尼日利亚西北部一家三级医院 HIV 暴露个体中接触后预防（PEP）的使用评估。

Assessment of Utilization of Post Exposure Prophylaxis (PEP) among HIV-Exposed Individuals in a Tertiary Hospital, Northwest Nigeria.

机构信息

Department of Internal Medicine, Faculty of Clinical Sciences, College of Medicine, Kaduna state university, Kaduna, Nigeria.

Department of Medicine, Barau Dikko Teaching Hospital, Kaduna, Nigeria.

出版信息

West Afr J Med. 2021 Oct 29;Vol. 38(10):999-1003.

PMID:34856776

Abstract

BACKGROUND

Human Immunodeficiency Virus (HIV) post-exposure prophylaxis (PEP) has been documented to be effective in preventing HIV in exposed individuals. World Health Organization (WHO) recommends that every individual exposed should be treated within 72hours. We aimed to assess the utilization of PEP among clients in a tertiary facility in Northwest, Nigeria.

METHODS

A retrospective study was conducted in Barau Dikko Teaching Hospital (BDTH), a tertiary hospital in Kaduna, Nigeria involving all clients who assessed HIV PEP between January 2016 - December 2019. Data collection sheet was used to document the sociodemographic parameters of clients, sources/circumstances of infection, client HIV status, source HIV status and the interval between exposure and commencement of PEP. Analysis of data was done using IBM SPSS version 23.

RESULTS

Analysis of 136 complete records was done, mean age was 31.97± 10.24 years, 77 (56.6%) were females, 102 (75%) were due to occupational exposures involving mostly nurses and medical and nursing students while 26 (76.5%) of non-occupational exposures were attributed to rape. The PEP service was assessed by 119 (87.5%) under 72hours but 120 (88.2%) never returned for follow-up. Source of exposure and HIV status of source were significantly associated with the time of assessing PEP. Statistical significance is determined by a p value of < 0.05.

CONCLUSION

A major proportion of those that assessed PEP did so in less than 72 hours which is the recommended time by WHO but follow-up and rescreening was poor. There is need for active follow-up of clients that assess the service and increased public health enlightenment on availability and effect of PEP when assessed at the appropriate time.

摘要

背景

人体免疫缺陷病毒（HIV）暴露后预防（PEP）已被证明可有效预防暴露个体感染 HIV。世界卫生组织（WHO）建议，应在 72 小时内对所有暴露者进行治疗。我们旨在评估尼日利亚西北部一家三级医疗机构中接受 PEP 的患者的利用情况。

方法

本研究是在尼日利亚卡杜纳的巴劳·迪克托教学医院（BDTH）进行的一项回顾性研究，涉及所有在 2016 年 1 月至 2019 年 12 月期间评估 HIV PEP 的患者。使用数据收集表记录患者的社会人口统计学参数、感染源/情况、患者 HIV 状态、源 HIV 状态和暴露与开始 PEP 之间的时间间隔。使用 IBM SPSS 版本 23 对数据进行分析。

结果

分析了 136 份完整记录，平均年龄为 31.97±10.24 岁，77 名（56.6%）为女性，102 名（75%）是因职业暴露而就诊，主要涉及护士以及医学生和护生，而 26 名（76.5%）非职业暴露归因于强奸。119 名（87.5%）患者在 72 小时内评估了 PEP 服务，但只有 120 名（88.2%）患者从未回来进行随访。暴露源和源 HIV 状态与评估 PEP 的时间显著相关。统计显著性由 p 值<0.05 确定。