Using Routine EMR Registration on a National Scale for Evaluating the Impact of HIV and ART on Childbirth in Burundi.

A number of international studies have reported that HIV+ mothers under ART on average deliver babies that have low birth weight (LBW), are smaller (LBH) and are more often premature [1,2,3,4,5,6,7,8,9]. These 3 elements are well known risk factors for neonatal mortality. In our study we wanted to assess the actual status of such supposed HIV and ART related neonatal mortality risks in Burundi by taking advantage of the country's large scale EMR implementation. A total of 64,682 birth records were extracted from EMRs in 17 hospitals for the period between January 1, 2018 and October 31, 2022. After quality control for missing or impossible data, 54,180 records were retained for the study. This study demonstrated that the use of ART during HIV+ pregnancies has no statistically significant impact on risk factors for neonatal mortality in Burundi. The study also indicates that the HIV prevalence among pregnant women in Burundi who give birth in a hospital is more than twice as high as expected based on the official figures. It was also demonstrated that an explanation for this finding cannot be found in a possible concentration of HIV+ deliveries in the hospital environment. The availability of large-scale implementation of structured electronic health records brings numerous new possibilities for population research based on routinely registered health data in a low-resource country like Burundi.

Transfusion transmitted infections among blood donors of Kamenge Teaching Hospital blood bank in Burundi.

Background: The current risk of contracting a transfusion transmitted infections (TTIs) is unknown in Burundi. Objectives: The aim of this study was to assess sociodemographic profiles of blood bank donors at Kamenge Teaching Hospital, the prevalence and associated risk factors of HIV, syphilis, HBV and HCV from 2015 to 2020. Methods: We conducted a cross-sectional study including all blood donors of Kamenge Teaching Hospital blood bank. During this study, 1370 blood samples were screened for HIV, Syphilis, HBV and HCV. We calculated prevalence of TTIs and performed logistic regression to know associated risk factors. Results: Blood donors were males at 77% and 23% females. They were mostly students (54.2%). On screening, 83 blood samples (6.06%) were seropositive for at least one TTI. The overall prevalence rate of HIV, Syphilis, HBV and HCV among blood donors was 1.3%, 0.2% ,1.6%, 2.9% respectively. There was difference in distribution of the four TTIs among blood donors which is statistically significant (x2=33.997, ϱ-value<0.001). Private donors were associated with a high risk of syphilis and being a first-time donor was associated with a high HBV risk factor. Conclusion: The prevalence of TTIs found still to be high; mandatory and continuous screening is necessary.

Factors associated with ART interruption during the COVID-19 crisis in Burundi (the EPIC community-based research program).

With a national prevalence of 0.9%, Burundi is close to achieving UNAIDS' 2025 targets. Despite this, different types of crises periodically disrupt its HIV health services. The community-based program EPIC measured the impact of the COVID-19 health crisis on people living with HIV (PLHIV) in Burundi in 2021. Specifically, it assessed ART interruption and associated factors since the beginning of the pandemic. The study questionnaire was administered to PLHIV in three cities between October and November 2021. Participants were recruited using convenience sampling. Logistic regression models helped identify factors associated with ART interruption. Of the 317 respondents, 37 (11.7%) reported interruption. The majority (79.2%) self-identified as belonging to key populations. Interruption was significantly associated with: fewer HIV medical follow-up visits (adjusted Odds Ratio, aOR = 7.80, p = 0.001) and forced HIV status disclosure (aOR = 4.10, p = 0.004). It was inversely associated with multi-month ART dispensing (aOR = 0.36, p = 0.017) since the beginning of the pandemic and the perception of not having been sufficiently informed by the HIV medical team about the risk of COVID-19 infection (aOR = 0.11, p < 0.001). Our results highlight the importance of multi-month ART dispensing, enhanced communication, and voluntary disclosure of one's HIV status in preventing ART interruption in times of crises in Burundi.

How Community-Based Organizations Responded to the Covid-19 Crisis to Maintain HIV Services Among Vulnerable Populations in Burundi, Mauritania, and Lebanon: Qualitative Results From the Multicountry EPIC Program.

Little is known about the adaption of community-based organizations (CBOs) during the COVID-19 crisis. This study aimed to study how HIV CBOs and their community health workers (CHWs) faced the COVID-19 outbreak. Semi-structured interviews (n = 53) were conducted among CHWs in Burundi, Mauritania, and Lebanon in 2021. A thematic content analysis was performed. Results showed that CBOs had succeeded in maintaining HIV services and integrated COVID-19 prevention and awareness in their activities. COVID-19 led to innovation in terms of HIV services (eg, telemedicine and online psychosocial support) and to opportunities to try new modalities of antiretroviral therapy dispensation. Field workers (a specific group among CHWs) were negatively impacted by the COVID-19 crisis and showed resilience in their adaptation to ensure the continuity of their activities. Considering the essential role of field workers during the crisis, their status and the sustainability of their activities should be clearly supported by health policies and programs.

Role of community health workers during the COVID-19 pandemicThis study explores how HIV community-based organizations (CBOs) and their community health workers (CHWs) adapted during the COVID-19 pandemic. We conducted interviews with 53 CHWs from Burundi, Mauritania, and Lebanon in 2021 to understand their experiences. We found that despite the challenges posed by COVID-19, CBOs managed to continue providing essential HIV services. They also incorporated COVID-19 prevention and awareness efforts into their work. The pandemic prompted innovation, such as the use of telemedicine and online psychosocial support, and provided opportunities to explore new ways of dispensing antiretroviral therapy (ART). However, field workers, a specific group of CHWs, faced significant negative impacts due to the pandemic. Despite these challenges, they showed remarkable resilience and adapted to ensure the continuity of their services. Given the critical role of field workers during the crisis, it is important for health policies and programs to support their status and ensure the sustainability of their activities.