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目的评估2006-2014年间玉溪市扩大HIV检测的效果,为艾滋病策略的调整提供科学参考。方法从单例HIV/AIDS病例发现成本、病例早发现情况、BED新近感染比例结果以及1年内死亡情况4个方面进行综合性评估。结果2006-2014年间每发现1例新报告HIV阳性病例的检测成本分别4 596元,5 224元,6 150元,5 958元,10 374元,11 074元,13 942元,12 254元,17 911元,成本不断上升;历年早发现病例占比分别为21.55%,32.35%,31.31%,27.56%,20.15%,19.59%,20.47%,20.51%20.35%,呈现下降趋势(χ~2=12.384,P<0.001);历年新近感染比例分别为23.29%,28.99%,17.26%,11.66%,12.88%,10.87%,呈逐年下降趋势(χ~2=14.581,P<0.001);1年内死亡率分别为6.90%,7.08%,6.23%,5.88%,3.69%,4.47%,6.15%,3.36%,3.16%,呈逐年下降趋势(χ~2=10.667,P<0.001)。结论虽然玉溪市HIV检测量不断加大,且每发现1例新报告HIV阳性患者的检测成本越来越高;检测体系仍然不够敏感,不能较早地发现阳性患者;及时、高效地抗病毒治疗(HAART)有效地避免了患者的死亡,延长了其生存时间。
Objective To assess the effect of expanding HIV testing between 2006 and 2014 in Yuxi city and provide scientific reference for the adjustment of AIDS strategy. Methods A comprehensive evaluation was made on the cost of single case HIV / AIDS cases, the early detection of cases, the rate of newly infected BEDs and the death within one year. Results The detection cost of one newly reported case of HIV-positive cases in 2006-2014 was 4 596 yuan, 5 224 yuan, 6 150 yuan, 5 958 yuan, 10 374 yuan, 11 074 yuan, 13 942 yuan, 12 254 yuan, 17 911 yuan, the cost is rising; the proportion of early detection cases over the years were 21.55%, 32.35%, 31.31%, 27.56%, 20.15%, 19.59%, 20.47%, 20.51% and 20.35% respectively, showing a downward trend (χ ~ 2 = 12.384, P <0.001). The rates of recent infections in recent years were 23.29%, 28.99%, 17.26%, 11.66%, 12.88% and 10.87% respectively, showing a declining trend year by year (χ ~ 2 = 14.581, P <0.001) The rates were 6.90%, 7.08%, 6.23%, 5.88%, 3.69%, 4.47%, 6.15%, 3.36% and 3.16% respectively, showing a decreasing trend year by year (χ ~ 2 = 10.667, P <0.001). Conclusions Although the detection of HIV in Yuxi City is constantly increasing, and the detection cost of one newly reported HIV-positive patient is getting higher and higher, the detection system is still not sensitive enough to detect positive patients earlier and the timely and efficient antiviral therapy (HAART) effectively avoids the death of patients and prolongs their survival time.