在南非夸祖鲁-纳塔尔省,社区卫生工作者可以接受培训,以确定有资格接受结核病预防治疗的患者,但在方案实施方面遇到了障碍。

IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Sarah Norton, Anthony P Moll, Jabulile Madi, Nkazi Nkomo, Ralph P Brooks, Laurie Andrews, Sheela V Shenoi
{"title":"在南非夸祖鲁-纳塔尔省,社区卫生工作者可以接受培训,以确定有资格接受结核病预防治疗的患者,但在方案实施方面遇到了障碍。","authors":"Sarah Norton,&nbsp;Anthony P Moll,&nbsp;Jabulile Madi,&nbsp;Nkazi Nkomo,&nbsp;Ralph P Brooks,&nbsp;Laurie Andrews,&nbsp;Sheela V Shenoi","doi":"10.2989/16085906.2023.2213213","DOIUrl":null,"url":null,"abstract":"<p><p>Tuberculosis (TB) remains one of the top 10 causes of death worldwide, ranking as the leading cause of death from infectious disease, above HIV and AIDS. South Africa has the sixth highest TB incidence rate in the world and the world's largest HIV epidemic. This study sought to demonstrate the feasibility of community health workers (CHWs) contributing to the implementation of tuberculosis preventive therapy (TPT) among people living with HIV and AIDS. Twelve community health workers were trained to test for communicable and non-communicable diseases and screen for TPT eligibility. They visited a select number of homes monthly to conduct screening for HIV, TB and non-communicable diseases. We recorded screening results, rates of referral for TPT, linkage to care - defined as being seen in the clinic for TPT - and treatment initiation. Among the 1 279 community members screened, 248 were identified as living with HIV, 99 (39.9%) individuals were identified as eligible for TPT, and 46 (46.5%) were referred to care. Among those referred, the median age was 39 (IQR 30-48) and 29 (63%) linked to care; 11 (37.9%) of those linked subsequently initiated treatment. In rural South Africa, it is feasible to train CHWs to identify and refer patients eligible for TPT, but losses occurred at each step of the cascade. CHWs can facilitate TPT implementation, although further implementation research exploring and addressing barriers to TPT (on an individual, provider and systems level) should be prioritised to optimise their role in rural resource-limited settings.</p>","PeriodicalId":50833,"journal":{"name":"Ajar-African Journal of Aids Research","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Community health workers can be trained to identify patients eligible for tuberculosis preventive therapy, but encounter barriers to programme implementation in KwaZulu-Natal, South Africa.\",\"authors\":\"Sarah Norton,&nbsp;Anthony P Moll,&nbsp;Jabulile Madi,&nbsp;Nkazi Nkomo,&nbsp;Ralph P Brooks,&nbsp;Laurie Andrews,&nbsp;Sheela V Shenoi\",\"doi\":\"10.2989/16085906.2023.2213213\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Tuberculosis (TB) remains one of the top 10 causes of death worldwide, ranking as the leading cause of death from infectious disease, above HIV and AIDS. South Africa has the sixth highest TB incidence rate in the world and the world's largest HIV epidemic. This study sought to demonstrate the feasibility of community health workers (CHWs) contributing to the implementation of tuberculosis preventive therapy (TPT) among people living with HIV and AIDS. Twelve community health workers were trained to test for communicable and non-communicable diseases and screen for TPT eligibility. They visited a select number of homes monthly to conduct screening for HIV, TB and non-communicable diseases. We recorded screening results, rates of referral for TPT, linkage to care - defined as being seen in the clinic for TPT - and treatment initiation. Among the 1 279 community members screened, 248 were identified as living with HIV, 99 (39.9%) individuals were identified as eligible for TPT, and 46 (46.5%) were referred to care. Among those referred, the median age was 39 (IQR 30-48) and 29 (63%) linked to care; 11 (37.9%) of those linked subsequently initiated treatment. In rural South Africa, it is feasible to train CHWs to identify and refer patients eligible for TPT, but losses occurred at each step of the cascade. CHWs can facilitate TPT implementation, although further implementation research exploring and addressing barriers to TPT (on an individual, provider and systems level) should be prioritised to optimise their role in rural resource-limited settings.</p>\",\"PeriodicalId\":50833,\"journal\":{\"name\":\"Ajar-African Journal of Aids Research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2023-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Ajar-African Journal of Aids Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2989/16085906.2023.2213213\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ajar-African Journal of Aids Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2989/16085906.2023.2213213","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0

