Naphezu kwamazinga aphezulu wokuzwela, ama-False Negatives akhiphe ukukhathazeka
Ngo-July 2012, i-US Food and Drug Administration (i-FDA) yase-United States inikeze imvume yokuhlolwa kwe- OraQuick In-Home Test , ukuhlinzeka abathengi nge- test yokuqala ye- HIV ngomlomo wokuqala, ekwazi ukunikeza imiphumela eyimfihlo emaminithi angu-20. Imvume ye-FDA yamukelwa yizinhlangano eziningi ezisekelwe emphakathini, eziye zaveza izinzuzo zokuhlolwa kwekhaya ngesikhathi lapho abantu abangu-20% baseMelika abayizigidi ezingu-1.2 abanesandulela ngculaza bengakwazi ngokuphelele isimo sabo.
Oyinhloko phakathi kweziphakamiso ekusekeleni ukuhlolwa kwekhaya:
- Imitholampilo eminingi yomphakathi e-US ingaphansi noma i-overtaxed, kubangele labo abangase bafune noma badinga ukuhlolwa ukuze bahlale kude. Ukuhlolwa kwangaphakathi ekhaya kungasiza ukunqoba lo mkhuba, ukuhlinzeka labo abasengozini kakhulu ngokuzimela okukhulu, ukulawula nokuyimfihlo .
- Ekuvumeleni kwabo umkhiqizo, i-FDA yathi ukuhlola ekhaya "kuzongena ngokulinganisa ... ngokusiza abantu abaningi abanegciwane ukuba baqaphele isimo sabo segciwane lesandulela ngculazi ngaleyo ndlela banciphise ukudluliswa kwe-HIV."
- I-hotline yamahora angu-24 nabasebenzi abaqeqeshwe kuzosiza ekuqinisekiseni ukuthi umkhiqizo usetshenziswa ngendlela efanele; ukuthi abasebenzisi baqonda ukulinganiselwa kokuhlolwa (kufaka phakathi okuthiwa isikhathi sefasitela ), nokuthi labo abathola imiphumela emihle badluliselwa emtholampilo oseduze noma ehhovisi likadokotela.
Kusukela ngo-Septhemba 2013, abakhiqizi be-OraQuick babike ukuthi "abantu abangaphezu kuka-200,000 manje bayazi isimo sabo se-HIV" ngenxa yomkhiqizo, nabahlaziyi bemboni babikezela ukuthengiswa kokuthengisa njengoba ukuqwashiswa kwabathengi kwanda.
Kodwa naphezu kwezinzuzo ezibonakalayo zokuhlolwa, izifundo eziningi ziye zaqokomisa ukukhathazeka mayelana nesisindo sekhaya, ukubuza ngokuqondile ukunemba kwezwe langempela lomkhiqizo, kanye nomthelela walo ekunakekelweni kwesiguli kanye nokuziphatha okungozini.
Yeka ukuthi Ziyiqiniso Kanjani Ukuhlolwa Kwegciwane lesandulela ngculazi?
Ngokombiko we-FDA, i-OraQuick Rapid In-Home Test ayilona ephephile futhi isebenziseka kalula, kodwa inikeza ukuzwela nokucaca okungaba ngu-95% -ngaphansi kuka-99.3% no-99.8% ababonwe ngephuzu-ye- izinkinobho zokunakekela ezisetshenziswa odokotela nemitholampilo.
Kodwa-ke, ngokungafani nokuhlolwa kwe-point-of-care, inguqulo yangaphakathi-ekhaya iyaziwa ukuthi inezinga elingamanga elingamaphesenti angu-7, okusho ukuthi ukuhlolwa kwesinye kwezingu-12 kuzoletha "konke okucacile" uphawu olungalungile. Ngenkathi lokhu kungabi nakancane ukuthi umkhiqizo ube nokusebenza kahle, kungabangela ukuthi ukuhlolwa kwezwe kwangempela kwezivivinyo kunikezwe amathuba okusebenzisa kabi umkhiqizo kanye / noma ukuhlolwa kwe-HIV ngaphambi kwesikhathi.
Ucwaningo olwenziwe ngo-2013 yiYunivesithi yaseCalifornia, eSan Francisco luphelile ukuthi izizukulwane zesine ezivivinya ngomlomo ezifana ne-OraQuick zazikwazi ukubona kahle ama-86% wezehlakalo eziphathelene negciwane lesandulela ngculaza, kakhulu kunalokho okwakubonakala ekuvivinyweni kwemitholampilo. Ngokuphathelene nokuthi okwamanje kwakungenxa yokuthi umkhiqizo wawunembile engu-54 kuphela ekuqinisekiseni i-serostatus ngesikhathi sesicathulo sokuqala sokutheleleka .
Ngebufakazi obukhulayo bokuthi ukungenelela ngesikhathi sokutheleleka okunzima kunganciphisa ukuthuthukiswa kwamanzi okugcina lapho i-HIV eyaziwa khona ukufihla (noma "ukuphikelela") amashumi eminyaka, isidingo sokuhlolwa ngezinga eliphezulu lokuzwela sesibalulekile-ikakhulukazi ekukhanyeni socingo lokuhlolwa jikelele kanye nokwelapha kokubili ngaphakathi nasemhlabeni wonke .
Ngenkathi i-OraQuick iphakheji ifakazela abasebenzisi ngengozi yokuhlolwa ngaphambi kwesikhathi, ukugcizelela okukhulu kuzodingeka kufakwe ekuthuthukiseni komkhiqizo, kunokuba kuqaphele ukuthengwa kwemikhiqizo, ukunqoba lezi zinsalela zezibalo.
