UBND THANH PHO UONG BI CONG HOA XA HOI CHU NGHIA VIVI' NAM BCD PHONG CHONG HIV/AIDS

DOc 14p - Ty' do - Hanh phiic

S6: 364/BC - BCD (Jong Bi, ngay 20 thang 7 nom 2018

BAO CAO Ttong ket danh gia 10 nom trien khai dieu tri nghien

cac chAt ding thuOc phien bang Methadone

I. DANH GIA CHUNG 1. fla. c diem tinh hinh va chieu huirng sir dung ma tuS, teen dia ban ThAnh ph6 UOng Bi,c6 dien tich to nhien ,'an 255,5 km2, dan so teen 17

van ngtrai (tinh dan so thwong trio va dan so quy c160, c6 11 don vi hanh chinh, Om 9 phuong 2 xa, vii 101 thOn, khu dan cu. ThAnh pho c6 su phdt trier' cua cong nghiep va du lich; co cac danh thang cap guoc gia, hang nom thu but hang nghin nguoi tir cac dia phuong khdc den sinh song va lam an; toc c16 do thi hod nhanh keo theo su phdt trien cua cac co sa dichs vg kinh doanh vui Choi giai

tri nhu qudn bar, Karaoke, truang, nha nghi....tiem an nhieu yeti to phirc tap N,4' an ninh teat tu.

Hang nom s8 ngirai di cai nghien ma tug' chap hanh xong an phat tu, dac so d6i tugng cai nghien bat bu6c hoac to nguyen tra ve dia phuong nhieu,

trong khi do cong tic quan so doi tugng nay hieu qud con thap. Nhieu d6i tugng sau khi tra ve khOng co vi'ec lam on dinh, tiep tuc Lang thang tai nghien. Viec lap ho so dua vAo cac trung tam cai nghien bat bu6c con gap nhieu kho khan vuang mac do quy dinh cua phdp luat, cong tic cai nghien tai cong &rig, gia dinh hieu qud con thap.

Nhan thirc ve tic hai dm ma t4 trong nhan dan dac biet IA trong giai tre con nhieu han che;, tinh trang

doi nien sir ching ma tug' tong hgp co chieu

huang gia tang. Doi vai cac doi tugng mua bdn trdi phep chat ma tug' mac du thai gian qua luc lugng Cong an da bat Oa xir 1S, nghiem rat nhieu doi tugng

nhung do 19,i nhuan cao nen bat chap phdp luat van co tinh vi pham. Qua cong tic Ichao sat tren dia bAn ThAnh phO hieu ,c6 197 doi tugng

nghien va nghi nghien ma t4 tong hop (co ho so quan W; so ngtrai nghien ma tug' truyen thong IA 84 nguai. 10/11 phuong xa teen dia ban ThAnh pho co nguai nghien va, sir dung ma t4; dia ban tap trung a nhang khu do thi trung tam ThAnh phO (Quang Trung; Yen Thanh;,Phuang Dong; Phuang Nam ). Tren dia ban ThAnh ph6 khOng c6 co s& san xuat ma t4, c6 cac to diem pink tap ve to flan, ma tug' nhung tinh tang bdn ma tug'nho le cac khu dan cu con dien ra nhieu.

Cong tic tuyen truyen ve phong, chong t6i pham ma t4 da dirgc quan tam thuc hien, tuy nhien hieu qua chua cao. Su vAo cu6c cua toan xa h6i nhat la doi vui to non nay chira dirgc phat huy manh me; Co not con coi day lA nhiem vu cua rieng luc lugng cong an. SO can b6 lam cong tic ph6ng chong ma tug' nhat lA

cong tac quan 15, dOi tugng sau cai a cac phuamg xa con thieu, chua dugc tap huan de nang cao trinh do nghiep vv thgc hien cong tac nay (chi, yeti la kiem

nhi0i) cling la mot trong ntang nguyen nhan chua lam giam dugc so nguai nghien ma tug.

