摘要
目的了解基于互联网平台支持下的艾滋病诊疗"一站式服务"的艾滋病病毒(HIV)抗体筛查阳性者的转介情况,为完善艾滋病诊疗"一站式服务"工作模式提供依据。方法利用互联网技术和平台建设,收集珠海市2017年4月26日至2018年5月31日艾滋病筛查阳性者的转介跟踪信息,对转介成功者与转介脱失者进行比较分析。结果共检出筛查阳性者687人次,删除重复检测后实际筛查阳性者为560例,其中既往阳性病例占39.3%(220例),新发现筛查阳性病例占60.7%(340例)。在340例新发现的筛查阳性者中,转介成功279例,转介脱失61例,转介成功比例为82.1%。从HIV抗体筛查阳性到确证采样的时间间隔中位数为3(1～8)天,从筛查阳性到确证阳性的时间间隔中位数为7(4～11)天。首次接受检测者转介成功比例是有重复检测经历者的0.249倍(P<0.05)。以医院感染科就诊者为参照,皮肤性病科就诊者、外科就诊者转介成功比例分别是其0.261倍和0.156倍(P<0.05)。转介脱失的主要原因是无法联系(27.9%)、拒绝确证检测(24.6%)和自述已离开本地(21.3%)。结论开展互联网平台支持下的艾滋病诊疗"一站式服务"后,HIV筛查阳性者转介成功率达80%以上,今后要重点提高非定点治疗机构及重点科室的转介成功率,有利于病例的早发现、早诊断、早治疗。
Objective To understand the status of the screened HIV-positive patients,and the referral services of HIV/AIDS testing and treatment based on the‘one-stop service'model supported by the internet,and provide evidence for improvement of"one-stop service".Methods The referral information of the screened HIV-positive patients was collected by using the internet during April 26^th,2017 to May 31^st,2018,and the difference between successful and unsuccessful referrals was compared and analyzed.Results 687 cases were screened as HIV antibody positive,among which 39.3%(220 cases)were previously screened and 60.7%(340 cases)were newly screened.82.1%(279 newly screened HIV positive cases)were successfully referred to for confirmation and treatment.The time between HIV screening and samples collection for HIV confirmation was 4 d(IQR 1-8).The time between HIV screened positive to HIV confirmed positive were 7 d(IQR 4-11).The patients who had received the first HIV antibody screening were 0.249 times more likely to refer than those who had received screening repeatedly(P<0.05).Compared with patients in the infection department of a hospital,the referral rate of the dermatology/STDs and the surgeon departments was 0.261 times and 0.156 times,respectively.The reasons for drop out of the screened HIV-positive patients for confirmation and treatment were being unable to contact the services(27.9%),refusal for confirmation(24.6%),and moving away from Zhuhai city(21.3%).Conclusion After launch of the one-stop AIDS diagnosis and treatment services supported by the internet,the referral rate for the screened HIVpositive patients reaches over 80%.In order to promote early detection,early diagnosis and early treatment,the focus should be on improving successful referral in the non-designated medical institutions and key departments of a hospital in the future.
作者
黄珊子
谢颖倩
周毅
代文灿
姚刚
李玮
李艳
HUANG Shanzi;XIE Yingqian;ZHOU Yi;DAI Wenchan;YAO Gang;LI Wei;LI Yan(Zhuhai Center for Disease Prevention and Control,Zhuhai 519060,China;Guangdong Provincial Center for Disease Prevention and Control,Guangzhou 511430;School of Medicine,Jinan University,Guangzhou 510632)
出处
《中国艾滋病性病》
CAS
CSCD
北大核心
2019年第2期178-181,共4页
Chinese Journal of Aids & STD
作者简介
第一作者:黄珊子( 1977-),女,广西壮族自治区桂林市人,副主任医师,主要从事艾滋病防治工作。Email:sandy287@126.com.
