2014年埃博拉疫情对利比里亚艾滋病护理的可能影响。

Likely effect of the 2014 Ebola epidemic on HIV care in Liberia.

作者信息

Loubet Paul, Mabileau Guillaume, Baysah Maima, Nuta Cecilia, Taylor Masietta, Jusu Hawa, Weeks Harry, Ingels Anne, Perennec-Olivier Marion, Chapplain Jean-Marc, Cartier Nathalie, Mendiharat Pierre, Raguin Gilles, Tattevin Pierre, Yazdanpanah Yazdan

机构信息

aINSERM, IAME, UMR 1137 bAP-HP, Hôpital Bichat-Claude Bernard, Service de Maladies Infectieuses et Tropicales, Paris, France cInfectious Diseases Clinic, Redemption Hospital dInfectious Diseases Clinic, John F. Kennedy Medical Center, Monrovia, Liberia eEnsemble pour une Solidarité Thérapeutique en Réseau (GIP-ESTHER), Paris fCentre Hospitalo-Universitaire de Rennes, Service de Maladies Infectieuses et Tropicales, Rennes gUniversité Paris Diderot, IAME, UMR 1137, Paris, France.

出版信息

AIDS. 2015 Nov;29(17):2347-51. doi: 10.1097/QAD.0000000000000821.

DOI:10.1097/QAD.0000000000000821

PMID:26544705

Abstract

OBJECTIVE

Liberia's health system has been severely struck by the 2014 Ebola epidemic. We aimed to assess the potential effect of this epidemic on the care of HIV patient in two clinics [John F. Kennedy (JFK) and Redemption Hospitals] in Monrovia, which stayed open throughout the epidemic.

DESIGN AND METHODS

A preexisting electronic database of HIV patient's follow-up visits was used to estimate three weekly parameters from January 2012 to October 2014: number of visits, number of new patient, and proportion of patients with follow-up delay. We used segmented negative binomial regressions to assess trends before and after the week of the Ebola outbreak defined in June 2014 by WHO.

RESULTS

The cumulative number of patients in care comprised 5948 patients with a total of 56 287 visits between January 2012 and October 2014. From June 2014, the number of visit per week, stable since 2012, abruptly decreased (59%) in Redemption (P < 0.001) and progressively decreased by 3% per week in JFK (P < 0.001). In both the clinics, the weekly proportion of patient with follow-up delay sharply increased after the point break from June 2014 (P value < 0.001). From June 2014, a significant decrease in new patients per week occurred in both the clinics: by 57% (P value < 0.001) in Redemption and by 4.6% per week (P value < 0.001) in JFK.

CONCLUSION

The Ebola epidemic had a significant effect on HIV care in Monrovia. Given the particular impact on the rate of patients with follow-up delay, a long-term impact is feared.

摘要

目的

利比里亚的卫生系统在2014年埃博拉疫情中受到重创。我们旨在评估这场疫情对蒙罗维亚两家在疫情期间一直营业的诊所（约翰·F·肯尼迪医院和救赎医院）中艾滋病毒患者护理的潜在影响。

设计与方法

利用现有的艾滋病毒患者随访就诊电子数据库，估算2012年1月至2014年10月期间的三个每周参数：就诊次数、新患者数量以及随访延迟患者的比例。我们使用分段负二项回归来评估世界卫生组织于2014年6月定义的埃博拉疫情爆发周之前和之后的趋势。

结果

2012年1月至2014年10月期间，接受护理的患者累计达5948例，总共就诊56287次。自2014年6月起，自2012年以来一直稳定的每周就诊次数在救赎医院急剧下降（59%）（P<0.001），在约翰·F·肯尼迪医院则每周逐渐下降3%（P<0.001）。在两家诊所，2014年6月出现转折点后，随访延迟患者的每周比例均急剧上升（P值<0.001）。自2014年6月起，两家诊所每周的新患者数量均显著减少：救赎医院减少了57%（P值<0.001），约翰·F·肯尼迪医院每周减少4.6%（P值<0.001）。