幽门螺杆菌(Helicobacter pylori,H.pylori)感染是消化道的常见病,我国的H.pylori感染率依然处于高位水平.随着近期H.pylori与慢性胃炎关系的京都共识、H.pylori治疗策略的多伦多共识两部指南的推出,对我国H.p y l o r i的防控策略值得...幽门螺杆菌(Helicobacter pylori,H.pylori)感染是消化道的常见病,我国的H.pylori感染率依然处于高位水平.随着近期H.pylori与慢性胃炎关系的京都共识、H.pylori治疗策略的多伦多共识两部指南的推出,对我国H.p y l o r i的防控策略值得开展进一步的思考.而目前随着抗生素的广泛耐药、宿主和菌株毒力等因素的影响,H.pylori的根除成功率逐渐降低,对于无症状人群是否开展H.pylori干预、开展扩大适应证根除后是否具有良好的费用-效应比等问题需要讨论,是否在我国也施行"检测即治疗"的策略引起争论.本文就我国目前H.pylori的感染流行现状及相关治疗策略的改变作一综述,以期为今后我国H.pylori防治策略的制定提供相关思路.展开更多
<strong>Introduction: </strong>To achieve viral suppression and reduce vertical transmission of HIV, more than eighty percent of pregnant or breastfeeding women in Zambia have been started on combined ART ...<strong>Introduction: </strong>To achieve viral suppression and reduce vertical transmission of HIV, more than eighty percent of pregnant or breastfeeding women in Zambia have been started on combined ART using the Test and Treat model. However, Chawama First Level Hospital in Lusaka had records which showed that 32 percent of pregnant or breastfeeding women were non-adherent to combined anti-retroviral therapy (cART). <strong>Method:</strong> A mixed-method study was conducted to establish predictors of non-adherence to cART by women in the Test and Treat model of care. For the quantitative component, 92 consenting Pregnant and breastfeeding women were randomly drawn from ART defaulter register and a semi-structured questionnaire was administered. Multiple logistic regression was conducted to improve predictive power and control for confounders. <strong>Quantitative Results: </strong>The mean age was 28years. The study established that housewives were 84 percent less likely to be non-adherent [AOR 0.16;95% CI 0.12, 0.36] compared to women who were formally employed with a statistically significant P-value of 0.04. Pregnant or breastfeeding women who were several months away from home were 84.9 percent more likely to be non-adherent [AOR 15.11;95% CI 13.9, 16.4] compared to women who had travelled away from home for several days. The associated P-value was 0.03. The study also established that pregnant and breastfeeding women who were counselled in individually enclosed units were 91 percent less likely to be non-adherent compared to those who were counselled in an open space as a group [AOR 0.09;95% CI 0.02, 0.53] with an associated P-value of 0.01. <strong>Conclusion:</strong> The study established that predictors of non-adherence to cART among pregnant and breastfeeding women were: being a working-class client;being away from home or usual clinic for several months;being counselled in open spaces, and negative staff attitude. Therefore, researcher can conclusively say that predictors of non-adherence to cART c展开更多
Introduction: The main outcome of efficiently implemented universal test and treat (UTT) program is improved survival. UTT implementation has been ongoing in Cameroon since 2016 but evaluation data are scarce. This st...Introduction: The main outcome of efficiently implemented universal test and treat (UTT) program is improved survival. UTT implementation has been ongoing in Cameroon since 2016 but evaluation data are scarce. This study aims to assess the survival of antiretroviral therapy (ART) patients initiated under UTT in Northwest region of Cameroon. Methods: This retrospective cohort study included HIV-positive patients initiated in 2016 at 27 purposefully selected sites and followed until 2021. Data was anonymously abstracted from ART registers and patients’ charts. Kaplan-Meier survival estimates and Cox model were used to compare the survival of patients initiated under UTT with those initiated otherwise, using stata version 14.0. Results: In total, 2490 HIV-positive patients (median age 42.7 years, 94.7% adults, and 69.0% female) participated in the study. Of 1389 patients with viral load (VL) test results, 55% were initiated on ART late. The VL suppression rate of patients initiated late and those initiated early were similar. During follow-up, 1020 (40.9%) participants censored. The survival curves of patients initiated early on ART and those initiated late were similar during the first 2.5 years of follow-up but significantly (p Conclusions: This study confirms the expected impact of UTT. Programs only need to close existing implementation gaps along the critical pathways (diagnosis and treatment) of UTT, focusing more on males.展开更多
文摘幽门螺杆菌(Helicobacter pylori,H.pylori)感染是消化道的常见病,我国的H.pylori感染率依然处于高位水平.随着近期H.pylori与慢性胃炎关系的京都共识、H.pylori治疗策略的多伦多共识两部指南的推出,对我国H.p y l o r i的防控策略值得开展进一步的思考.而目前随着抗生素的广泛耐药、宿主和菌株毒力等因素的影响,H.pylori的根除成功率逐渐降低,对于无症状人群是否开展H.pylori干预、开展扩大适应证根除后是否具有良好的费用-效应比等问题需要讨论,是否在我国也施行"检测即治疗"的策略引起争论.本文就我国目前H.pylori的感染流行现状及相关治疗策略的改变作一综述,以期为今后我国H.pylori防治策略的制定提供相关思路.
