Kuma me yasa yakamata ya zama damuwa ga dukkanmu
Kwayar cutar HIV ta Cascade ita ce samfurin da ake amfani da shi na tarayya, jihohi da kuma hukumomin gida don gane da rashin tsaro a kan mutanen da ke zaune tare da kwayar cutar HIV. Har ila yau, da aka sani da Cibiyar Kula da HIV / AIDs , wannan samfurin ya ba da misali mai mahimmanci game da yawancin jama'ar Amurka waɗanda suke shiga kowane mataki na kula da kwayar cutar HIV a cikin umarni masu sauka daga:
- Abinda aka kiyasta yawan mutanen da ke dauke da HIV;
- Yanayin da aka gano ;
- Yanayin da aka danganta da kulawa;
- Yanayin da aka kiyaye a kulawa;
- Yanayin da ake buƙatar tsarin farfadowa;
- A rabo cewa zahiri sami far, kuma;
- Sakamakon da ya dace don kula da kayan aikin hoto mai ban tsoro (la'akari da ma'auni na nasara).
Misali Edward Gardner da abokan aikinsa a farkon watan Maris na farko ne Dr. Edward Gardner da abokan aikinsa suka bayyana. An gano cewa bincike yana da cewa akwai matsala mai yawa a tsakanin kowane mataki na ci gaba har zuwa inda ya kirkiro dala mai ma'ana idan aka sanya shi mahallin hoto ( duba hoto ).
A mafi yawan abin da ya faru, abin da cutar ta HIV ke nunawa ita ce, kusan kimanin miliyan 1.2 na Amirkawa da aka kiyasta cewa suna da kwayar cutar HIV, kawai kimanin kashi 25 cikin 100 sun sami damar gudanar da ci gaba da maganin cutar ta HIV.
Mafi mawuyacin haka, daga cikin 66% waɗanda aka haɗu da farko a kulawa, kusan rabin su (kimanin mutane 219,000) ko dai sun rasa su bi ko iya samun damar kulawa da HIV.
Duk da yake akwai ci gaba a bincikar lafiya da haɗin gwiwa don kulawa daga 2010 zuwa 2012 (kara 2% da 4%, bi da bi), asarar tsakanin 3% da 4% aka lura a duk sauran nau'ukan.
Abin da Kwayar cutar ta HIV ta faɗa mana
Wadannan sharuɗɗa suna nuna ƙalubalen da suke fuskanta a gaba ga masu tsara manufofi kamar yadda jagororin Amurka na yau da kullum ke kiran ba kawai gwajin kwayar HIV na dukan shekarun Larabawa shekaru 15-65 ba, amma yana kira don farawa da cutar HIV a lokacin ganewar asali ba tare da la'akari da yawan CD4 ba.
Ƙarshe, manufar waɗannan manufofi shine don magance yawan mutane da dama don su kawo abin da ake kira "ƙwayar hoto mai kama da al'umma" (CVL) a cikin yawan mutane masu yawan gaske. Ta hanyar yin haka, yaduwar cutar HIV zai iya karuwa sosai yayin da yawancin mutane suka sauke.
Duk da haka, yana da ƙalubalantar tambayar ko waɗannan manufofin za su iya samun nasara ta hanyar raguwa da yawa a cikin kulawa, musamman a tsakanin 'yan Afirka na Afirka wadanda basu da alaka da kulawa (62%) da kuma ƙasa da iyakar yiwuwar maganin cututtuka (21% ).
Ƙananan Ƙasar Amirka (shekaru 25-34) har zuwa mafi muni, tare da kawai kashi 56% da ke da alaƙa da kulawa kuma kawai kashi 15% ne kawai ke cimma nauyin nau'i na kyamaran bidiyo.
Bugu da ƙari, wasu sunyi jayayya cewa, a matsayin kayan aiki, CVL mai nuna alama ce ga ƙwayar cuta yayin da yake rikitar da tasiri na mutane tare da ƙwayoyin magungunan hoto masu kamuwa da ƙwayoyin cuta yayin da basu kula da nauyin nauyin hoto na wadanda ba su da tabbas.
