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.
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.
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).
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.
- 1aCentre 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.
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