凉山州乡级艾滋病综合管理模式的效果和存在的问题

Study on the effectiveness and existing problems in AIDS integrated management mode at township level in Liangshan

目的探索分析凉山州乡级艾滋病(AIDS)防治综合管理的效果和存在问题,为推进AIDS防治提供科学依据。方法通过核实凉山州J乡报告的HIV/AIDS病人信息,分析依托现有的县-乡-村医疗卫生保健体系,科学地开展病例管理、实验室检测和医疗救治的效果和存在的问题。结果至2011年底,凉山州J乡AIDS病人接受高效抗反转录病毒治疗(HAART)比例为10.5%(60/571),随访干预比例提高到69.5%(397/571),CD4T淋巴细胞检测率提高到47.3%(270/571)。病例建档率81.1%(361/445),96.4%(81/84)的随访依托于村干部的联系。结论乡级AIDS综合管理模式能够促进病例信息的准确性,提高病例治疗率及管理率。村干部是实行乡级综合防治管理的关键联络人,乡村医生是主要执行者。建议在HIV/AIDS病人聚集地区推广乡级综合管理防治模式。

Objective To analyze the effectiveness of integrated management mode in human immunodeficiency virus（HIV）/acquired immunodeficiency syndrome（AIDS）prevention and control at the township level and the existing problems in Liangshan Prefecture,and to provide scientific evidence for promoting HIV/AIDS prevention and control.Methods Through examining the information on HIV/AIDS patients from Town J,the effectiveness and problems existing in scientific case management,laboratory testing and medical treatment based on the current county-township-village medical and health care system were analyzed.Results By the end of 2011,the rate of receiving highly active antiretroviral therapy（HAART） among AIDS patients from Town J was 10.5%（60/571）,the rate of follow-up intervention was 69.5%（397/571）,the rate of CD4 T detection was 47.3%（270/571）;cases management rate was 81.1%（361/445）,and 96.4%（81/84）of the follow-ups were implemented by village leaders.Conclusion The township level management mode can promote the accuracy of patients information,improve the rates of medical treatment and case management.Village leaders are the key coordinators and the village doctors are the main implementers.It is suggested that the township level management mode should be promoted in the areas where HIV/AIDS patients are concentrated.