Naphezu kweNqanaba eliphezulu loLuntu lokuBaluleka, i-False Negatives ibeke ixhala
NgoJulayi 2012, i-US Food and Drug Administration (i-FDA) ivumelekile kwi- OraQuick In-Home Test yoVavanyo lwe-HIV , ukubonelela abathengi ngeyokuqala, ukuvavanya i-HIV ngomlomo ngokusemthethweni ukukwazi ukunika iziphumo eziyimfihlo kwiminqaku engama-20. Imvume ye-FDA yamkelwa yimibutho emininzi yasekuhlaleni, eye yathetha ixesha elide izibonelelo zokuvavanywa kwangaphakathi ngexesha apho i-20% yezigidi ezingama-1.2 zaseMerika ezineNTSHOLONGWANE-NTSHOLONGWANE KAGAWULAYO zikwazi ngokupheleleyo isimo sabo.
Oyintloko phakathi kweengxoxo zokuxhasa ukuhlolwa kwekhaya:
- Amakliniki amaninzi aseburhulumenteni ase-US ahlawulwanga okanye ahlawuliswe ngokugqithiseleyo, kubangele abo bafuna okanye bafuna ukuvavanya ukuba bahlale kude. Ukuvavanywa kwangaphakathi ekhaya kunokunceda ukunqoba le nto, ukubonelela abo basengozini enkulu yokuzimela, ukulawula nokugcina imfihlo .
- Ngokwamukelwa kwemveliso, i-FDA yathi ukuhlolwa kwangaphakathi "kuza kuncedisa ngokulinganisela ... ngokunceda abantu abaninzi abanegciwane ukuba baqaphele isimo sabo se-HIV kwaye ngoko banciphise ukuhanjiswa kwe-HIV."
- I-hotline yamahora angama-24 kunye nabasebenzi abaqeqeshwe baya kunceda ukuqinisekisa ukuba imveliso isetyenziswa ngokuchanekileyo; ukuba abasebenzisi bayayiqonda imida yokuvavanya (kubandakanywa nexesha elibizwa ngokuba yi window ), kwaye ukuba abo bafumana umphumo omuhle bathunyelwa kwiklinikhi okanye kufuphi neofisi.
Ukususela ngoSeptemba 2013, abakhiqizi be-OraQuick babika ukuba "abantu abangaphezu kwama-200,000 ngoku bayazi isimo sabo se-HIV" ngenxa yeemveliso, kunye nabahlalutyi bezoshishino baqikelela ukunyuswa kweentengiso njengoko ukwanda kokwaziswa kwabathengi.
Nangona kunjalo nangaphandle kwezibonelelo ezibonakalayo zeemvavanyo, iinjongo ezininzi ziye zagqamisa iinkxalabo malunga neqhinga lasekhaya, ukubuza imibuzo ngokuchanekileyo kwehlabathi ngokwenene yemveliso, kunye neempembelelo zayo kwiinkathalo zonyango kunye nokuziphatha komngcipheko.
Uvavanyo olunjani kwi-Home Test Test?
Ngokombiko we-FDA, uvavanyo lwe-OraQuick Rapid In-Home alukhuselekanga kwaye lusebenziseka kalula, kodwa lunikeza ubunzulu kunye neenkcukacha ezimalunga nama-95% -ngaphantsi kwama-99.3% kunye no-99.8% abonayo nge-point-of- iikiti zokunyamekela ezisetyenziswa ngabagqirha kunye neekliniki.
Nangona kunjalo, ngokungafani neziphumo zokunyamekela, i-home version version iyaziwa ukuba inezinga elibi elingamanga malunga ne-7%, oku kuthetha ukuba ukuhlolwa kwesinye sezihlandlo ezili-12 kuya kuzisa "yonke into ecacileyo". Ngoxa le nto ayigxininisi ukusebenza kweemveliso, kuzisa umbuzo ochanekileyo wehlabathi weemvavanyo ezibonelelwe amathuba okusetyenziswa kakubi kweemveliso kunye / okanye ukuhlolwa kwe-HIV kwangaphambili.
