低收入和中等收入国家患者自我检测的使用:系统的范围审查

Sbongile Joyce Makhudu, Desmond Kuupiel, Nonjabulo Gwala, T. Mashamba-Thompson
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引用次数: 4

摘要

背景:通过使用创新卫生技术,如即时检测,改善获得卫生服务的机会,是全球卫生的一个优先事项。患者自我检测(PST)是一种即时检测策略,已被证明能够改善获得诊断检测的机会和自主权,并使资源有限环境中难以接触到的人群能够获得卫生保健服务。然而,关于在低收入和中等收入国家(LMICs)使用PST进行疾病诊断和管理的证据水平尚不清楚。我们绘制了关于中低收入国家使用PST证据的文献。方法数据来源:PubMed;EBSCOhost (Medline,健康来源:护理),WEB of Science;科学指引;和谷歌学术搜索。本研究的资格标准包括:关注PST的研究,报告PST使用的证据,在中低收入国家进行的研究,将PST与基于设施的测试进行比较。进行专题分析以确定PST的使用模式。采用2011版混合方法质量评价工具对纳入的初步研究进行质量评价。结果8项研究符合纳入标准。研究对象包括以下中低收入国家的人口:肯尼亚;南非;乌干达;保加利亚;和马拉维。在所有纳入的主要研究的18,816名参与者中,57%是男性。总体而言,8项纳入的研究中有7项(87.5%)报告了使用以下方法进行人类免疫缺陷病毒(HIV)自检的研究:口服液HIV自检(HIVST)、OraQuick家庭快速HIV-1/2抗体检测、OraQuick O-HIVST、口服液和指尖HIV自检。8项纳入的研究中有1项(12.5%)报告使用快速免疫化学粪便潜血检查结直肠癌。虽然这项研究的结果表明艾滋病毒感染者的使用率很高,但它也表明低收入中国家对其他传染病和非传染性疾病的PST使用率很低。我们提取了以下主题:PST的使用,PST的可行性,以及与纳入研究的相关性。在纳入的8项研究中,5项在方法学质量评估中得分最高(76-100%)。与其他传染病和非传染性疾病相比,本次审查的结果显示,在中低收入国家中使用艾滋病毒自我检测的研究证据水平很高。建议加强对传染病的预防和服务措施的实施,特别是对高危和难以接触的人群。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Use of Patient Self-Testing in Low- and Middle-Income Countries: A Systematic Scoping Review
Background Improving access to health through use of innovative health technologies such as points-of-care testing is 1 global health priority. Patient self-testing (PST) is one of the point-of-care testing strategies that was shown to have an ability to improve access to diagnostic testing, autonomy and allow access to health care for hard-to-reach populations in resource-limited settings. However, the level of evidence on the use of PST for diagnosis and management of diseases in low- and middle-income countries (LMICs) is unknown. We mapped literature on evidence of the use of PST in LMICs. Methods Data were sourced from the following databases: PubMed; EBSCOhost (Medline, health source: Nursing), WEB of Science; Science Direct; and Google Scholar. Eligibility criteria for this study included: studies that focused on PST, reported on evidence on use of PST, conducted in LMICs, comparing PST with facility-based testing. Thematic analysis was performed to identify the patterns of use of PST. The mixed method quality appraisal tool version 2011 was used to assess the quality of the included primary studies. Results Eight studies met the inclusion criteria. Studies included populations from the following LMICs: Kenya; South Africa; Uganda; Bulgaria; and Malawi. Of the 18,816 total participants in all included primary studies, 57% were males. Overall, 7 (87.5%) of the 8 included studies reported on human immunodeficiency virus (HIV) self-testing using the following: oral fluid HIV self-test (HIVST), OraQuick in Home Rapid HIV-1/2 Antibody Test, OraQuick O-HIVST, oral fluid, and Fingerstick HIV self-tests. One (12.5%) of the 8 included studies reported on colorectal carcinoma using rapid immunochemical fecal occult blood tests. Although the findings of this study shows high usage of HIVST, it also demonstrates poor level of use of PST for other communicable and noncommunicable diseases in LMICs. We extracted the following themes; use of PST, feasibility of PST, and linkage to care from the included studies. Of the 8 included studies, 5 scored the highest quality (76–100%) from the methodological quality assessment. Conclusions The findings of the review revealed a high level of research evidence on the use of HIV self-testing compared to other communicable diseases and noncommunicable diseases in LMICs. Increased implementation of PST for communicable diseases is recommended, particularly for high-risk and hard-to-reach populations.
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