Most service gaps for cluster of differentiation 4 (CD4) testing were previously addressed.

Aim: This study aimed to assess the impact of a tiered service on interlaboratory referral distances.

Setting: Data are reported for CD4 testing that are referred from a national network of laboratories.

Methods: Test volumes were extracted for source and testing laboratories from 2012 to 2021. The Euclidean distances (EDs) were calculated, with the annual and provincial medians reported and categorised (50 km, 51 km - 99 km, 100 km - 199 km, 200 km - 299 km and ≥ 300 km). The relationship between ED, referrals and turnaround time (TAT) was analysed. The change in the provincial median ED between 2012 and 2021 was calculated.

Results: Data included 14 487 006 referrals. The median ED ranged from 55 km to 60 km. An ED category of 51 km - 99 km, 100 km - 199 km, 200 km - 299 km and ≥ 300 km was reported for 35.1%, 13.2%, 3.5% and 0.3% of the specimens. A negative linear correlation was reported for ED with referral volumes (-0.1540) and TAT (-0.2305). The provincial median ED ranged from 16 km (Gauteng) to 186 km (Northern Cape). Excluding the Northern Cape, a provincial ED of ≤ 100 km was reported. The percentage change in median ED between 2012 and 2021 ranged from -55.7% (Free State) to 0.8% (Mpumalanga). Two source laboratories reported a median ED > 300 km in 2021 (Springbok and Beaufort West).

Conclusion: The study's findings indicate that the decentralisation of services reduced the national median ED to below 60 km.

Contribution: The tiered implementation improved accessibility, however, some coverage gaps still remain.

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来源期刊
Journal of Public Health in Africa
Journal of Public Health in Africa PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
自引率
0.00%
发文量
82
审稿时长
10 weeks
期刊介绍: The Journal of Public Health in Africa (JPHiA) is a peer-reviewed, academic journal that focuses on health issues in the African continent. The journal editors seek high quality original articles on public health related issues, reviews, comments and more. The aim of the journal is to move public health discourse from the background to the forefront. The success of Africa’s struggle against disease depends on public health approaches.
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