Impact of COVID-19 on HIV Prevention and Care Services for People Living With HIV in Bukavu City: An Explanatory Sequential Mixed Study
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Abstract
Introduction: Since its appearance in China at the end of 2019, the sanitary response to COVID-19 infection has disrupted the delivery of primary healthcare services, including those related to the human immunodeficiency virus (HIV). In the Democratic Republic of Congo, anti-COVID-19 measures (containment) effect on the use of HIV preventive and care services for people living with HIV (PLHIV) remains poorly described to date.
Objective: Compare and understand the effect of anti-COVID measures on the use of HIV prevention and care services for PLHIV in Outpatient treatment centers from Bukavu before (October 2019 to February 2020) and during (March to July 2020) anti-COVID measures.
Methods: Multisite mixed study with an explanatory sequential design carried out in Bukavu between July and September 2021. Quantitative phase is observational, descriptive, retrospective and based on programmatic data from Outpatient treatment centers (OTC). Qualitative phase, guided by quantitative results, is based on 31 semi-structured interviews with caregivers and PLHIV.
Results: Compared to the pre-COVID-19 period, anti-COVID-19 measures resulted in an 11-20% decrease in HIV preventive and PLHIV’s care services. They also led to stock outs of antiretrovirals and HIV tests, HIV services reorganization, some caregiver’s contamination with COVID-19 and death of others, and a drop in HIV services use.
Discussion and conclusion: In Bukavu, anti-COVID-19 measures have had a negative impact on the care of at-risk, HIV-infected people. They have hampered progress towards the objectives of 95% of people tested for HIV, 95% of PLHIV on treatment and 95% of PLHIV with a suppressed viral load.
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References
Akilimali, P. Z., Mashinda, D. K., Lulebo, A. M., Mafuta, E. M., Onyamboko, M. A., et Tran, N. T. (2022). The emergence of COVID-19 in the Democratic Republic of Congo: Community knowledge, attitudes, and practices in Kinshasa. PLoS ONE, 17(6), e0265538. https://doi.org/10.1371/journal.pone.0265538
Akonkwa, B., Jean, A., Katumbi, F., Kulondwa, M., Mahano, A. O., Mulashe, B., Sabuni, P., Alu, K., et Mangambu Mokoso, J. D. D. (2018). Adhérence des personnes vivant avec le VIH/SIDA aux antirétroviraux dans le district sanitaire de Bukavu (Sud-Kivu, République Démocratique du Congo). Annals of Laboratory Medicine, 4, 256‑269.
Amimo, F., Lambert, B., et Magit, A. (2020). What does the COVID-19 pandemic mean for HIV, tuberculosis, and malaria control? Tropical Medicine and Health, 48(1), 32. https://doi.org/10.1186/s41182-020-00219-6
Ayagirwe, R., Birindwa, B., Tchass, C., Baenyi Simon, P., Kashosi, T., Bisimwa, P., Ronald, T., Mugumaarhahama, Y., Valence, M., Bwami, M., Shukuru, W., Bisimwa, P., et Mukwege, D. (2022). Population Behavior and Practices during the First Wave of COVID-19 Pandemic in Low Resource-Conditions of South Kivu, East of Democratic Republic of Congo. Journal of Epidemiology and Public Health, 7, 17‑33. https://doi.org/10.26911/jepublichealth.2022.07.01.02
Baribeau, C. (2005). L’instrumentation dans la collecte de données. Le journal de bord du chercheur. Recherches Qualitatives Hors Série(2), 98 114. http://www.recherche-qualitative.qc.ca/documents/files/revue/hors_serie/hors_serie_v2/CBaribeau%20HS2-issn.pdf
Bourgault, P., Gallagher, F., Michaud, C., et St-Cyr Tribble, D. (2010). Le devis mixte en sciences infirmières ou quand une question de recherche appelle des stratégies qualitatives et quantitatives. Recherche en soins infirmiers, 103(4), 20‑28. https://doi.org/10.3917/rsi.103.0020
Brown, L. B., Spinelli, M. A., et Gandhi, M. (2021). The interplay between HIV and COVID-19 : Summary of the data and responses to date. Current Opinion in HIV and AIDS, 16(1), 63. https://doi.org/10.1097/COH.0000000000000659
Chersich, M. F., Gray, G., Fairlie, L., Eichbaum, Q., Mayhew, S., Allwood, B., English, R., Scorgie, F., Luchters, S., Simpson, G., Haghighi, M. M., Pham, M. D., et Rees, H. (2020). COVID-19 in Africa: Care and protection for frontline healthcare workers. Globalization and Health, 16, 46. https://doi.org/10.1186/s12992-020-00574-3
Creswell, J. W., et Plano Clark, V. L. (2018). Designing and Conducting Mixed Methods Research (3e éd.). Sage Publications.