Bang 1. Thimg ke so luvng nghi nghien tren aria ban thanh pha

VA, phtriYng S TT

SO nghi nghien Ma

tuy tong hoy (do CA

cung cap)

SO nghien cac chAt

clang thuec phien (Do nhan viers

tiep On ,CD cung cap)

SO tiep nhan vac, lieu tri

methadone

SO hien dang dieu

tri methadone

1 Quang Trung 35 18 15 10

2 Thanh San 13 13 11 9

3 Phucmg Dong 31 9 8 5

4 Yen Thanh 37 8 6 4

5 Bac Son 5 5 4 2

6 Nam Khe 15 2 2 2

7 Phuong Nam 25 8 7 4

8 Tnmg Vucmg 19 12 12 9

9 Vang Danh 17 8 8 7

10 Dien Cong 0 1 1 0

11 Thugng Yen COng 0 0 0 0

Cong 197 84 74 52

Hi4i tai Co so Dieu tri Methadone thanh ph6 Uong Bi co 44 nguai dm huyen Ichic dang dugc diet' tri tai co soy (Quang Yen: 36; Ha Long: 6; Dong Trial: 1, Hoanh Bo: 1).

Tong so nguai dang uong thuoc thuang xuyen la 96 nguiyi 2. Tinh hinh va chieu htrerng dich HIV/AIDS Twang hop nhigm HIV d'au tien cila Thanh phO dugc phat hien vao nam

1996 tinh den (30/06/2018) có 722 nguai co xet nghiem HIV ducmg tinh

2

nhiem HIV dung ten tuOi, dia chi quail 1/ dugc; SO (Id tir vong la 381 nguai; So con song hien co mat teen dia ban la 341 nguai.

- DOi tugng nhigin HIV tap trung a nhom trong do tuOi lao dOng tir 18 -60 tuoi con song la 323 chiem 94,7% so nguai nhiem HIV con song.

- DOi tugng nhigm HIV chii yeu la nam giai chiem 80,33%.

Bang 2. So ngtroi nhiim HIV va so nhiarn HIV ter vong duvc

p •

STT

_

Nam SO Oat hi0 moil

trong nam SO tit vong Oat hi0 trong nam

1 6 thang 6u nam 2018 6 2

2 2017 16 4

3 2016 17 10

4 2015 25 7

5 2014 18 20

6 2013 40 16

7 2012 20 15

8 2011 30 12

9 2010 35 6

10 2009 34 20

11 Truac nam 2009 481 269

COng 722 381

Bang 3. So n It& nhiim HIV con song tinh dtn 30/6/2018

STT X5, phiromg Nam Nit TOng

1 Bac San 8 5 13

3

2 Nam Khe 13 4 17

3 Phucmg &Ong 30 20 50

4 Phuang Nam 12 12 24

5 Quang Trung 67 17 84

6 Thanh San 49 18 67

7 Thucmg Yen Cong 1 4 5

8 Trung Vuang 18 6 24

9 Vang Danh 16 13 29

10 Yen Thanh 16 10 26

11 Dien COng 1 1 2

Cling 231 110 341

Thvc to ten day,cho thAy nhil-mg doi tugng nhi6m HIV a Thanh ph6 Uong

Bi chil yeu‘a nh6m tuoi tre trong d'6,tuoi lao d6ng va nam giOi van chiem tY le chii yeu, dieu do anh huang rat lan den sir phat trien kinh to dm Thanh pho.

II. CONG TAC CHI 030, PHOI HOP LIEN NGANH , Chi dao co sa dieu tri Methadone thanh phO Uong BI dd. phoi hgp ch4t

the vai Phong Lao Ong, Thucmg binh va Xa- h6i Thanh ph& C6ng an Thanh pith trong qua trinh tie') nh4n benh nhan vao diet' tri tranh trung 14p cac doi Wang da CO h6 sa di cai nghien tap trung tiep thin vao diet' tri.

Khi benh nhan W. bo diet' tri hoc xin ra khOi chuang trinh co. so deu thong bao veri Ph6ng Lao Ong thuang binh va X'a h6i va Cong an Thanh ph6 de ph6i hgp quan IY.

