Provision and continuation of antiretroviral therapy during acute conflict: the experience of MSF in Central African Republic and Yemen

 

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dc.contributor.author Ferreyra, Cecilia
dc.contributor.author O’Brien, Daniel
dc.contributor.author Alonso, Beatriz
dc.contributor.author Al-Zomour, Abdulbasset
dc.contributor.author Ford, Nathan
dc.date.accessioned 2018-07-09T12:58:15Z
dc.date.available 2018-07-09T12:58:15Z
dc.date.issued 2018-07-02
dc.identifier.citation Ferreyra, C., O’Brien, D., Alonso, B., Al-Zomour, A., & Ford, N. (2018). Provision and continuation of antiretroviral therapy during acute conflict: the experience of MSF in Central African Republic and Yemen. Conflict and Health, 12(1), 30.
dc.identifier.uri https://doi.org/10.1186/s13031-018-0161-1
dc.identifier.uri http://hdl.handle.net/11427/28282
dc.description.abstract Background: Unstable settings present challenges for the effective provision of antiretroviral treatment (ART). In this paper, we summarize the experience and results of providing ART and implementing contingency plans during acute instability in the Central African Republic (CAR) and Yemen. Case presentation: In CAR, MSF has provided HIV care in three conflict-affected rural regions; these were put on hold throughout the acute phase of violence. “Run-away bags” containing 3 or 4 months of ART were distributed to patients at MSF facilities. Among 1820 HIV patients enrolled into care, 1440 (79%) initiated ART. By December 2016, 782 (54%) patients were still under ART, 354 (25%) have been lost to follow up and 182 (13%) had died. In 2013, when violence disrupted services, 683 patients were receiving ART. Between September–December 2013, 594 (87%) patients received runaway bags and by February 2014, 313 (53%) of these patients returned to the clinic. In Yemen, when violence erupted, patients received a health card that included a helpline to call in case of drug shortages in admission to emergency stocks; this was not possible in CAR due to lack of a functioning telephone network. One thousand six hundred fifty-five PLWHA have been enrolled in care and 1470 (89%) initiated ART; 1056 (72%) are still followed on ART, 126 (9%) were lost to follow up, and 288 (20%) died. In January 2011 clashes began and by April 2011 MSF medical activities were interrupted. Of the 363 patients receiving ART, 363 (100%) received emergency bags to cover 9 months and by February 2012, 354 (98%) patients returned to care. In March 2015 a new wave of conflict affected Yemen, forcing HIV activities to revert to contingency planning. Conclusions: This experience provides further evidence that provision of HIV treatment and emergency drug stocks can be successfully provided to most patients in both conflict-affected settings.
dc.language.iso en
dc.publisher BioMed Central
dc.source Conflict and Health
dc.source.uri https://conflictandhealth.biomedcentral.com/
dc.subject.other HIV
dc.subject.other Conflict
dc.subject.other Contingency plan
dc.subject.other Emergency response
dc.title Provision and continuation of antiretroviral therapy during acute conflict: the experience of MSF in Central African Republic and Yemen
dc.type Journal Article
dc.date.updated 2018-07-08T03:42:29Z
dc.rights.holder The Author(s).
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Division of Infectious Disease and HIV Med en_ZA
uct.type.filetype Text
uct.type.filetype Image


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