Provision and continuation of antiretroviral therapy during acute conflict: the experience of MSF in Central African Republic and Yemen
| 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.date.updated | 2018-07-08T03:42:29Z | |
| 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.identifier.apacitation | Ferreyra, C., , 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. <i>Conflict and Health</i>, http://hdl.handle.net/11427/28282 | en_ZA |
| dc.identifier.chicagocitation | Ferreyra, Cecilia, , Beatriz Alonso, Abdulbasset Al-Zomour, and Nathan Ford "Provision and continuation of antiretroviral therapy during acute conflict: the experience of MSF in Central African Republic and Yemen." <i>Conflict and Health</i> (2018) http://hdl.handle.net/11427/28282 | en_ZA |
| 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.ris | TY - Journal Article AU - Ferreyra, Cecilia AU - O’Brien, Daniel AU - Alonso, Beatriz AU - Al-Zomour, Abdulbasset AU - Ford, Nathan AB - 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. DA - 2018-07-02 DB - OpenUCT DP - University of Cape Town J1 - Conflict and Health LK - https://open.uct.ac.za PB - University of Cape Town PY - 2018 T1 - Provision and continuation of antiretroviral therapy during acute conflict: the experience of MSF in Central African Republic and Yemen TI - Provision and continuation of antiretroviral therapy during acute conflict: the experience of MSF in Central African Republic and Yemen UR - http://hdl.handle.net/11427/28282 ER - | en_ZA |
| dc.identifier.uri | https://doi.org/10.1186/s13031-018-0161-1 | |
| dc.identifier.uri | http://hdl.handle.net/11427/28282 | |
| dc.identifier.vancouvercitation | Ferreyra C, , Alonso B, Al-Zomour A, Ford N. Provision and continuation of antiretroviral therapy during acute conflict: the experience of MSF in Central African Republic and Yemen. Conflict and Health. 2018; http://hdl.handle.net/11427/28282. | en_ZA |
| dc.language.iso | en | |
| dc.publisher | BioMed Central | |
| dc.publisher.department | Division of Infectious Disease and HIV Med | en_ZA |
| dc.publisher.faculty | Faculty of Health Sciences | en_ZA |
| dc.publisher.institution | University of Cape Town | |
| dc.rights.holder | The Author(s). | |
| 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 | |
| uct.type.filetype | Text | |
| uct.type.filetype | Image |