III. DANH GIA VIEC XAY DUNG VA TRIEN KHAI VAN BAN QUY PHAM PHAP LUAT, HANG DAN CHUYEN MON KY THUAT

1. Viec thin hien cac chinh sich trong Nghi dinh so 90/2016/ND-CP caa Chinh phii quy dinh ve dieu tri nghien cac chat clang thaw phien bang thuoc thay the

- Chinh sach doi vgi nguoi benh (Khoan 1,2 va 3 Dieu 22 Nghi dinh so 90/2016/ND-CP):

Tat ca nhang nguOi nghien chat clang thu6c phien teen dia ban tinh Quang Ninh c6 nhu cAu dugc tiep nh4n h6 sa va dua nguai nghien chAt d4rig thu6c phien clang 14 dieu tri vao co so, theo dung huang dan dm thong to 12/2015/TT- BYT va Nghi dinh 90/2016/ND-CP ngay 1/7/2016. Viec tiep nh'4'n benh nhan vao dieu tri van sap xep theo dot de tien theo doi, do lieu, kham dieu chinh lieu.

4

- Chinh sach voi nhan vien y to cong tic tai co soy dieu tri methadone (Khoan 4 Dieu 22 Nghi dinh 90/2016/ND-CP):

, Co soy dieu tri methadone thanh pho tieing Bi hien có 13 can bO lam viec cu the

Truerng ca so: 01 (kiem nhiem 01); PhO truerng ca sa: 01 (kiem nhiem 01); Phong kharn: 02; Tu van, hanh chinh: 01; Dugc cap plait: 04 (kiem nhiem 02);

Xet nghiem: 01; Bao ve: 03. Tat ca nhang can b8 va nhan vien nay dugc huang moi che do chinh sach

theo (Khoan 4 Dieu 22 Nghi dinh 90/2016/ND-CP) to ngu6n ngan sach dugc cap tir De an ho trg tai chinh pheng chong HIV/AIDS tinh Quang Ninh cap

hang nam. 2. Dinh gia viec thtrc hien cac van ban quy ph4m phap 1u4t va htromg

dAn chuyin mon k'Sf" thu4t Ca soy Dieu tri Methadone thanh pho Uong Bi da to chirc thvc hien tot

Nghi dinh 90/2016/ND-CP ngay 1/7/2016 cua Chinh phu quy dinh ve dieu tri nghien cac chat clang thuoc phien bang thuoc thay the; ThOng tu 14/2015/TT-BYT ngay 25/6/2015 dm 138 Y to ve quan ly thuoc methadone; Quyet dinh 3140/QD-BYT ngay 30/8/2010 dm B8 ,Y to ban hanh huang dan dieu tri thay the cac chat clang thuoc phien bang thuoc Methadone; Quyet dinh so 3509/QD-BYT ngay 21/8/2015 cna BO Y to ban hanhhuang clan to chirc thirc hien diet' tri nghien cac chat clang thuoc phien bang thuoc Methadone tai co. soy cap phat thu6c Methadone; Quyet dinh so 159/QD - BYT ngay 19/01/2016 B8' Y to

ban,hanh Fluxing dan dao tao ve diet' tri nghien cac chat clang thuoc phien bang thuoc Methadone.

Hang nam deu cir can b8 cua ca soy di tap huan nang cao chat lugng chuyen mon phvc vv. Tat ca benh nhan có du dieu kien dugc kham dieu tri theo dung quy dinh khong xay ra truarng hop ng8 dOc thuoc Methadone. Cong tic tiep nhan va bao quan thuoc,Methadone dugc chap hanh day dU chua xay ra tinh tang thieu but thuoc hoc cap phat sai chi dinh cua bac si.

3. Dinh gia viec thirc hien cac van ban chi d4o ciia Tinh, Thanh phO de trien khai cong tic dieu tri nghien cac chat ding thuoc phien bang thu6c methadone

Thanh ph8 da to chirc trien khai Ke hoach cua tinh Quang Ninh, xay dung Ke hoach cua Thanh ph8 trien khai thvc hien nhiem vv nay.

UBND Thanh pho da quan tam bo tri von dau tu xay dkrng ca soy vat chat cho ca so dieu tri Methadone vai so von khoang 3,6 tj, d8ng, hoan thanh vao

cu6i nam 2015. Sa Y to tinh da quan tam dau tu trang thiet bi cho Ca soy tir ngu6n Dv an

phat trien he th6ng y to do Qu'yi toan cau tai trg.

