Journal Article > CommentaryAbstract
Int Health. 2014 May 6; Volume 6 (Issue 1); DOI:10.1093/inthealth/ihu005
Grais RF, Adamou HO
Int Health. 2014 May 6; Volume 6 (Issue 1); DOI:10.1093/inthealth/ihu005
Journal Article > ReviewAbstract
Int Orthop. 2013 May 12; Volume 37 (Issue 8); DOI:10.1007/s00264-013-1904-7
Herard P, Boillot F
Int Orthop. 2013 May 12; Volume 37 (Issue 8); DOI:10.1007/s00264-013-1904-7
Journal Article > CommentaryAbstract Only
J Med Ethics. 2016 September 26; Volume 43 (Issue 4); 266-266.; DOI:10.1136/medethics-2016-103397
Calain P
J Med Ethics. 2016 September 26; Volume 43 (Issue 4); 266-266.; DOI:10.1136/medethics-2016-103397
Chiara Lepora and Robert Goodin invite us to join their insightful ‘conversation’ on complicity and compromise. Their book makes a dense, utterly precise and rewarding reading, as one proceeds stepwise through the logic of their philosophical arguments. For those unfamiliar with the relatively new discipline of ‘humanitarian ethics’, it might be disconcerting at first to see humanitarian actions brought to illustrate theories on complicity, with the Rwandan refugees crisis of 1994 and the tortured patient taken as two exemplary cases. Actually, this connects with an increasing body of research and reflexions, showing that humanitarian workers face frequent ethical challenges, some of them amounting to a distressful sense of complicity.
Other > Journal Blog
Lancet Global Health. 2017 November 10
Fotheringham C
Lancet Global Health. 2017 November 10
Journal Article > LetterFull Text
Lancet. 2017 October 16; Volume 390 (Issue 10106); DOI:10.1016/S0140-6736(17)32677-6
White K
Lancet. 2017 October 16; Volume 390 (Issue 10106); DOI:10.1016/S0140-6736(17)32677-6
Other > Journal Blog
BMJ Opinion (blog). 2012 March 5
de Jong K
BMJ Opinion (blog). 2012 March 5
Research & Publication Guidance > Guidelines/How-Tos
Mills C
2008 December 31
Journal Article > ResearchFull Text
Afr J Biotechnol. 2009 February 28; Volume 8 (Issue 4); 536-546.; DOI:10.5897/AJB2009.000-9091
Ahoua L, Guetta AN, Ekaza E, Bouzid S, N’Guessan R, et al.
Afr J Biotechnol. 2009 February 28; Volume 8 (Issue 4); 536-546.; DOI:10.5897/AJB2009.000-9091
A case-control study was carried out in 3 highly endemic regions of Côte d’Ivoire to study risk factors for Buruli ulcer. A case was defined as a Buruli ulcer occurring less than one year before the date of survey, resident in one of the regions investigated and there was no history of Buruli ulcer illness. Controls were selected from the general population by a two stage cluster sampling method. A total of 116 cases and 116 controls were included. For the cases, the male/female sex ratio was 0.84, the median age was 19.5 years and 40.5% were children 15 years. Biological results were obtained for 86 (74%) cases using skin exudate samples. Positive rates were 22.0, 22.1 and 27.9% respectively for smear examination, culture and PCR IS2404, respectively. After adjusting for possible confounders, no history of BCG vaccination (ORa = 5.0, CI 1.7 - 14.3), presence of a case 15 years (ORa = 8.3, CI 2.8 -24.1), having a river/lake/dam near the housing (ORa = 4.4, CI 1.6 - 12.2) and the type of place for fishing (p = 0.001) were associated with illness. Young children and women having daily water related activities were most at risk. Swab samples were not sensitive enough for Buruli ulcer diagnosis. There is an urgent need for a rapid field test to diagnosis Buruli Ulcer as PCR IS2404 remains expensive for most of the endemic countries.
Journal Article > EditorialFull Text
BMJ. 2021 December 20; Volume 375; n3126.; DOI:10.1136/bmj.n3126
Caluwaerts S
BMJ. 2021 December 20; Volume 375; n3126.; DOI:10.1136/bmj.n3126
Conference Material > Abstract
Ben-Farhat J
Epicentre Scientific Day Paris 2022. 2022 June 1
INTRODUCTION
The COVID-19 pandemic and the measures taken to limit its spread have severely disrupted health systems and medical care. People living with HIV (PLHIV) suffer from high levels of comorbidities and stigma, and often faced challenges in access to care prior to the pandemic. The aim of this study was to explore the extent to which the pandemic and the public health measures have affected medical care for PLHIV. The study took place in two different contexts in terms of care and experience of the pandemic where MSF operates, in Arua (Uganda) and Chiradzulu (Malawi).