Ingabe Ukuhlolwa Kwangaphakathi Kwekhaya Kungakuthuthukisa Ukuxhumeka Kwesineke Ekunakekelweni?
Ngokombono wezinqubomgomo, enye yezinhloso ezinkulu zokuhlola ekhaya-ukwandisa inani leziguli ezixhumene nentshisekelo yokunakekelwa kwe-HIV e-US. Umgomo wokuzikhandla wanikezwa ukuthi kuphela abantu abangama-874,000 baseMelika abathola ukuthi bane-HIV abaye bathola ukwelashwa, ngokusho kocwaningo olwanyatheliswa yi-US Centers for Disease Control and Prevention.
Ngenkathi ucwaningo oluningi lubonisa ukwamukelwa komphakathi okubanzi kokuhlolwa kwekhaya, kunesidingo esincane sangempela sokunquma ukuthi iziguli zizixhumanisa yini nokukhathalela ngenxa yalokhu kuhlolwa.
Nakuba izifundo eziningana e-Afrika zibonise ukwanda kokuxhumana emva kokuhlolwa kwekhaya-okungenani ngamaphesenti angama-300 kwezinye izimo-lezi ziqhutshwa ngemva kokuvakashelwa ukululekwa kokuhlolwa kwangaphambi kokuhlolwa kwenziwa ngumsebenzi oqeqeshiwe.
Ngaloluhlelo olunjalo olwenziwe e-US, ingabe kulindeleke okufanayo noma, ngokukodwa mhlawumbe, ingabe yenza ngempela umehluko?
Iningi liyavuma ukuthi kungaba nzima ukuhlola ngokugcwele izikhungo eziningi zokuhlola azibikezeli imiphumela ekuxhumaneni ukuze unakekele emva kokuhlolwa. Okuthi sikwaziyo, kodwa ukuthi ukuhlolwa kwe-HIV okungasekelwa, futhi ngokwakho, kufinyelela ezindaweni eziningi eziyinhloko-ikakhulukazi ekunciphiseni ukuziphatha okuphezulu kwengozi ebonakala kulabo abahlolwayo ababi.
Esifundweni esenziwa yi-Columbia University's Mailman School of Public Health, iziguli ezingu-5 000 ezazinikezwa ngezikhathi ezithile zithole ishidi lokwaziswa noma iseshini eselulekayo ngaphambi kokuhlolwa okusheshayo. Ngemva kwezinyanga ezingu-12, iziguli zahlolwa kabusha. Ngokumangalisayo, u-11.1% weqembu lwazi-kuphela lathola i-STD , kuyilapho cishe inani elifanayo labaguli (12.3%) bathola i-STD ngemuva kokunikezwa ukwelulekwa okufushane. Okutholakele kwakungaguquguquki kuyo yonke imitholampilo eyisishiyagalolunye esetshenziselwa ngemuva kokucabangela ubudala benduli, ubulili kanye nobuhlanga.
Uhlelo lwekhompiyutha ngeHIV / STD Uhlelo Lwezempilo Lomphakathi, Seattle & King County luphinde lisekele lesi siphetho, okuphakamisa ukuthi ukuhlolwa ekhaya kungandisa ukwanda kwegciwane lesandulela ngculaza kubantu abesilisa nabesilisa (MSM) kusuka esitelekeni sika-18.6% ukuya phakathi 22.5% kuya ku-27.5%.
Nakuba kungekho okunye okushiwo ukukhombisa ukuthi ukuhlolwa kwegciwane lesandulela ngculazi ekhaya kuzokwehlisa imizamo yezempilo yomphakathi, kuqinisa isidingo sokucaciswa okukhulu kwezinzuzo kanye nokulinganiselwa kokuhlolwa kwe-HIV ekhaya, kokubili kumthengi kanye nabenzi bomgomo wezempilo.
Imithombo:
I-US Food and Drug Administration (FDA). "Ikhaya lokuqala lokuqala-sebenzisa i-HIV Kit evunyelwe ukuzihlola." I-FDA Ulwazi Lwezempilo Lwabathengi. I-Silver Spring, MD; Julayi 2012. Idokhumenti: UCM311690.
I-Wall Street Journal. "I-OraQuick (R) Ukuhlolwa kwe-HIV yangaphakathi kwekhaya kuqala Isu lomkhankaso omkhankaso omusha -" Ukuphila. Njengoba siyazi. (TM) "Ikhuthaza ukuhlolwa kwe-HIV phakathi kwamaqembu aphezulu." Ukukhishwa kwezindaba kukhishwe ngo-Septhemba 30, 2013.
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I-Pai, N .; I-Sharma, J .; Shivkumar, S; et al. "Ukuhlolwa Okuzimele Kwangaphakathi Nokungavunyelwe Kwegciwane lesandulela ngculazi Emphakathini Wezinga eliphezulu Neziphansi: Ukubuyekezwa Okuhlelekile." I-PLOS | Eyodwa . Ngo-Ephreli 2, 2013; I-DOI: 10.1371 / iphephandaba.pmed.1001414.
Macpherson, P .; et al. "Ukuhlolwa kwasekhaya nokuqaliswa kwe-ART kulandela ukuhlolwa kwe-HIV: isilingo esihleliwe ngokuhlelekile ukuze kuthuthukiswe ukuxhumana ku-ART eBlantyre, eMalawi." Ingqungquthela ye-20 yama-Retrovirus kanye nezifo ezivame ukuqhutshwa (CROI); I-Atlanta, Georgia; I-Abstract 95LB, 2013.
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