2013-2015年广东省127例预防HIV母婴传播综合干预效果
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摘要
目的了解广东省以人群为基础的预防艾滋病母婴传播综合干预的效果,为进一步做好预防母婴传播工作提供依据。方法在国家预防艾滋病母婴传播信息系统中导出并整理了广东省2013-2015年127例艾滋病病毒(HIV)感染孕产妇的监测随访资料。采用SPSS 18.0统计软件进行描述性分析。结果2013-2015年127例HIV感染孕产妇,分娩婴儿135人(包含6例双胎,1例3胎),其中感染HIV婴儿6例,母婴传播率4.44%。孕期接受HIV检测的占69.29%(88/127);使用抗病毒药物治疗的孕产妇占74.80%(95/127),其中孕期(36周前)服用药物的占91.58%(87/95),产时和产后服药的占8.42%(8/95),两者的母婴传播率分别为2.11%、12.50%,差异有统计学意义(χ~2=4.502,P<0.05)。HIV感染孕产妇所生婴儿使用抗病毒药物的占85.93%(116/135),未服药的占14.07%(19/135),两者的母婴传播率分别为2.59%、15.79%,差异有统计学意义(χ~2=5.178,P<0.05);采用人工喂养方式的婴儿占92.59%(125/135),未采用人工喂养的占7.41%(10/135),两者的母婴传播率分别为3.20%、20.00%,差异有统计学意义(χ~2=4.634,P<0.05)。结论通过孕期尽早检测HIV,尽早对HIV感染孕产妇及所娩婴儿规范使用抗病毒药物,加强对孕产妇及所娩婴儿的监测随访指导,提倡人工喂养等综合干预措施,能有效降低HIV母婴传播。
Objective To evaluate the effect of integrated intervention for the prevention of mother to child transmission of HIV/AIDS in Guangdong.Methods Retrospective analysis was conducted based on the data of the HIV infected pregnant women and their infants from the national information management system of IPMTCT program during 2013-2015.Results 127 HIV infected pregnant women gave birth to 135 children,including 6 cases of HIV infected infants,with the maternal transmission rate of 4.44% (6/135).69.20% (88/127)received HIV testing during pregnancy.74.80% (95/127)used antiviral drugs during pregnancy(before the 36 th week).The women who used drugs had lower rate of mother to child transmission than those who didn't use(2.11% ,12.5% )(χ~2=4.502,P<0.05).85.93% (116/135)of the infants took antiviral drugs with the maternal transmission rate lower than that of those who didn't take(2.59% ,15.79% )(χ~2=5.178,P<0.05).Artificial feeding accounted for92.59% (125/135),with lower rate of mother to child transmission than the breast feeding(3.2% ,20% )(χ~2=4.634,P <0.05).Conclusion Through early detection of HIV during pregnancy,use of antiviral drugs can be initiated as soon as possible for HIV-infected pregnant women and the newborn.We should strengthen monitoring and guidance for pregnant women to promote artificial feeding,so as to effectively reduce mother-to-child transmission of HIV.
Objective To evaluate the effect of integrated intervention for the prevention of mother to child transmission of HIV/AIDS in Guangdong.Methods Retrospective analysis was conducted based on the data of the HIV infected pregnant women and their infants from the national information management system of IPMTCT program during 2013-2015.Results 127 HIV infected pregnant women gave birth to 135 children,including 6 cases of HIV infected infants,with the maternal transmission rate of 4.44% (6/135).69.20% (88/127)received HIV testing during pregnancy.74.80% (95/127)used antiviral drugs during pregnancy(before the 36 th week).The women who used drugs had lower rate of mother to child transmission than those who didn't use(2.11% ,12.5% )(χ~2=4.502,P<0.05).85.93% (116/135)of the infants took antiviral drugs with the maternal transmission rate lower than that of those who didn't take(2.59% ,15.79% )(χ~2=5.178,P<0.05).Artificial feeding accounted for92.59% (125/135),with lower rate of mother to child transmission than the breast feeding(3.2% ,20% )(χ~2=4.634,P <0.05).Conclusion Through early detection of HIV during pregnancy,use of antiviral drugs can be initiated as soon as possible for HIV-infected pregnant women and the newborn.We should strengthen monitoring and guidance for pregnant women to promote artificial feeding,so as to effectively reduce mother-to-child transmission of HIV.
引文
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[14]中华人民共和国卫生和计划生育委员会.预防艾滋病梅毒和乙肝母婴传播工作实施方案[Z].2015.
[15]乔亚萍,张燕,袁成,等.孕产妇首次接受HIV检测的时期及影响因素[J].中国艾滋病性病,2013,19(12):895-861.
[16]王临虹,方利文,王前,等.我国艾滋病母婴传播水平传播时期及干预效果研究[J].中国艾滋病性病,2008,14(5):435-438.
[17]王前,方利文,王临虹,等.感染HIV孕产妇及其所生婴幼儿应用抗反转录病毒药物的时间分布及变化趋势[J].中国艾滋病性病,2013,19(6):393-395.
[18]王临虹,方利文,龚双燕,等.感染HIV的妊娠妇女PMTCT服务需求障碍分析[J].中国艾滋病性病,2006,12(1):12-15.
