BMC Public Health (2021) 21:299 https://doi.org/10.1186/s12889-021-10296-9
INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic
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of the Congo (DRC) started implementing public health measures across Kinshasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
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UGANDA NATIONAL TUBERCULOSIS AND LEPROSY CONTROL PROGRAMME
Guidelines for treatment of drug-susceptible tuberculosis and patient care
Update 2017
A review of available evidence (2016).
28-29 June 2016; Geneva, Switzerland
The END TB strategy.
This report presents an overview of the transition process in Azerbaijan, some sustainability aspects and challenges stemming from donor withdrawal from TB-related activities, along with recommendations on how to overcome transition-related difficu
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lties and ensure sustainability.
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Single TB and HIV Concept Note Albania 2016-2018 27 April 2015
Summary Report on the Comprehensive Study
This study is made possible by the generous support of the American people through the United States Agency for International Development (USAID). The contents are the responsibility
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of their authors and do not necessarily reflect the views of USAID or the United States Government.
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Clinical Infectious Diseases
1586 - 1594 • CID 2016:62 (15 June) • HIV/AIDS
Rev. Latino-Am. Enfermagem 2019;27:e3086 DOI: 10.1590/1518-8345.2608.3086
Tuberculosis continues to represent a severe public health problem in the Region of the Americas, even more so in the case of indigenous peoples, w
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hose TB incidence is much higher than that of the general population. To achieve tuberculosis control in these communities, it is necessary to respond to communities’ diverse needs from an intercultural perspective that allows the application of a holistic approach—from a standpoint of equality and mutual respect—and considers the value of their cultural practices. In the Region of the Americas, although there has been progress toward recognizing the need for an intercultural approach to health services, obstacles rooted in discrimination, racism, and the exclusion of indigenous peoples and other ethnic groups persist. To respond to this situation, the Pan American Health Organization (PAHO) prepared this guidance which––based on an intercultural approach in accordance with the priority lines of the current PAHO Policy on Ethnicity and Health and its practical development in the Region’s indigenous populations––represent a support tool for implementing the End TB Strategy. This publication integrates PAHO’s accumulated experience and best practices developed by its Member States in recent years, including discussions and experiences shared in regional meetings on the issue, and emphasizes innovation and social inclusion. This requires an urgent shift away from traditional paradigms, taking specific actions that gradually reduce TB incidence and moving toward effective multisectoral actions that have proven effective in quickly containing the epidemic. This publication integrates PAHO’s accumulated experience and best practices developed by its Member States in recent years, including discussions and experiences shared in regional meetings on the issue, and emphasizes innovation and social inclusion. This requires an urgent shift away from traditional paradigms, taking specific actions that gradually reduce TB incidence and moving toward effective multisectoral actions that have proven effective in quickly containing the epidemic.
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