David Leuenberger1, Jean Hebelamou, Stefan Strahm, Nathalie De Rekeneire, Eric Balestre, Gilles Wandeler, François Dabis. 1. aCentre Médical de Macenta, Mission Philafricaine, Conakry, Guinea bINSERM U897 - Centre Inserm Epidémiologie et Biostatistique, Université de Bordeaux cUniversité de Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France dDepartment of Infectious Diseases, University Hospital Bern eInstitute of Social and Preventive Medicine, University of Bern, Bern, Switzerland fDepartment of Infectious Diseases, University of Dakar, Senegal.
Abstract
OBJECTIVE: The current Ebola epidemic massively affected the Macenta district in Forest Guinea. We aimed at investigating its impact on general and HIV care at the only HIV care facility in the district. DESIGN: Prospective observational single-facility study. METHODS: Routinely collected data on use of general hospital services and HIV care were linked to Ebola surveillance data published by the Guinea Ministry of Health. In addition, we compared retention among HIV-infected patients enrolled into care in the first semesters of 2013 and 2014. RESULTS: Throughout 2014, service offer was continuous and unaltered at the facility. During the main epidemic period (August-December 2014), compared with the same period of 2013, there were important reductions in attendance at the primary care outpatient clinic (-40%), in HIV tests done (-46%), in new diagnoses of tuberculosis (-53%) and in patients enrolled into HIV care (-47%). There was a smaller reduction in attendance at the HIV follow-up clinic (-11%). Kaplan-Meier estimates of retention were similar among the patients enrolled into care in 2014 and 2013. In a multivariable Cox regression analysis, the year of enrolment was not associated with attrition (hazard ratio 1.02; 95% confidence interval: 0.72-1.43). CONCLUSION: The Ebola epidemic resulted in an important decrease in utilization of the facility despite unaltered service offer. Effects on care of HIV-positive patients enrolled prior to the epidemic were limited. HIV care in such circumstances is challenging, but not impossible.
OBJECTIVE: The current Ebola epidemic massively affected the Macenta district in Forest Guinea. We aimed at investigating its impact on general and HIV care at the only HIV care facility in the district. DESIGN: Prospective observational single-facility study. METHODS: Routinely collected data on use of general hospital services and HIV care were linked to Ebola surveillance data published by the Guinea Ministry of Health. In addition, we compared retention among HIV-infectedpatients enrolled into care in the first semesters of 2013 and 2014. RESULTS: Throughout 2014, service offer was continuous and unaltered at the facility. During the main epidemic period (August-December 2014), compared with the same period of 2013, there were important reductions in attendance at the primary care outpatient clinic (-40%), in HIV tests done (-46%), in new diagnoses of tuberculosis (-53%) and in patients enrolled into HIV care (-47%). There was a smaller reduction in attendance at the HIV follow-up clinic (-11%). Kaplan-Meier estimates of retention were similar among the patients enrolled into care in 2014 and 2013. In a multivariable Cox regression analysis, the year of enrolment was not associated with attrition (hazard ratio 1.02; 95% confidence interval: 0.72-1.43). CONCLUSION: The Ebola epidemic resulted in an important decrease in utilization of the facility despite unaltered service offer. Effects on care of HIV-positivepatients enrolled prior to the epidemic were limited. HIV care in such circumstances is challenging, but not impossible.
Authors: Jacques D A Ndawinz; Mohamed Cissé; Mohamadou S K Diallo; Cheik T Sidibé; Eric D'Ortenzio Journal: Lancet Date: 2015-04-11 Impact factor: 79.321
Authors: Rachel B Yoder; Winstone M Nyandiko; Rachel C Vreeman; Samwel O Ayaya; Peter O Gisore; Paula Braitstein; Sarah E Wiehe Journal: J Acquir Immune Defic Syndr Date: 2012-02-01 Impact factor: 3.731
Authors: Rachel C Vreeman; Winstone M Nyandiko; Edwin Sang; Beverly S Musick; Paula Braitstein; Sarah E Wiehe Journal: Confl Health Date: 2009-04-04 Impact factor: 2.723
Authors: B S Camara; A M Delamou; E Diro; A El Ayadi; A H Béavogui; S Sidibé; F M Grovogui; K C Takarinda; D Kolié; S D Sandouno; J Okumura; M D Baldé; J Van Griensven; R Zachariah Journal: Public Health Action Date: 2017-06-21
Authors: Brinkley Raynor; Elvis W Díaz; Julianna Shinnick; Edith Zegarra; Ynes Monroy; Claudia Mena; Micaela De la Puente-León; Michael Z Levy; Ricardo Castillo-Neyra Journal: PLoS Negl Trop Dis Date: 2021-05-21
Authors: F Moisan; A Traore; D Zoumanigui; J Y Feindouno; A M Sagno; T Mollet; M Bruyand Journal: Epidemiol Infect Date: 2016-04-18 Impact factor: 4.434