[19]宋丽萍,耿文奎,蓝文展,等.预防HIV母婴传播干预措施利用的影响因素分析[J].中国妇幼保健,2012,27(12):1773-1777.
[20]梁科,桂希恩,张元珍,等,孕前或孕期感染人类缺陷病毒后的母婴传播[J].中华围产医学杂志,2012,15(1):10-15.
[21]李涛.四川省凉山州布拖县HIV抗体阳性孕产妇母婴阻断措施落实情况分析[J].现代预防医学,2012,39(11):2720-2721.
[22]毛雪梅,王清,杨红俊.促进艾滋病母婴阻断成功的综合干预措施及效果研究[J].现代预防医学,2012,39(18):4716-4718.
[23]乔亚萍,王爱玲,王临虹,等.艾滋病高发地区预防母婴传播项目实施效果分析[J].中国艾滋病性病,2014,20(5):343-345.
[24]吴冰.HIV阳性产妇分娩期及新生儿护理的研究进展[J].全科护理,2012,10(28):2659-2661.
[2]Granato SA,Gloyd S,Robinson J,et al.Results from a rapid national assessment of services for the prevention of mother-to-child transmission of HIV in Cote d Ivoire[J].J Int AIDS Soc,2016,19(5Suppl 4):20838-20842.
[3]Awiti PO,Grotta A,Kop M,et al.The effect of an interactive weekly mobile phone messaging on retention in prevention of mother to child transmission(PMTCT)of HIV program:study protocol for a randomized controlled trial(WELTEL PMTCT)[J].BMC Med Inform Decis Mak,2016,16(1):86-92.
[4]张璐,王临虹,方利文.分娩方式与艾滋病母婴传播[J].中国艾滋病性病,2012,18(4):265-268.
[5]World Health Organization.Use of antiretroviral drugs for treating pregnant women and preventing HIV infection in infants(Programmatic update)[R].Genvva,Switzerland:World Health Organization,2012.
[6]UNAIDS.Global plan towards the elimination of new HIV infections among children by 2015and keeping their mothers alive,2011-2015[R].Geneva,Switzerland:World Health Organization,2011.
[7]Ruton H,Mugwaneza P,Shema N,et al.HIV-free survival among nine-to 24-month-old children born to HIV-positive mothers in the Rwandan national PMTCT programme:a community based household survey[J].J Int AIDS Soc,2012,15:4.
[8]莫云,黄越华,李映.2007-2011年广西艾滋病及艾滋病病毒感染孕产妇死亡状况调查分析[J].中国临床新医学,2012,5(10):909-912.
[9]牟鸿江,杨梅,王伟人,等.贵州省孕产妇HIV,梅毒感染状况调查[J].中国妇幼保健,2013,28(3):506-508.
[10]方凤梅,徐志春.淳安县16 996例孕产妇HIV检测情况分析[J].中国农村卫生事业管理,2011,31(2):184-185.
[11]陈金英,胡颖敏.4 911例孕产妇AIDS、梅毒监测结果分析[J].中国妇幼保健,2011,26(1):30-31.
[12]方利文,王临虹,王前,等.四省572例HIV感染孕产妇流行病学特征及感染途径分析[J].中国妇幼保健,2008,23(11):1525-1528.
[13]黄桑,肖桐明,周涛.中山市HIV感染孕产妇流行病学特征分析[J].现代医院,2013,13(5):145-147.
[14]中华人民共和国卫生和计划生育委员会.预防艾滋病梅毒和乙肝母婴传播工作实施方案[Z].2015.
[15]乔亚萍,张燕,袁成,等.孕产妇首次接受HIV检测的时期及影响因素[J].中国艾滋病性病,2013,19(12):895-861.
[16]王临虹,方利文,王前,等.我国艾滋病母婴传播水平传播时期及干预效果研究[J].中国艾滋病性病,2008,14(5):435-438.
[17]王前,方利文,王临虹,等.感染HIV孕产妇及其所生婴幼儿应用抗反转录病毒药物的时间分布及变化趋势[J].中国艾滋病性病,2013,19(6):393-395.
[18]王临虹,方利文,龚双燕,等.感染HIV的妊娠妇女PMTCT服务需求障碍分析[J].中国艾滋病性病,2006,12(1):12-15.
[19]宋丽萍,耿文奎,蓝文展,等.预防HIV母婴传播干预措施利用的影响因素分析[J].中国妇幼保健,2012,27(12):1773-1777.
[20]梁科,桂希恩,张元珍,等,孕前或孕期感染人类缺陷病毒后的母婴传播[J].中华围产医学杂志,2012,15(1):10-15.
[21]李涛.四川省凉山州布拖县HIV抗体阳性孕产妇母婴阻断措施落实情况分析[J].现代预防医学,2012,39(11):2720-2721.
[22]毛雪梅,王清,杨红俊.促进艾滋病母婴阻断成功的综合干预措施及效果研究[J].现代预防医学,2012,39(18):4716-4718.
[23]乔亚萍,王爱玲,王临虹,等.艾滋病高发地区预防母婴传播项目实施效果分析[J].中国艾滋病性病,2014,20(5):343-345.
[24]吴冰.HIV阳性产妇分娩期及新生儿护理的研究进展[J].全科护理,2012,10(28):2659-2661.