Antiretroviral therapy in antenatal care to increase treatment initiation in HIV-infected pregnant women: a stepped-wedge evaluation.
作者： William P Killam , Bushimbwa C Tambatamba , Namwinga Chintu , Dwight Rouse , Elizabeth Stringer
DOI: 10.1097/QAD.0B013E32833298BE
关键词: Acquired immunodeficiency syndrome (AIDS) 、 Referral 、 Prenatal care 、 Surgery 、 Population 、 Obstetrics 、 Cohort 、 Pregnancy 、 Odds ratio 、 Medicine 、 Health care
摘要: BACKGROUND: The objective of the study was to evaluate whether providing antiretroviral therapy (ART) integrated in antenatal care (ANC) clinics resulted a greater proportion treatment-eligible women initiating ART during pregnancy compared with existing approach referral ART. ANALYSIS DESIGN AND METHODS: evaluation used stepped-wedge design and included all HIV-infected ART-eligible pregnant eight public sector Lusaka district Zambia. Main outcome indicators were enrolling into HIV within 60 days diagnosis these pregnancy. Adjusted odds ratios (AORs) confidence intervals (CIs) for enrollment initiation proportions estimated through logistic regression model accounting clinical site cluster time effects. RESULTS: Between 16 July 2007 31 2008 13917 started more than before intervention rollout constituted control cohort; 17 619 after ANC cohort. Of 1566 patients found eligible enrolled while cohort (376/846 44.4%) (181/716 25.3%) AOR 2.06 95% CI (1.27-3.34); initiated (278/846 32.9%) (103/716 14.4%) 2.01 (1.37-2.95). CONCLUSION: An strategy doubled pregnant.
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