Data for Impact-USAID. (2021). Estimating National and Area-Specific COVID-19 Effects on Health Service Use in the Democratic Republic of the Congo. https://pdf.usaid.gov/pdf_docs/PA02111N.pdf
Ditekemena, J. D., Nkamba, D. M., Muhindo, H. M., Siewe, J. N. F., Luhata, C., Bergh, R. V. den, Kitoto, A. T., Damme, W. V., Muyembe, J. J., et Colebunders, R. (2021). Factors associated with adherence to COVID-19 prevention measures in the Democratic Republic of the Congo (DRC): Results of an online survey. BMJ Open, 11(1), e043356. https://doi.org/10.1136/bmjopen-2020-043356
Dorward, J., Khubone, T., Gate, K., Ngobese, H., Sookrajh, Y., Mkhize, S., Jeewa, A., Bottomley, C., Lewis, L., Baisley, K., Butler, C. C., Gxagxisa, N., et Garrett, N. (2021). The impact of the COVID-19 lockdown on HIV care in 65 South African primary care clinics : An interrupted time series analysis. The Lancet. HIV, 8(3), e158‑e165. https://doi.org/10.1016/S2352-3018(20)30359-3
Duhant, A., Kusinza, B., Tantet, C., Bisimwa, B., Gare, M., Masemo, B., Alloui, C., Ntakwinjan, M., Mechai, F., Le, M. P., Gerber, A., Muhigirwa, B., Peytavin, G., Gordien, E., Brichler, S., Mukwege, M., et Le Gal, F. (2023). HIV-1 infection in South Kivu (Democratic Republic of Congo): High genotypic resistance to antiretrovirals. Journal of Antimicrobial Chemotherapy, 78(7), 1732‑1739. https://doi.org/10.1093/jac/dkad163
Écochard, R., Wimba, P., Bengehya, J., Katchunga, P. B., Lugwarha, S., Oyimangirwe, M., Bazeboso, J.-A., Tshilolo, L., Longo-Mbenza, B., Rabilloud, M., Iwaz, J., Étard, J.-F., et Vanhems, P. (2021). The COVID-19 pandemic is deepening the health crisis in South Kivu, Democratic Republic of Congo. International Journal of Infectious Diseases, 105, 716‑720. https://doi.org/10.1016/j.ijid.2021.03.043
Fortin, M.-F., et Gagnon, J. (2022). Fondements et étapes du processus de recherche : Méthodes quantitatives et qualitatives (4e éd.). Chenelière Éducation.
