【摘要】 目的探讨深圳市预防艾滋病母婴传播(PMTCT)项目孕产妇晚筛查的影响因素,以实现早发现和早干预的目标。方法利用国家妇幼信息系统预防艾滋病母婴传播工作月报表数据,分析2007—2017年深圳市预防艾滋病母婴传播项目(PMTCT)产前门诊检测率、产科病房检测率、孕期检测率的变化趋势。采用横断面调查法,在全市10个区分层随机抽取2015—2017年上报的分娩时才进行艾滋病抗体检测的孕产妇。通过电话问卷以及医疗机构HIS信息系统查询孕期产前门诊就诊情况。根据查询到的就诊日期,在实验室信息检测系统查询HIV抗体检测情况。结果2007—2017年,深圳市PMTCT项目产前门诊检测率、产科病房检测率和孕期检测率明显上升,差异有统计学意义。自2013年起,产前门诊检测率均超过97.00%,产科病房检测率自2011年起基本达到100.00%。在分娩量持续上升的情况下,孕妇在孕期接受HIV抗体检测的比例持续增加,至2017年已达到98.34%。共587例仅产时进行HIV抗体检测的孕产妇纳入个案分析。其中孕期到过医疗机构产前门诊进行产前保健,但被遗漏开取检验单的占32.37%;孕期已经进行过HIV抗体检测,但分娩时由于各种原因在产科病房重复检测的比例为16.35%;孕妇本人孕期从未进行产前保健的比例为48.38%,孕妇本人拒绝检测的比例为2.90%。其中,2017年产前门诊漏检率为20.35%,较2015年的39.57%和2016年的35.53%明显降低。结论深圳市预防艾滋病母婴传播(PMTCT)项目质量在10年间明显提升,但仍需进一步采取措施杜绝产前门诊漏筛查情况和产科病房重复检测情况的发生,并对拒绝检测的孕妇采取跟踪追访措施。更多还原

【Abstract】 Objective To investigate the influencing factors of the late screening of pregnant women in the program ofprevention of mother-to-child transmission of HIV/AIDS(PMTCT) in Shenzhen City, so as to achieve the early detection andintervention. Methods Based on the monthly report data of the National Maternal and Child Information System of theprevention of mother-to-child transmission of HIV/AIDS, the HIV detection rate of prenatal clinics, detection rate of deliveryrooms, and detection rate during pregnancy among the whole delivery women in Shenzhen PMTCT program were analyzed from2007 to 2017. The pregnant women were randomly selected and stratified from 10 districts with the cross-sectionalinvestigation method, and the pregnant women were reported only receiving the HIV detection on delivery from 2015 to 2017.Telephone questionnaires and HIS system of hospitals were used to investigate the clinic visits during pregnancy. According tothe date of clinic visiting retrieved, the test of HIV antibody was checked in the laboratory information system. Results From2007 to 2017, the HIV detection rate of prenatal clinics, detection rate of delivery rooms, and detection rate during pregnancyamong the whole delivery women in Shenzhen PMTCT program were increased obviously. Since 2013, the detection rate ofprenatal clinics was exceeded of 97.00%. The detection rate of delivery rooms reached 100.00% basically since 2011. Despiteof the sustained rise of delivery, the proportion of pregnant women receiving HIV antibody detection during pregnancycontinued to increase, up to 98.34 % in 2017. Totally 587 pregnant and lying-in women receiving the HIV antibody detectionson delivery were included in the case study. Among them, 32.37% of the pregnant women missed screening in prenatal clinicsduring pregnancy, 16.35% of them had the repeated tests in the delivery rooms for various reasons, 48.38% of them never hadany antenatal examinations during pregnancy, and 2.90% of them refused the test when visiting prenatal clinics. The rate ofmissed screening in prenatal clinics was 20.35% in 2017, which was significantly lower than that in 2015(39.57%) and 2016(35.53%). Conclusions The organizational and managing capabilities of Shenzhen PMCTC program have improvedsignificantly in the past 10 years. However, further measures should be taken to prevent the occurrence of missed tests inprenatal clinics and repeated tests in delivery rooms. Some follow-ups should be emphasized for the women who refuse the test.更多还原