Olunye uphando oluqhutywe ngo-2013 yiYunivesithi yaseCalifornia, iSan Francisco yagqiba ukuba isizukulwana sesine isivivinyo somlomo esiphuthumayo njenge-OraQuick sakwazi ukuchonga ngokuthe ngqo i-86% yeengxaki ze-HIV, ngokungaphantsi kwezinto ezazibonwayo kwizilingo zonyango. Okungakumbi malunga noko kwakungokokuba loo mveliso yayinama-54% ngokuchanekileyo ekuqinisekiseni i-serostatus ngexesha lokusasazeka (ekuqaleni) .
Ngobungqina obandayo bokuba ukungenelela ngexesha lokusuleleka kancinci kunokunciphisa ukuphuhliswa kwamagumbi okugcina apho i-HIV iyaziwa ukufihla (okanye "ukuqhubeka") kangangeminyaka emininzi, imfuneko yokuvavanya ngeqondo eliphezulu kakhulu yenzeni-kubaluleke kakhulu ekukhanyeni lwefowuni yokuvavanywa kwendalo yonke kunye nonyango kokubili ngaphakathi nakwihlabathi .
Nangona i-OraQuick package ifakela phambili kubasebenzisi malunga nomngcipheko wokuvavanywa kwangaphambi kwexesha, kugxininiswa ngakumbi kuya kufakwa ekuphuculweni komkhiqizo, kunokuba kuqaphele ukuxhamla umthengi, ukunqoba ezi mpazamo.
Ngaba ukuVavanywa kwangaphakathi kweNdlu kuya kuphucula ukuxhunyaniswa kweMonde kwiNkathalelo?
Ukususela kumbono womgaqo-nkqubo, enye yeenjongo eziphambili zokuvavanya ngaphakathi ekhaya kukunyusa inani lezigulane ezinxulumene nokunyamekela kwe-HIV kwi-US. Injongo yokuzikhangela ekunikelwe ukuba kuphela abangama-437,000 kuma-874,000 aseMelika afunyaniswe ne-HIV afumane unyango, ngokubhekiselele kuphando olupapashwe ngamaziko e-US for Control and Prevention of Disease.
Nangona uphando oluninzi lubonisa ukwamkelwa koluntu ngokubanzi kwindlela yokuvavanya kwangaphakathi, kukho idatha encinci yokwenza ukuba izigulane zizixhomekeke ekunyamekeleni ngenxa yezi mvavanyo.
Nangona izifundo ezininzi e-Afrika zibonise ukwanda kwintsebenziswano emva kokuvavanywa kwekhaya-ngo-300% kwezinye iimeko-ezi ziqhutywe emva kokutyelelwa kweengcebiso zangaphambili zenziwa ngongcali oqeqeshiwe.
Ngaphandle kwesi sicwangciso esisebenzisayo eU.S., ngaba kulindeleke okufanayo okanye, ngokukodwa ngokukodwa, ngaba ngokwenene, yenza ukubahluko?
Abaninzi bayavuma ukuba kuya kuba nzima ukuvavanya ngokupheleleyo kunikwe amaninzi amaziko okuvavanya angabhengezi iziphumo zokudibana nokunyamekela emva kokuvavanywa. Oko sikwaziyo, nangona kunjalo, ukuvavanywa kwe-HIV, engekaxhaswa, kungenakukufutshane kwimiba ephambili-ngokubaluleke kakhulu ekunciphiseni iimpembelelo eziphezulu ezibonakalayo kulabo abavavanya kakubi.
Kwisifundo esenziwa yi-Columbia University of Mailman School of Health Public, ama-5,000 ngokulandelelana abanika izigulane ezithe zafumana ifowuni yolwazi okanye iseshwankathelo esincinane sokucebisa ngaphambi kokuvavanya ngokukhawuleza. Emva kweenyanga ezili-12, izigulane zaphinde zahlolwa kwakhona. Ngokukhawuleza, i-11.1% yecandelo leenkcukacha-mali kuphela lifumene i-STD , ngelixa inani elifanayo labagulane (12.3%) lathola i-STD emva kokunikezelwa ngcebiso olufutshane. Ukufunyaniswa kwakunjalo kuzo zonke iikliniki ezithoba ezisetyenziselwa emva kokuqwalasela ubudala, isini kunye nobuzwe.
