The evolving challenges confronting adults living with HIV in three North African countries during the COVID-19 crisis: a survey-based study.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has resulted in a huge burden on healthcare systems, especially on programs for chronic illnesses such as HIV. We aimed to assess the challenges confronting adult people living with HIV (PLHIV) in three countries in North Africa during the COVID-19 crisis and their awareness of COVID-19 non-pharmaceutical preventive measures. METHODS: This online survey included PLHIV aged ≥18 y from three countries in North Africa recruited by a snowball sampling technique, who were asked to complete a modified questionnaire originally developed by the University of Antwerp in Belgium, which was then disseminated through social media tools to assess the study outcomes. RESULTS: Out of 369 respondents, 260 (70.5%) were males and 237 (64.2%) were aged 18-39 y. Adherence to COVID-19 preventive measures, wearing facemasks (308 [83.2%]), applying hand-sanitizers (299 [80.8%]) and following cough etiquette (261 [70.5%]), were predominantly reported. Only 48 (13%) were vaccinated against influenza. One hundred and forty-five participants (42%) experienced flu-like symptoms, 29 (20%) were tested for COVID-19, with only one confirmed case identified. Among 344 (93.2%) on antiretroviral therapy (73.8% efavirenz- vs 6.4% dolutegravir-based regimens), 219 (63.7%) attended their scheduled visits, 144 (41.9%) had limited access to care due to lockdown and 29 (8.4%) became less adherent to their antiretroviral therapy. Covariates associated with challenges during access to care were age ≥60 y (OR=6.5; 95% CI 1.8 to 23.2) and receiving second-line HIV treatment such as protease inhibitors (OR=2.7; 95% CI 1.3 to 5.8). CONCLUSION: The pandemic adversely affected PLHIV. New innovative strategies should be implemented to ensure the continuity of HIV services.

Prioritization of Medicine Importation by the Private Sector in Sudan: Evidence from a Data Analysis, 2012-2015.

OBJECTIVES: The objective of this study is to analyze the annual medicines imported by private sector for the period between 2012 and 2015 with the help of priority system based on ABC-VEN matrix analysis and therapeutic category analysis. METHODS: A retrospective cross-sectional study was conducted. The Always, Better, and Control (ABC) analysis based on drug expenditure and Vital, Essential, and Nonessential (VEN) analysis based on the criticality of the drugs was performed for annual importation in 2015. RESULTS: Using ABC analysis, we found that 47 items (9.2%) accounted for 70% of the budget (class A), whereas a larger numbers of items (344; 67.2%) accounted for only 10% of the importation costs (class C). A moderate number of items (120; 23.5%) comprised 20% of the annual medicine importation value (class B). VEN analysis revealed that 89 items (17.4%) in the vital category constituted 41.6% of the importation value, whereas 349 (68.3%) grouped as essential constituted 45.1% of the value, and 73 (14.2%) of the items considered as nonessential medicines consumed only 13.3% of the total medicines imported in 2015. From the resultant ABC-VEN coupled matrix, three categories were created I, II and III. CONCLUSION: In view of limited resources, it is important that the existing resources should be utilized appropriately. This study identified a range of suggestions for better medication importation. The ABC and VEN analyses along with the therapeutic category analysis technique are convenient, systematic, and replicable methods and should be adopted for optimization and prioritization of resources.