RESUMEN
Human-to-animal and animal-to-animal transmission of SARS-CoV-2 has been documented;however, investigations into SARS-CoV-2 transmission in congregate animal settings are lacking. We investigated four animal shelters in the United States that had identified animals with exposure to shelter employees with laboratory-confirmed COVID-19. Of the 96 cats and dogs with specimens collected, only one dog had detectable SARS-CoV-2 neutralizing antibodies;no animal specimens had detectable viral RNA. These data indicate a low probability of human-to-animal transmission events in cats and dogs in shelter settings with early implementation of infection prevention interventions.
RESUMEN
Background: In 2019, UNAIDS estimated there were 150,000 new HIV infections among children (<15 years old) and 170,000 among adolescents (10-19 years old), highlighting the ongoing need for HIV testing and diagnosis among these populations. We aim to describe the impact of COVID-19 on HIV testing and diagnosis in children and adolescents. Methods: We analyzed U. S. President's Emergency Plan for AIDS Relief (PEPFAR) Monitoring, Evaluation and Reporting (MER) data from 14 countries in sub-Saharan Africa to compare the number of children (1-14) and older adolescents (15-19) who received an HIV test and were diagnosed as HIVpositive before (January - March, 2020) and during (April - June, 2020) the COVID-19 pandemic across all HIV testing modalities and for index testing (i.e. exposure-based). We calculated the percent change for the two indicators in the two time periods. Results: Overall, pediatric HIV testing and diagnoses declined by 40% and 29%, respectively, across the 14 countries. The testing decline ranged from -13% (DRC) to -81% (Zimbabwe) with the greatest volume of decline in South Africa (-150,469). Lesotho (-61%), Zimbabwe (-57%) and South Africa (-53%) had the largest declines in HIV diagnoses. Pediatric HIV testing and diagnoses increased in Cameroon, 32% and 6%. Pediatric index testing declined by 33% overall with the largest declines in Malawi (-80%) and Lesotho (-66%) and increases in Cameroon (+74%). For older adolescents, HIV testing and diagnoses declined 28% and 29%, respectively, across modalities. Lesotho (-60%), Zimbabwe (-54%) and Ethiopia (-48%) had the largest declines in testing for this group with the greatest volume of decline in South Africa (-147,891). Seven countries had >25% declines in HIV diagnoses for older adolescents, with Lesotho (-50%) and Zimbabwe (-49%) having the largest declines. While index testing for older adolescents decreased in most countries (-31%), it increased in Cameroon (+25%), Nigeria (+20%) and Côte d'Ivoire (+15%). Conclusion: Pediatric and adolescent HIV testing and diagnoses dramatically declined in many sub-Saharan African countries during the COVID-19 pandemic. Countries - like Cameroon, Côte d'Ivoire and Nigeria - that maintained or increased index testing during COVID-19 had the lowest declines in case finding. To mitigate the effects of COVID-19, programs may consider strategies to maximize index testing for children and adolescents (<19) of people living with HIV.
RESUMEN
Background: The COVID-19 pandemic has interrupted the implementation of many HIV prevention programs supported by the US President's Emergency Plan for AIDS Relief (PEPFAR), especially in sub-Saharan Africa. We evaluated the effects of COVID-19 pandemic (e.g., lockdowns, lack of personal protective equipment, community fears) on efforts to reach the UNAIDS 90-90-90 targets by HIV case finding using index testing (IT) and provider-initiated testing and counseling (PITC) as well as HIV treatment initiation. Methods: We conducted a descriptive analysis using programmatic data from persons aged 15 years and older reported to PEPFAR from 11 purposefully selected countries in sub-Saharan Africa. We calculated the percentage change in reported HIV case finding indicators during the COVID period, defined as January-June 2020, as compared to the pre-COVID period, during the same time frame in the preceding year, January-June 2019. Results: Of the 11 countries, persons tested for HIV through PITC declined in seven (64%) and persons testing positive declined in 10 (91%), comparing the COVID to pre-COVID periods (see Table 1). Across all countries, total HIV testing and total number of persons testing positive by PITC decreased by 20% and 23% when comparing the COVID to the pre-COVID period, respectively. In parallel, five of the 11 countries (Cameroon, DRC, Mozambique, Nigeria, South Africa) saw an increase in both IT and HIV case finding through IT, in COVID as compared to the pre-COVID period. Across all countries, total IT increased by 13% and HIV case finding through IT increased by 17% when comparing the COVID to the pre-COVID period. The number of HIV-positive people linked to treatment decreased in seven (64%) countries during the COVID period compared to pre- COVID. Across all countries, an increase of 3% in those HIV-positive people linked to treatment. Conclusion: While testing through PITC decreased during the COVID period, testing and case finding through IT increased. The increase in IT may reflect the actions of healthcare facilities and providers to ensure that HIV-exposed individuals identified by an index case were still tested. Focusing on IT may help programs effectively identify HIV-positive people, even during a pandemic or other disturbance.