文摘<strong>Introduction: </strong>To achieve viral suppression and reduce vertical transmission of HIV, more than eighty percent of pregnant or breastfeeding women in Zambia have been started on combined ART using the Test and Treat model. However, Chawama First Level Hospital in Lusaka had records which showed that 32 percent of pregnant or breastfeeding women were non-adherent to combined anti-retroviral therapy (cART). <strong>Method:</strong> A mixed-method study was conducted to establish predictors of non-adherence to cART by women in the Test and Treat model of care. For the quantitative component, 92 consenting Pregnant and breastfeeding women were randomly drawn from ART defaulter register and a semi-structured questionnaire was administered. Multiple logistic regression was conducted to improve predictive power and control for confounders. <strong>Quantitative Results: </strong>The mean age was 28years. The study established that housewives were 84 percent less likely to be non-adherent [AOR 0.16;95% CI 0.12, 0.36] compared to women who were formally employed with a statistically significant P-value of 0.04. Pregnant or breastfeeding women who were several months away from home were 84.9 percent more likely to be non-adherent [AOR 15.11;95% CI 13.9, 16.4] compared to women who had travelled away from home for several days. The associated P-value was 0.03. The study also established that pregnant and breastfeeding women who were counselled in individually enclosed units were 91 percent less likely to be non-adherent compared to those who were counselled in an open space as a group [AOR 0.09;95% CI 0.02, 0.53] with an associated P-value of 0.01. <strong>Conclusion:</strong> The study established that predictors of non-adherence to cART among pregnant and breastfeeding women were: being a working-class client;being away from home or usual clinic for several months;being counselled in open spaces, and negative staff attitude. Therefore, researcher can conclusively say that predictors of non-adherence to cART c
文摘Introduction: The main outcome of efficiently implemented universal test and treat (UTT) program is improved survival. UTT implementation has been ongoing in Cameroon since 2016 but evaluation data are scarce. This study aims to assess the survival of antiretroviral therapy (ART) patients initiated under UTT in Northwest region of Cameroon. Methods: This retrospective cohort study included HIV-positive patients initiated in 2016 at 27 purposefully selected sites and followed until 2021. Data was anonymously abstracted from ART registers and patients’ charts. Kaplan-Meier survival estimates and Cox model were used to compare the survival of patients initiated under UTT with those initiated otherwise, using stata version 14.0. Results: In total, 2490 HIV-positive patients (median age 42.7 years, 94.7% adults, and 69.0% female) participated in the study. Of 1389 patients with viral load (VL) test results, 55% were initiated on ART late. The VL suppression rate of patients initiated late and those initiated early were similar. During follow-up, 1020 (40.9%) participants censored. The survival curves of patients initiated early on ART and those initiated late were similar during the first 2.5 years of follow-up but significantly (p Conclusions: This study confirms the expected impact of UTT. Programs only need to close existing implementation gaps along the critical pathways (diagnosis and treatment) of UTT, focusing more on males.
