ABSTRACT
Initial and subsequent waves of COVID-19 in Uganda disrupted the delivery of HIV care. In rural areas, village health teams and organisations on the ground had to develop strategies to ensure that people living with HIV could continue their treatment. It was necessary to take evolving circumstances into account, including dealing with movement restrictions, constrained access to food and stigma due to anonymity being lost as a result of a shift from health facility-based services to community-level support. Uganda has a long history of community-driven response to HIV, although health systems and response programming have become more centralised through government and donors to address political commitments to HIV treatment and other targets. The delivery system for antiretroviral therapy was vulnerable to the impacts of COVID-19 restrictions and related circumstances. To understand the continuum of challenges, and to inform ongoing and future support of treatment for people living with HIV, interviews were conducted with HIV organisation implementers, health workers, village health team members and people living with HIV. It was found that stigma was a central challenge, which led to nuanced adaptations for delivering antiretroviral treatment. There is a need to strengthen support to households of people living with HIV through improving community capacity to manage crises through improving household food gardens and savings, as well as capacity to organise and interact with support systems such as the village health teams. In communities, there is a need to evoke dialogue on stigma and to support community leadership on pressing issues that affect communities as a whole and their vulnerable groups. There are opportunities to reawaken the grassroots civic response systems that were evident in Uganda's early response to HIV yet were lacking in the COVID-19 context.
Subject(s)
Patient Care Team , Leukemia, Lymphocytic, Chronic, B-Cell , HIV , COVID-19 , Community Health Workers , Community ParticipationABSTRACT
L'etude retrospective du profil clinique et biologique de la leucemie lymphoide chronique portant sur 50 cas recrutes dans les services d'hematologie clinique du CHU de Yopougon et de Option : Medecine interne du CHU de Treichville a permis de retenir les resultats suivants. Au plan clinique et epidemiologique : il existe une legere predominance feminine avec un sex-ratio de 0;43; l'age moyen est de 60;46 ans; la tranche d'age predominante est celle de 61 a 70 ans; le groupe ethnique le plus atteint est le groupe KWA; 72 pour cent; les menageres sont les plus exposees. 60 pour cent; le syndrome tumoral domine le tableau clinique avec; au premier rang la splenomegalie dans 32 pour cent. Au plan biologique : il existe une hyperleucocytose moderee et constante dans 78 pour cent des cas; la lymphocytose medullaire est constante chez 70 pour cent de nos patents; la lymphocytose sanguine est moderee (inferieure a 50000 mm3) chez 86 pour cent de nos patients; leucemie lymphoide chronique; syndrome tumoral ; lymphocytose sanguine et medullaire; lymphocytes