Impact of the Ebola epidemic on general and HIV care in Macenta, Forest Guinea, 2014.

Leuenberger, David; Hebelamou, Jean; Strahm, Stefan; De Rekeneire, Nathalie; Balestre, Eric; Wandeler, Gilles; Dabis, François (2015). Impact of the Ebola epidemic on general and HIV care in Macenta, Forest Guinea, 2014. AIDS, 29(14), pp. 1883-1887. Lippincott Williams & Wilkins 10.1097/QAD.0000000000000784

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

UniBE Contributor:

Wandeler, Gilles

Subjects:

300 Social sciences, sociology & anthropology > 360 Social problems & social services
600 Technology > 610 Medicine & health

ISSN:

0269-9370

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Annelies Luginbühl

Date Deposited:

01 Oct 2015 10:48

Last Modified:

11 Sep 2016 02:30

Publisher DOI:

10.1097/QAD.0000000000000784

PubMed ID:

26372393

BORIS DOI:

10.7892/boris.71858

URI:

https://boris.unibe.ch/id/eprint/71858

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