Golin, R., Godfrey, C., Firth, J., Lee, L., Minior, T., Phelps, B. R., Raizes, E. G., Ake, J. A., et Siberry, G. K. (2020). PEPFAR’s response to the convergence of the HIV and COVID-19 pandemics in Sub-Saharan Africa. Journal of the International AIDS Society, 23(8), e25587. https://doi.org/10.1002/jia2.25587
Groupe d’étude sur le Congo. (2021). Covid business en RDC. Repenser la riposte aux épidémies. https://cic.nyu.edu/wp-content/uploads/2023/02/crg-covid-business-_en-rdc-repenser-la-_riposte-aux-_epidemies.pdf
Hogan, A. B., Jewell, B. L., Sherrard-Smith, E., Vesga, J. F., Watson, O. J., Whittaker, C., Hamlet, A., Smith, J. A., Winskill, P., Verity, R., Baguelin, M., Lees, J. A., Whittles, L. K., Ainslie, K. E. C., Bhatt, S., Boonyasiri, A., Brazeau, N. F., Cattarino, L., Cooper, L. V., … Hallett, T. B. (2020). Potential impact of the COVID-19 pandemic on HIV, tuberculosis, and malaria in low-income and middle-income countries: A modelling study. The Lancet. Global Health, 8(9), e1132‑e1141. https://doi.org/10.1016/S2214-109X(20)30288-6
International Center for AIDS Care and Treatment Programs. (2020). Perspectives from Recipients of Care during the COVID-19 Pandemic. https://cquin.icap.columbia.edu/wp-content/uploads/2020/04/CQUIN-ITPC-RoC-Perspectives_MASTER-FINAL21April.pdf
Intissar, S., et Rabeb, C. (2015). Étapes à suivre dans une analyse qualitative de données selon trois méthodes d’analyse : la théorisation ancrée de Strauss et Corbin, la méthode d’analyse qualitative de Miles et Huberman et l’analyse thématique de Paillé et Mucchielli, une revue de la littérature. Revue Francophone Internationale de Recherche Infirmière, 1(3), 161‑168. https://doi.org/10.1016/j.refiri.2015.07.002
Jiang, H., Zhou, Y., et Tang, W. (2020). Maintaining HIV care during the COVID-19 pandemic. The Lancet. HIV, 7(5), e308‑e309. https://doi.org/10.1016/S2352-3018(20)30105-
Bonhomme Kalimira Kachelewa, P.P. Lunjwire Mulemangabo, et C. Kyambikwa Bisangamo. (2016) Elevation of the transaminases and factors associated at people living with the HIV - AIDS (PVVIH) in the center of Ambulatory Treatment of the PHARMAKINA - BUKAVU (CTA). International Journal of Innovation and Scientific Research, 26, (1), 341–346. http://www.ijisr.issr-journals.org/abstract.php?article=IJISR-16-190-01
Kaur, N., Vedel, I., El Sherif, R., et Pluye, P. (2019). Practical mixed methods strategies used to integrate qualitative and quantitative methods in community-based primary health care research. Family Practice, 36(5), 666‑671. https://doi.org/10.1093/fampra/cmz010
Kickbusch, I. (2018, novembre 23). Nurses will help turn the promise of universal health care into a reality. STAT. https://www.statnews.com/2018/11/23/nurses-deliver-promise-universal-health-care/
Kowalska, J. D., Skrzat-Klapaczyńska, A., Bursa, D., Balayan, T., Begovac, J., Chkhartishvili, N., Gokengin, D., Harxhi, A., Jilich, D., Jevtovic, D., Kase, K., Lakatos, B., Matulionyte, R., Mulabdic, V., Nagit, A., Papadopoulos, A., Stefanovic, M., Vassilenko, A., Vasylyev, M., … ECEE Network Group. (2020). HIV care in times of the COVID-19 crisis — Where are we now in Central and Eastern Europe? International Journal of Infectious Diseases: IJID: Official Publication of the International Society for Infectious Diseases, 96, 311‑314. https://doi.org/10.1016/j.ijid.2020.05.013
Le Fonds Mondial. (2021). Rapport 2021 sur les résultats. https://www.theglobalfund.org/media/11305/corporate_2021resultsreport_report_fr.pdf
