P Ditondo, A Luemba, R Ingwe Chuy, G Mucinya, S Ade
{"title":"服务点诊断在确定晚期艾滋病毒疾病方面的贡献。","authors":"P Ditondo, A Luemba, R Ingwe Chuy, G Mucinya, S Ade","doi":"10.5588/pha.23.0005","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Médecins Sans Frontières Belgium installed point-of-care (POC) diagnostics for the early detection of advanced HIV disease (AHD), and in its presence, TB and cryptococcosis, in six health centres (Kasai, St Ambroise, St Joseph, Libondi, Lisanga and Kimia) in Kinshasa, Democratic Republic of the Congo (DRC).</p><p><strong>Objective: </strong>To document their contribution to the diagnosis of these conditions.</p><p><strong>Method: </strong>This is a retrospective cross-sectional study of HIV-positive adolescents and adults admitted with suspected AHD. A comparison 2 years before and 2 years after installation of POC was performed.</p><p><strong>Results: </strong>A total of 745 and 887 patients were included before and after POC, respectively. The mean age was 39.7 years (standard deviation [SD] 12.04); 66% (<i>n</i> = 1,077) were women. Patients with CD4 counts increased from 40.3% (<i>n</i> = 300) to 64.4% (<i>n</i> = 573) (<i>P</i> < 0.001). After the installation of POC, they ranged from 47.8% (Lisanga) to 97.1% (Kasai). The proportion of AHD was comparable (<i>n</i> = 158, 52.7% vs. <i>n</i> = 288, 50.3%; <i>P</i> = 0.779). Among patients with AHD, TB was detected in 28.5% (<i>n</i> = 82), of which 41.5% (<i>n</i> = 34) were confirmed; cryptococcosis was detected in 24.7% (<i>n</i> = 71), of which 9.9% (<i>n</i> = 7) were confirmed. Disparities between centres were observed.</p><p><strong>Conclusion: </strong>The POCs have increased patient access to CD4 testing and diagnosis of AHD in the six centres in DRC. However, actions are required to improve this performance, including screening for TB and cryptococcosis.</p>","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10380412/pdf/","citationCount":"0","resultStr":"{\"title\":\"Contribution des diagnostics au points de service dans l’identification de la maladie à VIH avancée.\",\"authors\":\"P Ditondo, A Luemba, R Ingwe Chuy, G Mucinya, S Ade\",\"doi\":\"10.5588/pha.23.0005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Médecins Sans Frontières Belgium installed point-of-care (POC) diagnostics for the early detection of advanced HIV disease (AHD), and in its presence, TB and cryptococcosis, in six health centres (Kasai, St Ambroise, St Joseph, Libondi, Lisanga and Kimia) in Kinshasa, Democratic Republic of the Congo (DRC).</p><p><strong>Objective: </strong>To document their contribution to the diagnosis of these conditions.</p><p><strong>Method: </strong>This is a retrospective cross-sectional study of HIV-positive adolescents and adults admitted with suspected AHD. A comparison 2 years before and 2 years after installation of POC was performed.</p><p><strong>Results: </strong>A total of 745 and 887 patients were included before and after POC, respectively. The mean age was 39.7 years (standard deviation [SD] 12.04); 66% (<i>n</i> = 1,077) were women. Patients with CD4 counts increased from 40.3% (<i>n</i> = 300) to 64.4% (<i>n</i> = 573) (<i>P</i> < 0.001). After the installation of POC, they ranged from 47.8% (Lisanga) to 97.1% (Kasai). The proportion of AHD was comparable (<i>n</i> = 158, 52.7% vs. <i>n</i> = 288, 50.3%; <i>P</i> = 0.779). Among patients with AHD, TB was detected in 28.5% (<i>n</i> = 82), of which 41.5% (<i>n</i> = 34) were confirmed; cryptococcosis was detected in 24.7% (<i>n</i> = 71), of which 9.9% (<i>n</i> = 7) were confirmed. Disparities between centres were observed.</p><p><strong>Conclusion: </strong>The POCs have increased patient access to CD4 testing and diagnosis of AHD in the six centres in DRC. However, actions are required to improve this performance, including screening for TB and cryptococcosis.</p>\",\"PeriodicalId\":46239,\"journal\":{\"name\":\"Public Health Action\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2023-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10380412/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Public Health Action\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5588/pha.23.0005\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Public Health Action","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5588/pha.23.0005","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
Contribution des diagnostics au points de service dans l’identification de la maladie à VIH avancée.
Background: Médecins Sans Frontières Belgium installed point-of-care (POC) diagnostics for the early detection of advanced HIV disease (AHD), and in its presence, TB and cryptococcosis, in six health centres (Kasai, St Ambroise, St Joseph, Libondi, Lisanga and Kimia) in Kinshasa, Democratic Republic of the Congo (DRC).
Objective: To document their contribution to the diagnosis of these conditions.
Method: This is a retrospective cross-sectional study of HIV-positive adolescents and adults admitted with suspected AHD. A comparison 2 years before and 2 years after installation of POC was performed.
Results: A total of 745 and 887 patients were included before and after POC, respectively. The mean age was 39.7 years (standard deviation [SD] 12.04); 66% (n = 1,077) were women. Patients with CD4 counts increased from 40.3% (n = 300) to 64.4% (n = 573) (P < 0.001). After the installation of POC, they ranged from 47.8% (Lisanga) to 97.1% (Kasai). The proportion of AHD was comparable (n = 158, 52.7% vs. n = 288, 50.3%; P = 0.779). Among patients with AHD, TB was detected in 28.5% (n = 82), of which 41.5% (n = 34) were confirmed; cryptococcosis was detected in 24.7% (n = 71), of which 9.9% (n = 7) were confirmed. Disparities between centres were observed.
Conclusion: The POCs have increased patient access to CD4 testing and diagnosis of AHD in the six centres in DRC. However, actions are required to improve this performance, including screening for TB and cryptococcosis.
期刊介绍：
Launched on 1 May 2011, Public Health Action (PHA) is an official publication of the International Union Against Tuberculosis and Lung Disease (The Union). It is an open access, online journal available world-wide to physicians, health workers, researchers, professors, students and decision-makers, including public health centres, medical, university and pharmaceutical libraries, hospitals, clinics, foundations and institutions. PHA is a peer-reviewed scholarly journal that actively encourages, communicates and reports new knowledge, dialogue and controversy in health systems and services for people in vulnerable and resource-limited communities — all topics that reflect the mission of The Union, Health solutions for the poor.
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