Background During the first wave of COVID pandemic, cases and deaths in Africa remained low, nevertheless population was affected by movement restrictions and other limitations. Experts have expressed concern about impact of COVID-19 on disruption to HIV programmes, that could lead to reduced care seeking for new patients, and to treatment interruption for patients on care. This work aims to describe actions undertaken by DREAM, (an HIV program based on free-of-charge access, use of Information Technology, patient empowerment) to address effects of pandemic on PLWH in Africa. Description of the intervention More than 500 community health workers attended an online training course, which spread information on SARS-CoV-2 prevention. Fabric mask production was undertaken in order to address the scarcity of masks. Ongoing training involved health professionals working in the DREAM centres, and proper PPE were purchased. Symptom and anamnestic screening was carried out at the entrance of every facility, suspected cases had a dedicated path. Stable HIV patients were scheduled to pick drug for 3-6 months. Lessons learned Investment previously made on informatization allowed to maintain contacts and to easily share knowledge and guidelines. All centres remained opened during the period. An evaluation on impact of restrictions on HIV care was carried out comparing new accesses, LTFU and deaths and respect of appointments for drugs refill between April- September 2019 and April-September 2020, which included patients in 8 DREAM Centres in Malawi, 7 in Mozambique and in 5 West/Central Africa. Overall number of PLWH in ART at the beginning of the two periods was 46.181 and 47.393. New initiations of ART declined by 47% (1832 to 975). Mortality slightly declined (0,7% in 2019, 0,5% in 2020), and so did rate of LTFU (1,5% in 2019, 1% in 2020). Attendance to scheduled appointments slightly declined but was high in both periods (100% attendance for 82% of the sample in 2019, for 80,6% in 2020). Conclusions/next steps Our data seem to indicate a reduction of new initiations of ART in the period. The multi-level intervention of DREAM seemed to be successful in maintaining HIV patients in care despite the disruption of daily life in the countries.
HIV care during COVID pandemic in Africa: experience from DREAM Programme
A. M. Doro Altan
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2021-01-01
Abstract
Background During the first wave of COVID pandemic, cases and deaths in Africa remained low, nevertheless population was affected by movement restrictions and other limitations. Experts have expressed concern about impact of COVID-19 on disruption to HIV programmes, that could lead to reduced care seeking for new patients, and to treatment interruption for patients on care. This work aims to describe actions undertaken by DREAM, (an HIV program based on free-of-charge access, use of Information Technology, patient empowerment) to address effects of pandemic on PLWH in Africa. Description of the intervention More than 500 community health workers attended an online training course, which spread information on SARS-CoV-2 prevention. Fabric mask production was undertaken in order to address the scarcity of masks. Ongoing training involved health professionals working in the DREAM centres, and proper PPE were purchased. Symptom and anamnestic screening was carried out at the entrance of every facility, suspected cases had a dedicated path. Stable HIV patients were scheduled to pick drug for 3-6 months. Lessons learned Investment previously made on informatization allowed to maintain contacts and to easily share knowledge and guidelines. All centres remained opened during the period. An evaluation on impact of restrictions on HIV care was carried out comparing new accesses, LTFU and deaths and respect of appointments for drugs refill between April- September 2019 and April-September 2020, which included patients in 8 DREAM Centres in Malawi, 7 in Mozambique and in 5 West/Central Africa. Overall number of PLWH in ART at the beginning of the two periods was 46.181 and 47.393. New initiations of ART declined by 47% (1832 to 975). Mortality slightly declined (0,7% in 2019, 0,5% in 2020), and so did rate of LTFU (1,5% in 2019, 1% in 2020). Attendance to scheduled appointments slightly declined but was high in both periods (100% attendance for 82% of the sample in 2019, for 80,6% in 2020). Conclusions/next steps Our data seem to indicate a reduction of new initiations of ART in the period. The multi-level intervention of DREAM seemed to be successful in maintaining HIV patients in care despite the disruption of daily life in the countries.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.