Li, Q., Guan, X., Wu, P., Wang, X., Zhou, L., Tong, Y., Ren, R., Leung, K. S. M., Lau, E. H. Y., Wong, J. Y., Xing, X., Xiang, N., Wu, Y., Li, C., Chen, Q., Li, D., Liu, T., Zhao, J., Liu, M., … Feng, Z. (2020). Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. The New England Journal of Medicine, 382(13), 1199‑1207. https://doi.org/10.1056/NEJMoa2001316
Linnemayr, S., Jennings Mayo-Wilson, L., Saya, U., Wagner, Z., MacCarthy, S., Walukaga, S., Nakubulwa, S., et Karamagi, Y. (2021). HIV Care Experiences During the COVID-19 Pandemic: Mixed-Methods Telephone Interviews with Clinic-Enrolled HIV-Infected Adults in Uganda. AIDS and Behavior, 25(1), 28‑39. https://doi.org/10.1007/s10461-020-03032-8
Masimango, M. I., Sumaili, E. K., Wallemacq, P., Malembaka, E. B., Hermans, M. P., Fillée, C., D’Hoore, W., Winkler, C. A., Limou, S., et Jadoul, M. (2020). Prevalence and Risk Factors of CKD in South Kivu, Democratic Republic of Congo: A Large-Scale Population Study. Kidney International Reports, 5(8), 1251‑1260. https://doi.org/10.1016/j.ekir.2020.05.028
Mayala, G. M., Niangi, L. M., Wembo, G. L., et Ntumba, J.-M. K. (2022). Première année de la pandémie à COVID-19 en République Démocratique du Congo : revue de la gestion d’une crise dans un système de santé décentralisé. Annals of African Medicine, 15(2), e4561-e4576. https://dx.doi.org/10.4314/aam.v15i2.5
Mbithi, I., Thekkur, P., Chakaya, J. M., Onyango, E., Owiti, P., Njeri, N. C., Kumar, A. M. V., Satyanarayana, S., Shewade, H. D., Khogali, M., Zachariah, R., Rusen, I. D., Berger, S. D., et Harries, A. D. (2021). Assessing the Real-Time Impact of COVID-19 on TB and HIV Services: The Experience and Response from Selected Health Facilities in Nairobi, Kenya. Tropical Medicine and Infectious Disease, 6(2), 74. https://doi.org/10.3390/tropicalmed6020074
Médecins Sans Frontières. (2017). État des lieux sur la disponibilité des intrants essentiels pour la lutte contre le SIDA à Kinshasa. https://msfaccess.org/sites/default/files/MSF_assets/HIV_AIDS/Docs/MSF%20Stockout_Web%20%282%29.pdf
Medina, N., Alastruey-Izquierdo, A., Bonilla, O., Ortíz, B., Gamboa, O., Salazar, L. R., Mercado, D., Pérez, J. C., Denning, D. W., Arathoon, E., et Rodriguez-Tudela, J. L. (2021). Impact of the COVID-19 pandemic on HIV care in Guatemala. International Journal of Infectious Diseases, 108, 422‑427. https://doi.org/10.1016/j.ijid.2021.06.011
Mrazguia, C., Aloui, H., Fenina, E., Boujnah, A., Azzez, S., et Hammami, A. (2021). L´infection par le COVID-19 chez le personnel de santé à l´Hôpital Régional de Nabeul : épidémiologie et circonstances de transmission. PAMJ - One Health, 4(11). https://doi.org/10.11604/pamj-oh.2021.4.11.27891
Mutyambizi, C., Dunlop, J., Maluleke, C., Ranoto, L., Chetty, T., Ndou, R., Struthers, H., McIntyre, J. A., et Rees, K. (2021). Effect of COVID-19 on HIV, tuberculosis, and prevention of mother-to-child transmission of HIV indicators in Mopani district, South Africa. The South African Medical Journal, 111(12), 1181-1189. https://doi.org/10.7196/SAMJ.2021.v111i12.15822
Muzaliwa, I., Isia, N. F., Yenga, D., Kikobya, D., Lunjwire, P., et Katchunga, P. B. (2016). The validity of the biological eligibility criteria to antiretroviral treatment in comparison to the systematic antiretroviral treatment in a cohort of people living with the HIV in the Southern Kivu Province, Democratic Republic of the Congo. The Pan African Medical Journal, 25(210). https://doi.org/10.11604/pamj.2016.25.210.9799