Trung tam Y to da chti d'Ong bo tri ngan sach craa Dan vi va cir can b6 tham gia dao tao kien thirc, k57 Wang do Cue phong ch6ng HIV/AIDS va Truing Dai hoc Y Ha N6i to chirc; quan tam trang bi cac thiet bi con lai de co soy c6 the dua vao host d6ng cuOi nam 2015.

IV. DANH GIA KET QUA THIX HIEN "Ke hoych dieu tri nghien cac chAt dyng thuOc phien bang thuoc thay the "do U57 ban nhan din Tinh phe duyet

1. Muc tieu - Myc tieu chung: + Nang cao trach nhiem ca nhan, gia dinh va toan xa h6i de chir d6ng

phong ngira va giai quyet tinh trang nghien ma dry, tang man nhAn thirc ve nghien ma tray, cai nghien ma tray nham gop phan ngan chan giam co ban to nan nghien ma tray va giam den mirc thap nhat tac hai dm ma try den sirc khoe, gia dinh xa h6i.

+ Tang ctrOng hieu qua kinh to xa h6i cua chtrang trinh dieu tri nghien cac chat clang thu6c phien thay the bang Methadone.

- Muc tieu cy the + 100 % nguai nghien cac chat dang thuOc phien c6 nhu cau va dam bao

lieu kin dung theo quy dinh dugc dieu tri thay the bang Methadone. + Dam bao an toan trong qua trinh dieu tri. + Giam tS/ le tai nghien sau qua trinh dieu tri. 2. Hoyt dOng UBND tinh Quang Ninh da ban hanh Quyet dinh so 1778/QD-UBND

ngay 24/6/2015 ve viec thanh lAp co so diet' tri Methadone thanh phi Uong Bi. Thang 11 /2015 bat dau khai lieu dieu tri. Den 30/6 /2018 da thkrc hien

khOi lieu diet' tri cho 126 truong hop (Phu lyc 1). Trong qua trinh trien khai thuc hien co soy dieu tri Methadone thanh phi

Uong Bi dugc skr chi dao cua UBND Thanh phi; va cac ban nganh co lien quan nhu Phong Lao d6ng, Thuang,binh va Xa h6i Thanh phi, Cong an Thanh phi. Hien tai benh nhan dang uong hang ngay, th&mg xuyen la 96 ngtroi, c6 30 nguai ding uong thuoc (4) le; 23,8%). Nguyen nhan do pham t6i, khong chap hanh diet' tri, chuyen not sinh song.

V. DANH GIA HIEU QUA DIEU TRI CAC CHAT DANG THUOC PHIEN BANG THUOC THAY THE GIAI DOAN 2008-2018

1. Hieu qua ve y to

- 100% benh nhan dugc kham phat hien sOrn, dieu tri, to van h6 to tam 1)", cac benh y kern theo, gop phan vao viec: giam tac hai do nguai nghien cac chat dang thuoc phien gay ra nhu giam tS, le mac cac benh lay nhiem do sir dung qua tiern chich (HIV, Viem gan B,C...) hau het cac benh nhan vao tri deu tang can troy lai, co ban cac benh nhan da c6 chuyen bien rat tot ye tinh than, cai thien rat lan ve yeu to than kinh: Sau dieu tri benh nhan biet chia se kilo khan gia

dinh, cal ma trong giao tiep, quan tam to Fang sirc khoe ban than

- Ve van de sir dung Heroin:

6

Teen 3 nam co soy di vao hog Ong, da dieu tri cho 126 benh nhan hien con 96 benh nhan dang dieu tri : 100% benh nhan da het nghien; 95% benh nhan dieu tri ten 6 thang thuOng xuyen có xet nghi'em am tinh vOi cac chat dang thuoc phien.

2. Hieu qua ve an ninh, an town va tr4t tu. xa hOi Den nay nhang benh nhan nay da khong phai tim kiern thu6c de sir dung

vao viec hut chich, nhieu benh than da có viec lam try giup gia dinh, giam ganh nang ye an ninh trat tu.

3. WA so ton tuft va kilo khan finh huii.ng den hieu qua dieu tri:

- Hien nay nhang nguai nghien sir ,cac chat dang thuoc phien chuyen sang s dung ma tuy da nen khOng dua vao diet' tri Methadone dugc.

