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目的了解社区美沙酮维持治疗(MMT)门诊服药人员中,丙型肝炎(简称丙肝)病毒(HCV)感染者因HCV感染的就诊情况,并分析其影响因素。方法 2015年7-9月,在云南、甘肃两省4所MMT门诊招募HCV感染者进行横断面研究,调查其社会人口学特征、戒毒治疗情况、饮酒行为、丙肝知识认知及因HCV感染就诊情况等。结果共招募MMT门诊感染HCV的服药人员250例,因HCV感染就诊的117例(占46.8%),51例(20.4%)接受HCV RNA检测,45例(18.0%)接受了干扰素治疗,10例(4.0%)治愈。影响HCV感染者就诊率的多因素Logistic回归分析结果显示,大专及以上文化程度[比值比(OR)=7.8,95%可信区间(CI):1.1~54.6]、与家人/朋友共同居住(OR=9.2,95%CI:2.8~29.9)、有职业(OR=2.7,95%CI:1.0~77.0)、丙肝相关知识认知良好(OR=4.1,95%CI:1.5~11.1)、首次知晓抗-HCV阳性时被建议进一步诊治(OR=10.3,95%CI:4.7~22.7)和有丙肝相关症状体征(OR=4.4,95%CI:2.1~9.3)等,是促进HCV感染者就诊的因素。结论 MMT门诊感染HCV的服药人员中,因HCV感染就诊的比例不足半数。医务人员的建议、对丙肝的认知及良好的社会支持环境等,对HCV感染者及时寻求相关卫生服务十分重要。应进一步规范门诊工作流程,加强门诊工作人员的能力建设,使之能更好地为HCV感染者提供宣传教育、咨询及转介服务。
Objective To investigate the prevalence of HCV infection among community-based methadone maintenance treatment (MMT) outpatients and their influencing factors. Methods From July to September of 2015, four MMT clinics in Yunnan and Gansu provinces were recruited to conduct a cross-sectional study to investigate their socio-demographic characteristics, treatment of detoxification, drinking behaviors, cognition of hepatitis C and treatment for HCV infection Situation and so on. Results A total of 250 drug abusers were recruited from MMT clinics, 117 (46.8%) were HCV infected, 51 (20.4%) were tested for HCV RNA, 45 (18.0%) received interferon, and 10 Cases (4.0%) cured. Logistic regression analysis of multivariate logistic regression analysis showed that the educational level of college education and above [odds ratio (OR) = 7.8, 95% confidence interval (CI): 1.1-54.6], living with family and friends (OR = 9.2,95% CI: 2.8-29.9). There were occupations (OR = 2.7,95% CI: 1.0-77.0) and good knowledge of HCV (OR = 4.1,95% CI 1.5-11.1) Further diagnosis and treatment (OR = 10.3,95% CI: 4.7-22.7) and hepatitis C related symptoms and signs (OR = 4.4,95% CI: 2.1-9.3) are recommended for the diagnosis of anti-HCV positive the elements of. Conclusion MMT outpatient HCV infected patients, the proportion of patients treated for HCV infection less than half. Medical staff’s suggestion, cognition to hepatitis C and good social support environment, etc. It is very important to timely seek relevant health services for HCV infected persons. Outpatient work processes should be further regulated and capacity building of outpatient staff should be strengthened so that they can better provide information, education, counseling and referral services for those infected with HCV.