Ndubuka, N. O., Lim, H. J., van der Wal, D. M., et Ehlers, V. J. (2016). Health-related quality of life of antiretroviral treatment defaulters in Botswana. Southern African Journal of HIV Medicine, 17(1), a475. https://doi.org/10.4102/sajhivmed.v17i1.475
Ngongo, N. M., Nani-Tuma, H. S., Mambimbi, M. M., Mashi, M. L., Izizag, B. B., Ndolumingu, F. K., Maes, N., Moutschen, M., et Darcis, G. (2021). Decrease in late presentation for HIV care in Kinshasa, DRC, 2006–2020. AIDS Research and Therapy, 18(1), 41. https://doi.org/10.1186/s12981-021-00366-8
Ntagereka, P. B., Oyola, S. O., Baenyi, S. P., Rono, G. K., Birindwa, A. B., Shukuru, D. W., Baharanyi, T. C., Kashosi, T. M., Buhendwa, J.-P. C., Bisimwa, P. B., Kusinza, A. B., Basengere, R. A., et Mukwege, D. (2022). Whole-genome sequencing of SARS-CoV-2 reveals diverse mutations in circulating Alpha and Delta variants during the first, second, and third waves of COVID-19 in South Kivu, east of the Democratic Republic of the Congo. International Journal of Infectious Diseases, 122, 136‑143. https://doi.org/10.1016/j.ijid.2022.05.041
Programme commun des Nations unies sur le VIH/Sida. (2022). Fiches d’informations sur la République démocratique du Congo. https://www.unaids.org/fr/regionscountries/countries/democraticrepublicofthecongo
Ordre national des infirmiers de la RDC. (2018). Plan stratégique 2019-2023. https://pdf.usaid.gov/pdf_docs/PA00TWGD.pdf
Otshudiema, J. O., Folefack, G. L. T., Nsio, J. M., Mbala-Kingebeni, P., Kakema, C. H., Kosianza, J. B., Mfumu, A. K., Saidi, G. N., Kabongo, P. M., Okum, R., Tshimbombu, T. N., Ahuka-Mundeke, S., Karamagi, H. C., Muyembe, J.-J. T., et Djiguimde, A. P. (2022). Epidemiological Comparison of Four COVID-19 Waves in the Democratic Republic of the Congo, March 2020–January 2022. Journal of Epidemiology and Global Health, 12(3), 316‑327. https://doi.org/10.1007/s44197-022-00052-6
Programme National Multisectoriel de Lutte contre le Sida. (2022). Rapport synthèse de l’état de la réponse de l’épidémie du VIH en RDC 2021. https://pnmls.cd/documentation/uploads/RAPPORT_SYNTHESE_2021_PNMLS.pdf
Radio Okapi. (2022, décembre 2). Sud-Kivu : plus de 11 000 nouveaux cas de contamination au VIH/Sida en trois mois. https://www.radiookapi.net/2022/12/02/actualite/sante/sud-kivu-plus-de-11-000-nouveaux-cas-de-contamination-au-vihsida-en-trois
Le Président de la République. (2020). Ordonnance n° 20/014 du 24 mars 2020 portant proclamation de l’état d’urgence sanitaire pour faire face à l’épidémie de COVID-19. Partenariat pour le développement social. https://www.leganet.cd/Legislation/JO/2020/Ordonnance%2024.03.2020.html
Riziki, R., Freud, M., J-Lambert, M., Synthia, A., Fefe, M., David, K., Espoir, A., et Binvenue, R. (2021). Prevention of HIV infection among adolescents and young people in South Kivu: Challenges and prospectives. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 10, 2169. https://doi.org/10.18203/2320-1770.ijrcog20212143
Rosa, W. E., Dossey, B. M., Koithan, M., Kreitzer, M. J., Manjrekar, P., Meleis, A. I., Mukamana, D., Ray, M. A., et Watson, J. (2020). Nursing Theory in the Quest for the Sustainable Development Goals. Nursing Science Quarterly, 33(2), 178‑182. https://doi.org/10.1177/0894318420903495
