The impact of the COVID-19 pandemic on accessing HIV care: A case report

Kaswa, Ramprakash

doi:10.4102/safp.v63i1.5344

Cited by 6 publications

(2 citation statements)

References 11 publications

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“…Participants in this study recommended that an excess supply of medication is needed within healthcare facilities as part of future preparedness. A study conducted in South Africa found 13% of people living with HIV reported not having access to their medication during the COVID-19 pandemic [ 56 ]. This may lead to an increase in virological failure and vulnerability to infections [ 56 ].…”

Section: Discussionmentioning

confidence: 99%

“…A study conducted in South Africa found 13% of people living with HIV reported not having access to their medication during the COVID-19 pandemic [ 56 ]. This may lead to an increase in virological failure and vulnerability to infections [ 56 ]. It is thus important that the healthcare system takes the lessons learnt during the COVID-19 pandemic into consideration when formulating health intervention strategies and alternative methods of chronic medication dispensation, improves communication across healthcare platforms and within communities, and improves the use of telehealth to avoid the threats of possible future infectious disease outbreaks.…”

Section: Discussionmentioning

confidence: 99%

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Health Workers’ Responses to COVID-19 Pandemic’s Impact on Service Delivery to Adolescents in HIV Treatment in Cape Town, South Africa: A Qualitative Study

Mayman,

Crowley,

van Wyk

2024

Healthcare

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Adolescents living with HIV (ALHIVs) are considered a priority population in the fight against HIV, requiring dedicated services. The COVID-19 pandemic and subsequent disruptions deprived ALHIVs on antiretroviral therapy (ART) of the care and social support essential for treatment adherence and positive treatment outcomes. This study describes health managers’ and healthcare workers’ responses to the impact of COVID-19 on service delivery to ALHIVs in HIV treatment in the Cape Town Metropole. A descriptive qualitative design was employed, where semi-structured individual interviews (n = 13) were conducted with senior and programme managers as well as healthcare workers between April and October 2023. Inductive thematic analysis was performed using Atlas.ti version 23. Two main themes emerged from these interviews: “HIV service delivery to adolescents during the COVID-19 pandemic” and “Lessons learnt—the way forward”. The de-escalation of health services at primary health facilities and the disruption of HIV services resulted in disengagement from care by ALHIVs, increasing mental health and treatment challenges. This warrants the restoration of psychosocial support services and the re-engagement of ALHIVs. The findings from this study can function as a guide for health systems and healthcare providers to navigate future pandemics to ensure that vulnerable populations such as ALHIVs continue to receive care and treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Health Workers’ Responses to COVID-19 Pandemic’s Impact on Service Delivery to Adolescents in HIV Treatment in Cape Town, South Africa: A Qualitative Study

Mayman,

Crowley,

van Wyk

2024

Healthcare

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Fluconazole

2021

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Lack of efficacy: case reportA 51-year-old woman experienced lack of efficacy during treatment with fluconazole for cryptococcal infection. The woman was brought to a hospital in South Africa with multiple complaints on 28 January 2021. She tested positive for COVID-19. She was found to have an active lesion of oropharyngeal candidiasis and was chronically ill-looking and dehydrated. Anamnesis revealed that she had been treated with unspecified antiretroviral therapy (ART) since 2014 after the diagnosis of HIV, and she was compliant with the ART until the COVID-19 lockdown in March 2020. She avoided visits to the health centre (because of the fear of COVID-19) and defaulted on the ART since April 2020. Following examination, she was diagnosed with COVID-19 pneumonia and HIV with defaulted ART. She was rehydrated with sodium chloride [normal saline], and she started receiving offlabel treatment with dexamethasone 6mg and a stat dose of ceftriaxone 1mg for COVID-19 pneumonia. Also, she was treated with unspecified low-molecular-weight heparins [low molecular weight heparin] and nystatin. Then, she was moved to the COVID-19 ward. Oxygen saturation improved on a face mask with oxygen. On the following day, she still tested positive for COVID-19 in addition to Treponema pallidum antibody. ART (unspecified) was re-initiated, and she started receiving unspecified tuberculosis prevention therapy (TPT) with cotrimoxazole prophylaxis. She exhibited clinical improvement initially; however, she developed confusion after 1 week. On 9 February 2021, serum cryptococcal antigen test was positive, while the tests for meningitis were unremarkable. She started receiving fluconazole protocol [route and dosage not stated] for the cryptococcal infection; however, she continued to deteriorate (lack of efficacy). In the following week, she tested positive for GeneXpert mycobacterium tuberculosis/ rifampicin sensitivity. TPT was therefore discontinued, and unspecified anti-TB treatment was started. Subsequently, the clinical diagnosis was amended to COVID-19 pneumonia, HIV and TB immune reconstruction inflammatory syndrome. She continued to test positive for COVID-19 on day 15, day 23 and day 32 after the first positive test, and she continuously deteriorated despite receiving optimum treatment. She died on 3 March 2021 [cause of death not stated].

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Locked Down: Economic and Health Effects of COVID-19 Response on Residents of a South African Township

et al. 2022

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Background Little research has examined how pandemics affect residents in under-resourced communities. This study investigated how COVID-19 and lockdown policies affected residents of Alexandra, one of Johannesburg, South Africa’s lowest-income townships. Methods We conducted a telephone survey May 11–22, 2020, while the lockdown and alcohol ban were in effect, of a spatially stratified sample of 353 adult Alexandra residents drawn randomly from voter registration, credit card application, and prior studies’ sampling frames. We examined economic consequences; health experiences, including COVID-19 exposure and mental health symptoms; alcohol use; and personal experiences with violence. Results Respondents were aged 18 to 89 and 47% female. About 70% of those employed before the lockdown were no longer working. Over half of households lost at least one source of income. About 50% of respondents reported stockpiling food. A majority reported price rises and declines in availability of food. Smaller percentages reported such changes for other items. Over 80% reported stress or anxiety, or depression due to the pandemic. The prevalence of past-week alcohol use fell from over 50% before the lockdown to less than 10% during the lockdown. Self-reported physical violence victimization increased. Discussion COVID-19 and the lockdown disrupted Alexandra residents’ lives through unemployment, lost income, mental health problems, and increased violence. The differences between these outcomes and those in more advantaged communities deserve investigation. Research should also seek to identify tailored responses to effectively address the challenges of marginalized communities that often have limited resources to deal with pandemics and policies to contain them.

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The impact of the COVID-19 pandemic on accessing HIV care: A case report

Cited by 6 publications

References 11 publications

Health Workers’ Responses to COVID-19 Pandemic’s Impact on Service Delivery to Adolescents in HIV Treatment in Cape Town, South Africa: A Qualitative Study

Health Workers’ Responses to COVID-19 Pandemic’s Impact on Service Delivery to Adolescents in HIV Treatment in Cape Town, South Africa: A Qualitative Study

Fluconazole

Locked Down: Economic and Health Effects of COVID-19 Response on Residents of a South African Township

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