TAILIEUCHUNG - Báo cáo y học: " Provision of antiretroviral treatment in conflict settings: the experience of Médecins Sans Frontières"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Provision of antiretroviral treatment in conflict settings: the experience of Médecins Sans Frontières. | O Brien et al. Conflict and Health 2010 4 12 http content 4 1 12 CONFLICT AND HEALTH RESEARCH Open Access Provision of antiretroviral treatment in conflict settings the experience of Médecins Sans Frontieres Daniel P O Brien 1 2 3 Sarah Venis4 Jane Greig4 Leslie Shanks1 Tom Ellman4 Kalpana Sabapathy1 Lisa Frigati1 5 and Clair Mills1 6 Abstract Introduction Many countries ravaged by conflict have substantial morbidity and mortality attributed to HIV AIDS yet HIV treatment is uncommonly available. Universal access to HIV care cannot be achieved unless the needs of populations in conflict-affected areas are addressed. Methods From 2003 Médecins Sans Frontieres introduced HIV care including antiretroviral therapy into 24 programmes in conflict or post-conflict settings mainly in sub-Saharan Africa. HIV care and treatment activities were usually integrated within other medical activities. Project data collected in the Fuchia software system were analysed and outcomes compared with ART-LINC data. Programme reports and other relevant documents and interviews with local and headquarters staff were used to develop lessons learned. Results In the 22 programmes where ART was initiated more than 10 500 people were diagnosed with HIV and received medical care and 4555 commenced antiretroviral therapy including 348 children. Complete data were available for adults in 20 programmes n 4145 . At analysis 2645 64 remained on ART 422 10 had died 466 11 lost to follow-up 417 10 transferred to another programme and 195 5 had an unclear outcome. Median 12-month mortality and loss to follow-up were 9 and 11 respectively and median 6-month CD4 gain was 129 cells mm 3. Patient outcomes on treatment were comparable to those in stable resource-limited settings and individuals and communities obtained significant benefits from access to HIV treatment. Programme disruption through instability was uncommon with only one program experiencing interruption to services and

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