Sabetian, G., Moghadami, M., Hashemizadeh Fard Haghighi, L., Shahriarirad, R., Fallahi, M. J., Asmarian, N., et Moeini, Y. S. (2021). COVID-19 infection among healthcare workers: A cross-sectional study in southwest Iran. Virology Journal, 18(1), 58. https://doi.org/10.1186/s12985-021-01532-0
Samudyatha, U. C., Kosambiya, J. K., et Rathore, M. S. (2022). HIV Care in the Times of COVID-19 Pandemic in Urban South Gujarat: An Operational Overview. Journal of the International Association of Providers of AIDS Care, 21. https://doi.org/10.1177/23259582221084885
Saunders, B., Sim, J., Kingstone, T., Baker, S., Waterfield, J., Bartlam, B., Burroughs, H., et Jinks, C. (2018). Saturation in qualitative research: Exploring its conceptualization and operationalization. Quality et Quantity, 52(4), 1893‑1907. https://doi.org/10.1007/s11135-017-0574-8
Thekkur, P., Takarinda, K. C., Timire, C., Sandy, C., Apollo, T., Kumar, A. M. V., Satyanarayana, S., Shewade, H. D., Khogali, M., Zachariah, R., Rusen, I. D., Berger, S. D., et Harries, A. D. (2021). Operational Research to Assess the Real-Time Impact of COVID-19 on TB and HIV Services: The Experience and Response from Health Facilities in Harare, Zimbabwe. Tropical Medicine and Infectious Disease, 6(2), 94. https://doi.org/10.3390/tropicalmed6020094
Thekkur, P., Tweya, H., Phiri, S., Mpunga, J., Kalua, T., Kumar, A. M. V., Satyanarayana, S., Shewade, H. D., Khogali, M., Zachariah, R., Rusen, I. D., Berger, S. D., et Harries, A. D. (2021). Assessing the Impact of COVID-19 on TB and HIV Programme Services in Selected Health Facilities in Lilongwe, Malawi: Operational Research in Real Time. Tropical Medicine and Infectious Disease, 6(2), 81. https://doi.org/10.3390/tropicalmed6020081
Torres, T. S., Hoagland, B., Bezerra, D. R. B., Garner, A., Jalil, E. M., Coelho, L. E., Benedetti, M., Pimenta, C., Grinsztejn, B., et Veloso, V. G. (2021). Impact of COVID-19 Pandemic on Sexual Minority Populations in Brazil: An Analysis of Social/Racial Disparities in Maintaining Social Distancing and a Description of Sexual Behavior. AIDS and Behavior, 25(1), 73‑84. https://doi.org/10.1007/s10461-020-02984-1
United Nations Programme on HIV/AIDS, Comité national de lutte contre le Sida, Programme National Multisectoriel de Lutte contre le Sida et Centre International d’Appui au Renforcement des Systèmes de Santé. (2021). Baromètre analytique de la lutte contre le VIH/Sida en République démocratique du Congo. Progrès dans la réalisation des objectifs 95-95-95. https://www.unaids.org/sites/default/files/2021_RDC_barometre_fr.pdf
Van Overbeek, F., et Tamás, P. A. (2018). Autochthony and insecure land tenure: The spatiality of ethnicized hybridity in the periphery of post-conflict Bukavu, DRC. Journal of Eastern African Studies, 12(2), 290‑309. https://doi.org/10.1080/17531055.2018.1459084
Wimba, P. M., Bazeboso, J.-A., Katchunga, P. B., Tshilolo, L., Longo-Mbenza, B., Rabilloud, M., Vanhems, P., Iwaz, J., Étard, J.-F., et Écochard, R. (2020). A dashboard for monitoring preventive measures in response to COVID-19 outbreak in the Democratic Republic of Congo. Tropical Medicine and Health, 48(1), 74. https://doi.org/10.1186/s41182-020-00262-3
World Health Organization. (2020). Coronavirus disease 2019 (COVID-19). Situation Report-50. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200310-sitrep-50-covid-19.pdf
World Health Organization. (2022). Training Manual – Implementation of DHIS2. https://phkh.nhsrc.pk/sites/default/files/2022-07/Training%20Manual%20for%20Implementation%20of%20DHIS2%20System%20ICT%202022.pdf