Sagaon-Teyssier Luis, Kamissoko Aliou, Yattassaye Adam, Diallo Fodié, Rojas Castro Daniela, Delabre Rosemary, Pouradier Fabrice, Maradan Gwenaëlle, Bourrelly Michel, Cissé Mamadou, Vidal Laurent, Keïta Bintou Dembélé, Spire Bruno
Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, Marseille, France.
ARCAD Santé PLUS, Bamako, Mali.
Health Policy Open. 2020 Dec;1:100017. doi: 10.1016/j.hpopen.2020.100017. Epub 2020 Oct 15.
In Mali, the non-governmental association (NGO) ARCAD Santé PLUS launched the CovidPrev program in response to the COVID-19 outbreak to ensure continuity of HIV care-related activities. This study aimed to identify individual and structural factors associated with mental health disorders (MHD) in the NGO's healthcare workers (HCW) in the early stage of the outbreak.
Data were collected between April 6 and 11, 2020 for 135 HCW in ARCAD Santé PLUS's 18 community-based HIV care centers. Outcomes corresponded to the PHQ-9, GAD-7 and ISI instruments for depression, anxiety and insomnia, respectively. A general mixture model with a negative binomial distribution was implemented.
Most HCW were men (60.7%) and median age was 40 years IQR[33-46]. Symptoms of depression, anxiety and insomnia were declared by 71.9, 73.3, and 77% participants, respectively. Women were at greater risk of MHD. A lack of personal protection equipment and human resources, especially nurses, was associated with a high risk of MHD.
Health policy must place non-front line HCW, including those in NGOs, at the core of the healthcare system response to the COVID-19 outbreak, as they ensure continuity of care for many diseases including HIV. The efficacy of public health strategies depends on the capacity of HCW to fully with and competently perform their duties.
在马里，非政府组织“ARCAD Santé PLUS”启动了CovidPrev项目，以应对新冠疫情，确保与艾滋病毒护理相关活动的连续性。本研究旨在确定该非政府组织的医护人员在疫情早期阶段与心理健康障碍（MHD）相关的个人和结构因素。
于2020年4月6日至11日收集了ARCAD Santé PLUS的18个社区艾滋病毒护理中心的135名医护人员的数据。结果分别对应用于评估抑郁、焦虑和失眠的PHQ-9、GAD-7和ISI工具。实施了具有负二项分布的一般混合模型。
大多数医护人员为男性（60.7%），年龄中位数为40岁，四分位间距为[33 - 46]。分别有71.9%、73.3%和77%的参与者表示有抑郁、焦虑和失眠症状。女性患心理健康障碍的风险更高。缺乏个人防护设备和人力资源，尤其是护士，与心理健康障碍的高风险相关。
卫生政策必须将包括非政府组织医护人员在内的非一线医护人员置于医疗系统应对新冠疫情的核心位置，因为他们确保了包括艾滋病毒在内的多种疾病护理的连续性。公共卫生策略的有效性取决于医护人员充分履行并胜任其职责的能力。