Ɗaya daga cikin irin wannan nazarin da Jami'ar Chapel Hill, Jami'ar Carolina Carolina ta yi, ya nuna cewa CVL na iya zama sau biyu a halin yanzu a lokacin da aka yi gyare-gyare na annoba.
Rufe Gaba
Domin ya rage wasu raguwa a ci gaba da kulawa, ana gudanar da bincike ga hukumomin kiwon lafiya na gari da ingantaccen kulawa. Daga cikin mahimman manufofin:
- Bayar 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.
- Yin amfani da ruwa ta hanyar jarraba, haɗawa da kulawa, da kuma kula da marasa lafiya a cikin wani kayan aiki (wani tsarin da aka fi sani da TCL-Plus). San Francisco, Los Angeles, Birmingham, da Birnin Washington, DC suna cikin cikin biranen Amirka da ake kira a kai a kai suna nuna abubuwan mafi kyau na TLC-Plus.
- Ƙarfafa ƙoƙari don gano marasa lafiya "batattu" da sake sake danganta su don kula. A shekarar 2013, Ma'aikatar Kiwon Lafiya ta Jama'ar New York City ta gano kimanin mutane 689 daga cikin wadanda suka kamu da kwayar cutar HIV da suka rasa rayukansu, sannan suka sake mayar da kashi 77 cikin 100 zuwa ga likita.
- Raba bayanan likitan lantarki tsakanin hukumomin kiwon lafiya mai izini don tabbatar da "sadarwar lantarki" ga waɗanda aka rasa su biyo baya ko kuma suna buƙatar magani. Daga tsakanin 2009 zuwa 2011, Ma'aikatar Lafiya na Louisiana ta iya ganowa da kuma sakar da marasa lafiya HIV 345 ta hanyar Lissafin Labaran Harkokin Kiwon Lafiyar Jama'a na Louisiana (LaPHIE), ainihin lokaci, tushen tsarin kiwon lafiyar lantarki.
- Bincike duk litattafai da al'adun gargajiya don inganta haɗin kai tsakanin mutane a kan maganin antiretroviral. Wannan ya hada da haɓaka hulɗar likita-haƙuri. Nazarin ya nuna cewa marasa lafiya tare da likita guda daya a kowace shekara suna da ƙwayar cuta 94% na rashin lafiya ko mutuwa fiye da wanda ke da hudu. Ƙara hulɗar likita-haƙuri kuma ya danganta ga ingantaccen adheran miyagun ƙwayoyi.
Sources:
Cohen, M .; Miller, W .; Powers, K .; da kuma Smith, M. "Kasuwancin Gano Jariyar Lafiya a matsayin Matakan Bincike na Gurasar cutar HIV kamar Rigakafin." Cututtuka na Lancet cututtuka. Mayu 2013; 13 (5): 459-464.
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.
Giordano, T. Gifford, A ;; White, A .; et al. "Dakatarwa a Kulawa: Kwayar da ke Cutar da Cutar HIV." Cututtuka na cututtuka na asibiti. Yuli 4, 2007; 44 (11): 1493-1499.
Herwehe, J. Wilbright, W .; Abrams, A .; et al. "Aikatawa na Neman Labaran Harkokin Kiwon Lafiyar Harkokin Kifi na Electronic (EMR) da Harkokin Watsa Labarun Harkokin Kiwon Lafiyar Jama'a don HIV / AIDS." Jaridar Ƙungiyar Bayar da Harkokin Kasuwancin Amirka. Mayu Yuni 2012; 19 (3): 448-452.
Binciken Na'urar. "TLC +: Ayyuka mafi kyau don aiwatar da Harkokin gwaje-gwaje na HIV, Tsarin Gida, Ƙari da Talla (TLC-Plus) a Sarakuna guda hudu." San Francisco, California; Agusta 2011.
Udeagu, C .; Webster, T .; Bocour, A .; et al. "Rushewa ko Daidai Kashewa: Gwiwar Kiwon Lafiyar Jama'a don Komawa HIV-Infected Persons Lost to Follow-up to HIV-Care." AIDS. Satumba 10, 2013; 27 (14): 2271-2279.
Cibiyoyin Kula da Cututtuka da Cututtuka na Amurka (CDC). "CDC Fact Sheet | HIV a Amurka: Sashen Kulawa." Atlanta, Jojiya; aka buga Yuli 2012.