摘要

结核病仍然是全世界十大死亡原因之一,是导致传染病死亡的主要原因,超过艾滋病毒和艾滋病。南非是世界上结核病发病率第六高的国家,也是世界上艾滋病流行最严重的国家。本研究旨在证明社区卫生工作者(CHWs)有助于在艾滋病毒和艾滋病感染者中实施结核病预防治疗(TPT)的可行性。12名社区保健工作人员接受了传染病和非传染性疾病检测和TPT筛查资格的培训。他们每月走访一些选定的家庭,进行艾滋病毒、结核病和非传染性疾病的筛查。我们记录了筛查结果,TPT转诊率,与护理的联系-定义为在诊所看到TPT -和治疗开始。在接受筛查的1279名社区成员中,248人被确定为艾滋病毒感染者,99人(39.9%)被确定为有资格接受TPT治疗,46人(46.5%)被转诊。其中,中位年龄为39岁(IQR 30-48岁),29岁(63%)与护理相关;其中11人(37.9%)随后开始治疗。在南非农村,培训卫生保健员识别和转诊有资格接受TPT治疗的患者是可行的,但在每一步都有损失。卫生保健工作者可以促进TPT的实施,尽管应该优先考虑进一步的实施研究,探索和解决TPT的障碍(在个人、提供者和系统层面),以优化他们在农村资源有限的环境中的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Community health workers can be trained to identify patients eligible for tuberculosis preventive therapy, but encounter barriers to programme implementation in KwaZulu-Natal, South Africa.

Tuberculosis (TB) remains one of the top 10 causes of death worldwide, ranking as the leading cause of death from infectious disease, above HIV and AIDS. South Africa has the sixth highest TB incidence rate in the world and the world's largest HIV epidemic. This study sought to demonstrate the feasibility of community health workers (CHWs) contributing to the implementation of tuberculosis preventive therapy (TPT) among people living with HIV and AIDS. Twelve community health workers were trained to test for communicable and non-communicable diseases and screen for TPT eligibility. They visited a select number of homes monthly to conduct screening for HIV, TB and non-communicable diseases. We recorded screening results, rates of referral for TPT, linkage to care - defined as being seen in the clinic for TPT - and treatment initiation. Among the 1 279 community members screened, 248 were identified as living with HIV, 99 (39.9%) individuals were identified as eligible for TPT, and 46 (46.5%) were referred to care. Among those referred, the median age was 39 (IQR 30-48) and 29 (63%) linked to care; 11 (37.9%) of those linked subsequently initiated treatment. In rural South Africa, it is feasible to train CHWs to identify and refer patients eligible for TPT, but losses occurred at each step of the cascade. CHWs can facilitate TPT implementation, although further implementation research exploring and addressing barriers to TPT (on an individual, provider and systems level) should be prioritised to optimise their role in rural resource-limited settings.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Ajar-African Journal of Aids Research
Ajar-African Journal of Aids Research 医学-公共卫生、环境卫生与职业卫生
CiteScore
1.80
自引率
8.30%
发文量
38
审稿时长
>12 weeks
期刊介绍: African Journal of AIDS Research (AJAR) is a peer-reviewed research journal publishing papers that make an original contribution to the understanding of social dimensions of HIV/AIDS in African contexts. AJAR includes articles from, amongst others, the disciplines of sociology, demography, epidemiology, social geography, economics, psychology, anthropology, philosophy, health communication, media, cultural studies, public health, education, nursing science and social work. Papers relating to impact, care, prevention and social planning, as well as articles covering social theory and the history and politics of HIV/AIDS, will be considered for publication.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信