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地点:乌干达的1个近郊区和4个郊区。目的:了解结核病患者中人类免疫缺陷病毒(HIV)检测水平及相关影响因素。设计:2007年8—11月间对选取的5个地区进行了横断面调查。本研究纳入了在结核病和艾滋病医疗卫生机构接受抗结核治疗,并返回取药的、年龄≥18岁的患者,排除重症、不会讲英语或当地学习用语的患者。诊断为结核病的患者自我报告是否接受过HIV检测,用门诊记录进行确认。结果:本研究纳入261例患者。其中,169例(65%)患者在诊断为结核病之后接受了HIV检测。经多变量分析发现,患者年龄>45岁(比值比0.27,95%可信区间0.08～0.87)、患者未获得TB/HIV相关性信息(比值比0.35,95%可信区间0.15～0.77)、医疗卫生机构/医务人员未提供HIV检测(比值比0.02,95%可信区间0.006～0.042)、患者对就诊的私密空间不满意(比值比2.49,95%可信区间1.11～5.55),以及患者在门诊就诊时花费了30～60min(比值比4.48,95%可信区间1.66～12.10),这些因素明显影响了HIV检测水平。结论:按照政策,所有结核病患者均应接受HIV检测。但本研究发现结核病患者的HIV检测水平不甚令人满意。乌干达卫生部应在本研究强调的重点地区的医疗卫生机构继续扩展HIV检测工作及其他TB/HIV合作服务。
Location: 1 suburb and 4 suburbs in Uganda. Objective: To understand the detection of human immunodeficiency virus (HIV) in tuberculosis patients and related factors. Design: A cross-sectional survey of 5 selected areas from August to November 2007 was conducted. This study included patients aged 18 and older who received anti-tuberculosis and tuberculosis and HIV medical and health facilities, those who were over 18 years of age, those who were critically ill, did not speak English, or learned the language locally. Patients diagnosed with tuberculosis self-report whether they have been tested for HIV and confirmed with outpatient records. Results: This study included 261 patients. Of these, 169 (65%) received HIV testing after diagnosis of tuberculosis. Multivariate analysis found that patients were> 45 years of age (odds ratio 0.27, 95% confidence interval 0.08-0.87) and did not receive TB / HIV-related information (odds ratio 0.35, 95% confidence interval 0.15 to 0.77) HIV / AIDS testing was not provided by medical / healthcare institutions (odds ratio 0.02, 95% confidence interval 0.006 to 0.042), dissatisfaction with patient visits to private spaces (odds ratio 2.49, 95% confidence interval 1.11-5.55), and patient It took 30 to 60 minutes (odds ratio 4.48, 95% confidence interval 1.66 to 12.10) at outpatient visits, and these factors significantly affected HIV testing. Conclusion: According to the policy, all TB patients should be tested for HIV. However, this study found that the level of HIV testing in tuberculosis patients was less than satisfactory. Uganda’s Ministry of Health should continue to expand HIV testing and other TB / HIV cooperation services in health care facilities in key areas highlighted in this study.