Inkqubo yekhompyutheni nge-HIV / STD Inkqubo yeMpilo kaRhulumente, iS Seattle & King County iphinde ixhase esi sigqibo, iphakamisa ukuba ukuvavanya ekhaya kungandisa ukwanda kwe-HIV phakathi kwamadoda abelana ngesondo kunye namadoda (MSM) ukusuka kwisiseko esili-18.6% ukuya naphakathi 22.5% ukuya kwi-27.5%.
Nangona akukho nanye yale nto ithetha ukubonisa ukuba ukuhlolwa kwe-HIV kwintsapho kuya kunciphisa imizamo yezempilo yoluntu, kuqinisekisa ukuba kufuneka ukucaciswa ngakumbi kwezibonelelo kunye nokunciphisa ukuhlolwa kwe-HIV ekhaya, kokubili kubathengi kunye nabenzi bomgaqo-nkqubo wezempilo.
Imithombo:
US Administration and Drug Administration (FDA). "Okokuqala Ekhaya Ngokukhawuleza-Sebenzisa i-HIV Kit evunyelwe ukuvavanya." I-FDA Ulwazi lwezeMpilo yabathengi. Silver Spring, MD; Julayi 2012. Umbhalo: UCM311690.
I-Wall Street Journal. "I-OraQuick (R) I-Test Home yaseVilweni yeNtsholongwane kaGawulayo iqalisa iqhinga elitsha elijoliswe kwiCape -" Life. Njengoko siyazi. (TM) "Ikhuthaza ukuvavanya i-HIV phakathi kwamaqela aphezulu aphezulu." Ukhuphelo olukhutshwa nguSeptemba 30, 2013.
I-Pilcher, C; Louie, B; Facente, S .; okqhubekayo. "Ukusebenza kwe-Rapid Point-of-Care kunye neeNzame zeLebhu zeNgcaciso kunye nokuSungulwa koGawulayo eSan Francisco." PLOS | Nye. Disemba 12, 2013; INGXELO: 10.1371 / iphephandaba.pone.0080629.
Pai, N; Sharma, J .; Shivkumar, S; okqhubekayo. "Ukunyamekela nokunyamekela ukuhlolwa kwe-HIV kwi-High-and Low-Risk populations:". I-PLOS | Enye . Ngo-Aprili 2, 2013; INGXELO: 10.1371 / iphephandaba.pmed.1001414.
Macpherson, P .; okqhubekayo. "Ukuhlola kwasekhaya kunye nokuqaliswa kwe-ART emva kokuvavanya uvavanyo lwe-HIV: ityala le-random eselungelelanisa ukuphucula ukuhanjiswa kwi-ART e-Blantyre, eMalawi." INgqungquthela ye-20 kwi-Retroviruses kunye neZifo eziKhuselekileyo (CROI); Atlanta, Georgia; Abstract 95LB, 2013.
Metsch, L .; Ukukhawuleza, iD .; Gooden, L .; okqhubekayo. "Impembelelo yokunciphisa amathuba okunciphisa umngcipheko ngokuvavanya ngokukhawuleza kwe-HIV engozini yokufumana izifo ezithathelwana ngesondo: i-AWARE ilinganisi yekliniki." Umbhalo we-American Medical Association. Oktobha 23, 2013; 310 (16): 1701-1710.
Katz, D .; ICassels, iS .; kunye ne-Sketler, J. "Ukutshintshwa kweeNzululwazi eziSebenzisiweyo ngeeNzame zokuSebenzisa iiNzame zingaphaya ukunyuka kwe-HIV phakathi kwe-Seattle Amadoda alala neentlobo zabantu: Ubungqina obuvela kwiMathematika." Izifo ezithathelwana ngesondo. Ja nuwari 2014; 41 (1): 2-9.