Daya daga cikin alamun farko wanda mai haƙuri ba zai iya cimma nasarar maganin cutar antiretroviral (ART) shi ne lokacin da aka gano mutumin da ake kira "likita hopper" - wanda kawai ya ziyarta, wanda ya ziyarci asibitin da yawa ko likitoci a kan hanya shekaru, watanni, ko ma makonni.
Akwai wasu dalilai na dalilai da ya sa mai haƙuri ya zaɓi yayi haka.
A wani lokaci, mai yiwuwa mai haƙuri ba ya son likita ko asibitin, ko yana buƙatar magani ga yanayin da ke hade, irin su ciwon haifa C (HCV) , cin zarafi, ko kiwon lafiya.
Amma, sau da yawa fiye da haka, kawai shine mai haƙuri ba ya yarda ya yarda ko fuskantar wasu batutuwa da suka danganci ganewar asali , gudanarwa, ko magance cutar HIV . Misalan sun haɗa da:
- Karyatawa, ko kuma tsoron tsoratarwa da lalata .
- Marasa lafiya waɗanda suka sami rashin lafiya ta hanyar maganin rashin lafiya ta hanyar maganin magungunan ƙwayar cuta kuma suna so su koma wani likita fiye da yarda (ko adawa) asalin wadanda basu yarda da su ba.
- Marasa lafiya waɗanda basu yarda su yarda ko basu iya jimre wa ganewar asali ba, wanda ya yi tsalle daga likita zuwa likita yana fata don sakamako daban.
- Rashin gazawar karɓar bukatun miyagun ƙwayoyi na yau da kullum ko halayen jima'i .
Yanayi da labaran likitocin Doctor Hoppers
Nazarin shekarar 2013 daga Makarantar Medicine na Perelman a Jami'ar Pennsylvania yayi nazari da yaduwar cutar likita a kan shekaru biyu daga 2008 zuwa 2010.
A cikin binciken su, masu binciken sun binciki ɗakunan asibitin, tarihin ART, da kuma kwayar cutar HIV a cikin marasa lafiya 13,000 a cikin gidajen asibitoci na Ryan Ryan da aka samu a asusun ajiyar kuɗi . Daga cikin wannan yawan, kusan 1,000 aka gano cewa sun ziyarci ɗakunan shan magani.
Binciken ba wai kawai ya tabbatar da cewa wadannan marasa lafiya marasa kwakwalwa ba su iya samun maganin maganin cututtuka fiye da takwarorinsu guda ɗaya (68% zuwa kashi 78%), kuma sun kasance da wuya su dauki ART idan an buƙata (69% zuwa 83%) .
Bugu da ƙari kuma, yayin da mafi yawan likita suka fara faruwa a farkon shekara ta kulawa, 20% ya ci gaba a duk tsawon lokacin.
Kwararrun likitoci a cikin wannan binciken sun fi mayar da hankali akan kasancewa ƙarami, Afrika ta Amirka, mata, ba tare da wata inshora ko a kan asibiti na kiwon lafiya ba.
Harkokin Doctor Kira
Sakamakon likitancin likita yana iya zama da muhimmanci tun lokacin da yawancin wadannan marasa lafiya sun kasa bayyana tarihin baya tare da sababbin likita. Wannan zai iya haifar da kurakuran da aka tsara da ƙwayoyin magungunan miyagun ƙwayoyi, ba tare da sanarwa ba, ba tare da wani ɓangare na cutar HIV ba .
Bugu da ƙari, ingancin, mita, da kuma daidaito na haɗin kai-mai haɗin gwiwa-inda aka kula da mai haƙuri a kulawa a asibiti ko tare da likita - an san su don inganta sakamakon asibiti. Binciken daga Makarantar Ma'aikatar Medicine ta Vanderbilt ta nuna cewa rashin kulawa a cikin farkon shekara ta jiyya na iya zama fiye da sau biyu na hadarin mutuwar marasa lafiya da kwayar cutar HIV, tare da 2.3 mutuwar shekaru 100-shekaru masu haƙuri da kawai mutuwar mutum daya kawai a cikin 100- shekara-shekara ga wadanda ke da kulawa da kulawa guda-daya.
Daga hanyar kula da lafiyar jama'a, likitan likita zai iya zama cikakke, ya haifar da kwafin aikin yin amfani da shi kuma bacewar albarkatun da ke inganta yawan kulawar lafiyar lafiyar jama'a.
Gano maɓallin tushen wannan zai zama babban mataki na gaba idan jami'an kiwon lafiyar Amurka suna fatan samun ci gaba da ragewa a cikin kwayar cutar HIV tare da sharuɗɗan gwaji da kulawa .
Wadannan shawarwarin yanzu sun hada da:
- Sauko da ciwon haƙuri ta hanyar ƙarfafa gwaji, haɗin kai don kulawa, da kuma kula da kwayar cutar HIV a cikin wani ɗakunan da aka tanadar, wata hanyar da ake kira "TLC-Plus."
- Bayar da bayanan likita na lantarki tsakanin hukumomin kiwon lafiya izini don gane da marasa lafiya wanda likita ko likita suke yiwa ko kuma suna da tarihin kulawa da lafiya.
- Samar da mafi girma ga kulawa da cutar HIV, musamman ga al'ummomin da aka rage. Ƙarin damar yin amfani da asibiti na Medicaid da kamfanoni na asibiti a karkashin Dokar Kulawa da Kwarewa na iya taimakawa wajen kawar da lafiyar lafiyar jama'a a cikin al'ummomin da aka shafi.
Sources:
Yehia, B .; Schranz, A; Momplaisir, F .; et al. AIDS da kuma hali. "Sakamakon wadanda ke fama da kwayar cutar HIV dauke da kulawa a magunguna masu yawa." Satumba 28, 2013; An wallafa a gaba kafin bugawa; PMID: 2407731.
Gardner, E; McLees, M .; Steiner, J. et al. "Abinda ke da dangantaka tsakanin cutar HIV da kulawa da shi ga Tsarin Gwaje-gwaje da Gudanarwa don Rigakafin Rigakafin HIV." Cututtuka na cututtuka na asibiti. Maris 2011; 52 (6): 793-800.
Herwehe, J. Wilbright, W .; Abrams, A .; et al. "Yin aiwatar da wani sabon rikodin kayan aikin lantarki (EMR) da kuma bayanin musayar ilimin kiwon lafiya na HIV / AIDS." Jaridar Ƙungiyar Bayar da Harkokin Kasuwancin Amirka. Mayu Yuni 2012; 19 (3): 448-452.
Mugavero, M .; Lin, H .; Willig, J. et al. "Mataimakin da bacewa bace da aka samu a cikin marasa lafiya wadanda suka fara maganin cutar HIV." Cututtuka na cututtuka na asibiti . Janairu 15, 2009; 48 (2): 248-256.