- MOt so benh nhan khong dam cong khai minh nghien vi so gia dinh xa lanh va bi bat di cai nghien tap trung.

- S6 benh than c6 cai thien tot ve sirc khOe, tinh than nhung khong co cong an viec lam de on dinh cuOc song con chiem 35-40%, theri gian nhan roi, sau khi di uong thuoc ye khong co viec lam c6 the la ly do tai sir dung Heroin va ma tUy di.

- MOt s6 benh nhan có cong an viec lam do dieu kien ve thoi gian lam viec kh6ng thu xep &roc de di uong thuOc hang ngay anh huang den tuan thu dieu tri (chiem khoang 10%), thinh thoang lai nghi uong thuoc mot vai ngay.

- Dieu tri thOi gian dai, benh nhan met mai, tam ly bun char, vi bi go be) vao viec uong thuoc hang ngay; benh nhan khOng có viec lam, it dugc gia

dinh quan tam dan den,benh,nhan vi pham nhu: thi thoang dung lai heroin, nghi uong khong xin phep, tan suat nghi nhieu

- Benh nhan dieu tri tai co soy co 98% la nam, do tu6i trung binh tir 30 den 45, ten 70% benh than mac cac benh lay nhiem nhu HIV, lao, viem gan..., nguy co phat sinh ngu6n lay tai co so ding nhu viec sir dung cac chat gay nghien va chap hanh not quy dm co soy.

VI. KE HOACH TRIEN KHAI CONG TAC DIEU TR! NGHIEN GIAI DOAN 2018-2020

1. Muc tieu + 100% ngued nghien cac chat clang thu6c phien có nhu cau va dam bao

dieu kin dung theo quy dinh dugc dieu tri thay the bang Methadone; + Dam bao an toan trong qua trinh dieutri; + Giam tS,

, tai nghien sau qua trinh tri;

2. Chi tieu benh nhan can dut

TT Ten co' so. dieu tri Den 31/12/2018

Den 31/12/2019

Den 31/12/2020

Ca soy DT Methadone TP Uong Bi

100 130 150

7

ham TuAn £04t PHO CHU TICH UBND THANH PHO

3. Phtrung htr&ng Moat Ong trong tho'i gian tot

- Chi dao Trung tam Y to thanh ph6 tiep tvc duy tri cac hog dOng theo &Si va diet' tri, to van, cap phat cho benh nhan 'long thuoe tai co kr an toan; duy tri cac hoat Ong kharn va dieu tri cac benh ly kern theo, quan ly co so dam bao an ninh trg U", an toan va phan dau hoan thanh chi tieu &roc giao.

- T6 chirc Oa° dpc nh6m cho ngtreli h6 try \fa benh nhan tai Co soy de tuyen truyen ves tac'hai nhang chat nghien khac nhu Methamphetamin, co, can sa... Yeu cau benh nhan cam ket, c6 bien phap xir 1/ cuong quyet doi voi benh nhan nay.

- Chi dao Trung tam Y to thanh ph6 ph6i hop chat the \Teri Cong an Thanh pho (D6i ph6ng chong ma nay), dam bao an toan cho ngay to chirc xet nghiem, có bien phap ran de cac benh nhan sir dung cac chat nghien khac, (long thOi ngan chan va xir ly kip thari nhung benh nhan co hanh vi con d6 gay r6i mat trast tv, de doa nhan vien co. so dam bao an toan cho co so.

4. Kien nghi, de xuAt lien quan de hoan thanh chi tieu De nghi UBND tinh chi dao cac SO, nganh có lien quan cap ngan sach chi

thixOng xuyen cho co s& dieu tri Methadone nhu cho cac don vi su nghiep y to du phengilchac cua Tinh.

Tren day la Bao cao tong ket 10 ,nam viec thvc hien cong tac dieu tri nghien cac chat clang thuoc phien thay the bang Methadone dm thanh ph6 Uong B

Noi - Thtr'mg trvc Thanh ny, FIEND TP (b/c); - Sa Y to (b/c); - TTKS benh tat Tinh (t6ng Flo:7p bac cao); - TTYT, phong Y to TP; - L.ru: VT./.

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