METHODS
We conducted a multicentric mixed-methods study . The quantitative component explored patients’ retention in care and viral suppression using programmatic data routinely collected from January 2018 to April 2021 . The qualitative study investigated patient perspectives and perceptions of the impact of Covid-19 and the public health and social measures on their lives and ability to manage their health, and on HIV care. The interviews with patients were conducted from January to June 2021.
RESULTS
From 2020 to 2021, we observed a 15% decrease in active cohort among adults on any regimen and a 17% decrease among children and adolescents in Arua. During the same period in Chiradzulu, the first- and second-line cohorts decreased in size (10% drop and 12% drop, respectively). In addition, we observed a reduction in ART initiations and in clinical consultations at the start of pandemic (50% and 68% in Arua and 34% and 60% in Chiradzulu, respectively) and a gradual decrease in viral load coverage. In Uganda, the lockdown affected patients’ and caregivers’ livelihoods, education, access to food and psychosocial wellbeing negatively, which at times affected their ability to manage HIV condition at home and to adhere. Adolescents lost support, experienced increasing HIV stigma, and started to provide for themselves. In Malawi, patients and caregivers emphasized the impact of the pandemic and public health measures on livelihoods and food security and noted the reduction or absence of MSF social support activities during this time. Also, the fear of COVID at health facilities and the confusion and lack of communication about regarding day-to-day changes in activities was disturbing to both patients and staff.
CONCLUSION
The COVID-19 epidemic and public health measures had an important negative impact on HIV care in the health facilities and in the community in Arua and Chiradzulu. To ensure a conducive environment for patients’ access to essential HIV care and treatment during potential future outbreaks requires continued collaboration with the national authorities and advocacy for more non-violent and less authoritarian ways of implementing restrictions. In addition, innovative public health information campaigns about COVID-19 and care services, to reduce fear of disease and to dispel rumours and misinformation are recommended.
KEY MESSAGE
COVID-19 has severely disrupted access to health systems and treatment. The measures put in place to limit the spread of the epidemic have altered people's bearings. How has the pandemic in Arua and Chiradzulu affected PLHIV, who already suffer from higher levels of mental health problems, comorbidities and stigma?
This abstract is not to be quoted for publication.
The COVID-19 pandemic and the measures taken to limit its spread have severely disrupted health systems and medical care. People living with HIV (PLHIV) suffer from high levels of comorbidities and stigma, and often faced challenges in access to care prior to the pandemic. The aim of this study was to explore the extent to which the pandemic and the public health measures have affected medical care for PLHIV. The study took place in two different contexts in terms of care and experience of the pandemic where MSF operates, in Arua (Uganda) and Chiradzulu (Malawi).
METHODS
We conducted a multicentric mixed-methods study . The quantitative component explored patients’ retention in care and viral suppression using programmatic data routinely collected from January 2018 to April 2021 . The qualitative study investigated patient perspectives and perceptions of the impact of Covid-19 and the public health and social measures on their lives and ability to manage their health, and on HIV care. The interviews with patients were conducted from January to June 2021.
RESULTS
From 2020 to 2021, we observed a 15% decrease in active cohort among adults on any regimen and a 17% decrease among children and adolescents in Arua. During the same period in Chiradzulu, the first- and second-line cohorts decreased in size (10% drop and 12% drop, respectively). In addition, we observed a reduction in ART initiations and in clinical consultations at the start of pandemic (50% and 68% in Arua and 34% and 60% in Chiradzulu, respectively) and a gradual decrease in viral load coverage. In Uganda, the lockdown affected patients’ and caregivers’ livelihoods, education, access to food and psychosocial wellbeing negatively, which at times affected their ability to manage HIV condition at home and to adhere. Adolescents lost support, experienced increasing HIV stigma, and started to provide for themselves. In Malawi, patients and caregivers emphasized the impact of the pandemic and public health measures on livelihoods and food security and noted the reduction or absence of MSF social support activities during this time. Also, the fear of COVID at health facilities and the confusion and lack of communication about regarding day-to-day changes in activities was disturbing to both patients and staff.
CONCLUSION
The COVID-19 epidemic and public health measures had an important negative impact on HIV care in the health facilities and in the community in Arua and Chiradzulu. To ensure a conducive environment for patients’ access to essential HIV care and treatment during potential future outbreaks requires continued collaboration with the national authorities and advocacy for more non-violent and less authoritarian ways of implementing restrictions. In addition, innovative public health information campaigns about COVID-19 and care services, to reduce fear of disease and to dispel rumours and misinformation are recommended.
KEY MESSAGE
COVID-19 has severely disrupted access to health systems and treatment. The measures put in place to limit the spread of the epidemic have altered people's bearings. How has the pandemic in Arua and Chiradzulu affected PLHIV, who already suffer from higher levels of mental health problems, comorbidities and stigma?
This abstract is not to be quoted for publication.